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Inflammation In Testicles And Took Cipro. Had Oral Sex. Treatment?

Posted on Thu, 3 Oct 2013

Question: Hey Doc I have had inflammation in my testicles for over 3 years now I have cured it each time w a course of cipro ... The last two occurrences haven't been the same or easy to cure . The first episode was inflammation in both testicles burning while urination, itching around the pupic area smell n cloudy weak urine but this time I was have a pain in my right testicle which I never had before , I was tested for stds across the board and everything was negative as usual and I was give 1 dosage of Zithro and I think some cipro again and all the pain and symptoms cleared up ! Well four months later I had random oral sex again and everything came back so I was prescribed a z pack of 5 days and nothing happened I also been on augmentin for 2 week and the symptoms seemed to clear up again before having oral sex w my gf and the pain symptoms came back so I was told to go back on cipro from my urologist and doxycycline for three weeks this hasn't helped I have been having a throbbing pain in and out of my testicle and a lil groin n back pain . I have an appointment to get a 4 glass stamey smears glass culture test but I am told that after all of these antibiotics it will probably be negative . So my question is what do I do ? Do I try another antibiotic ? Like bactrim or levoflaxicin ? This really worrying me cause I feel like the symptoms may be getting worse and I know their has to be a resistant bacteria in my prostate some where ?

Answered by Dr. Dr. P. T. Patil (50 minutes later)

Brief Answer:
You have chronic Prostatitis with Orchitis.

Detailed Answer:
Hello,

Thanks for your query.

Based on the facts that you have posted it appears that you have chronic Prostatitis with secondary infection of your Rt Testicle (Orchitis). You have been taking number of antibiotics over a period of time to resolve the issue.
Please get following investigations done to establish the diagnosis.
1) Routine urine test and urine culture to trace out the organisms causing this infection and antibiotics to which they are sensitive to.
2) Ultrasound scanning of the abdomen and trans- rectal ultrasound scanning to confirm the prostatitis,
3) Ultrasound scanning of the scrotum.
4) Microscopic examination and culture of a discharge from the urethra after prostatic massage.(You will need help of a qualified Dr to have prostate massage)
5) Blood test to rule out Filarial Infection.

Please consult qualified Urologist for clinical and digital rectal examination and get these investigations done under his guidance.
Since you have tried almost most of the antibiotics with limited results I shall suggest you to take long acting Penicillin (Penidure ) twice weekly for one month along with anti inflammatory medication like Seropeptidase and Diclofenac twice daily.

Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you
Dr.Patil.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (19 hours later)

Hey Doc when I get all of these test done and everything comes out normal what would be the cause of these symptoms ? I was told since I have been on so many antibiotics that the test won't show anything. I just don't understand how the Zithro work the last time and took away the pain and symptoms but it didn't work the second time what could be the reason for that ? I would have to have some type of bacteria in there somewhere irritating my scrotum ? I also don't get much semen fluid after ejaculation it comes out mostly clear . What antibiotic would penetrate my prostate the best and eradicate any bacteria that's likely to come from a girls mouth or vagina ?

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
This is Chronic infection resistant to antibiotic

Detailed Answer:
Hello Thanks for follow up. In Chronic infection of the Genito Urinary system bacterial flora always change their sensitivity pattern and that is the reason you may no get results with antibiotics which otherwise was very effective earlier.
You have to repeat culture and sensitive tests every time you have recurrence of the symptoms to trace out organisms and their sensitivity pattern.
The reduction in the volume of your ejaculate may be likely to be due to Orchitis and will get resolved once the infection is controlled.
Since you had almost all the antibiotics commonly used I would suggest you to take long acting penicillin for a month..
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (27 minutes later)

Ok that's kind of good news my urologist put me on bactrim my symptoms are on and off a lil less it's been 3 days so far could this work ? And if so how long would it take for me to start noticing improvements ?? Thanks alot Doc

Answered by Dr. Dr. P. T. Patil (38 minutes later)

Brief Answer:
May take 0ne month to resolve.

Detailed Answer:
Hello
Thanks for follow up.
You may continue taking Bactrim .It will take one week to notice the results and will take at least one month to get your problem resolved.
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. P. T. Patil (2 days later)

Hey doc why do you recommend the pennidure antibiotic ? I was doing some research and it seems that the penicillin antibiotic diesnt penetrate the prostate that well Is this true or does pennidure penetrate well ?

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
Penicillin is effective in Prostatitis.

Detailed Answer:
Hello
Thanks for follow up.
I have observed in my last 40 years of practice that penicillin is the most effective antibiotic when you do not get results with other antibiotics and treat my patients of Prostatitis with penicillin who are resistant to other antibiotics.
Thanks and Regards.
Dr.Patil,.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. P. T. Patil (4 hours later)

Hey doc would be ok to take the pennidure with the bactrim ? And is the pennidure an injection ?

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
Yes, you can take both the drug simultaneously.

Detailed Answer:
Hello,

Thanks for follow up.

You can take Bactrim and Penidure simultaneously.
Penidure is thick milky injection given only on buttocks and little painful.It has to be given under the supervision of a qualified Doctor after giving the test dose and confirmation that you are not allergic to Penicillin.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (3 hours later)

Hey Doc I'm on my seventh day of bactrim and I'm not feeling much improvement in the pain in the testis should I discontinue if I don't see improvement by the 2 week XXXXXXX ? What do you think about the antibiotic rufloxacin for this issue if I'm not able to get the pennidure shot ? Also what do you think about taking a antifungal med because I have been reading that alot of prostatitis cases can be caused by yeast or fungi ?

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
You can take Bactrim for 2 weeks.

Detailed Answer:
Hello
Thanks for follow up.If you do not get results with Bactrim you can try Rufloxacin for 2 weeks and try to get Inj Penidure LA.12 from somewhere .
Thanks and Regards.
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. P. T. Patil (13 hours later)

Doc do you think it would ok to take a antifungal like diflucon to be sure it's not fungus causing this to ? Could I take the bactrim n antifungal simultaneously ?

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
I would not recommed to take antifungal medication

Detailed Answer:
Hello,

Thanks for writing again.

Fungal infection of the testicle is not known.

I would not recommend to take anti fungal medication unless we have positive test results suggesting fungal infection.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (19 hours later)

Hey doc my worries are could this be CPPS ? Can CPPS cause orchitis and lack of semen in ejaculation ? Mind you I have a prior history of urinary tracts resulting in orchitis when I was diagnosed with prostatis it was because my semen wasn't coming out much and orchitis all after unprotected sex otherwise very healthy person and I had the same symptoms 4 months ago and the Zithro cleared everything up so I am super confused and because I don't think the bactrim is fully working how long could this take to clear with the bactrim ? Thanks Doc

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Repeat culture of fluid after prostate massage

Detailed Answer:
Hello
Thanks for follow up

CPPS is a Chronic Pelvic Pain Syndrome and differs from prostatitis in the sense that it is abacterial prostatitis and there is pain in pelvis and perineum .

Since you do not have these symptoms do not get yourself confused by reading on internet.

I would rather suggest you to get culture and sensitivity of a fluid after doing prostate massage by a qualified doctor to detect organisms causing this infection and antibiotics sensitivity pattern. If needed you can be started on Bactrim for 2-3 weeks.

Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. P. T. Patil (20 hours later)

Hey Doc I do have some slight aching pain in my pelvis area but most of the pain is in the testicle the testilce is still on and off enflammed so your saying most likely with the information I have you this is a chronic bacterial form ?

Answered by Dr. Dr. P. T. Patil (51 minutes later)

Brief Answer:
Need to be confirmed by lab test .

Detailed Answer:
Hello

Thanks for writing again

.Abacterial prostatitis can be confirmed only on microscopic examination and culture of fluid obtained by prostatic massage.Please get it done to rule out the same at your earliest.
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Raju A.T