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Suggest Treatment For Epididymitis
Question: Doctor I am suffering from epididymitis since 2 months.
I have completed Levofloxacin for 21 days, and continuing with Nitrofurantoin, Sulphamethoxazole + Trimethoprim and Diethylcarbazamine citrate (Since last 6 days).
Symptoms:
1. Swollen epididymis
2. Pain in epididymis/ left testicle
3. Sometimes severe pain in right testicle but not swollen
4. Sometimes Pain in tip of penis and feeling of something coming out but nothing comes
5. Pain in base of penis on either side and extends to lower abdomen (Not severe)
When shall I expect to recover OR How can I know whether the above antibiotics are working or not. Or shall I undergo any test OR Do I need to change medicine
Medical History
05/11/2014:
Symptoms:since 05/10/2014, Urge for Frequent Urination, Pain in tip with burning sensation,Urine incontinence, No fever, No swollen epididymis, sensation of incomplete voiding
Testing Done: Whole Abdomen sonography done and found normal
Drugs taken: Levoflux for 5 days & Nafodil for 22 days
24/11/2014:
Symptoms:Pain in left testis
Drugs advised: Zerodol if pain. I didnot take as it stopped paining for around 5 days
02/12/2014:
Symptoms:Pain in left testis since 3 days
Testing Done: Urine routine and micro done and found normal
Drugs taken: Nafodil & pregabalin for 07 days
04/12/2014:
Symptoms: Severe Pain in left testis followed by inflamation of epididymis
Testing Done: USG scortum using 7.5 MHz linear transducer (Test report attached)Both epididymis appear bulky in size with hetrogenous echotexture. S/O Bilateral Epididymitis. Milf free fluid in bilateral scrotal sac.
Drugs taken: Livoflux, Brufen,Nafodil & pregabalin for 15 days
26/12/2014:
Testing Done: USG scortum using 7.5 MHz linear transducer (Test report attached)The epididymis and cord structure are normal bilaterally.
29/12/2014:
Symptoms: Again Severe Pain in left testis followed by inflamation of epididymis
Testing Done: Mantoux test: Positive, AFB Urine 3 days: Negative
Drugs taken: Nitrofurantoin for 21 days
10/01/2015:
Drugs taken: Nitrofurantoin continuing, Bactrim for 10 days, Hetrazan for 20 days
Current Medications
Bactrim DS for 10 days
Hetrazan 100 mg for 20 days
Nitrofurantoin 150mg
I have completed Levofloxacin for 21 days, and continuing with Nitrofurantoin, Sulphamethoxazole + Trimethoprim and Diethylcarbazamine citrate (Since last 6 days).
Symptoms:
1. Swollen epididymis
2. Pain in epididymis/ left testicle
3. Sometimes severe pain in right testicle but not swollen
4. Sometimes Pain in tip of penis and feeling of something coming out but nothing comes
5. Pain in base of penis on either side and extends to lower abdomen (Not severe)
When shall I expect to recover OR How can I know whether the above antibiotics are working or not. Or shall I undergo any test OR Do I need to change medicine
Medical History
05/11/2014:
Symptoms:since 05/10/2014, Urge for Frequent Urination, Pain in tip with burning sensation,Urine incontinence, No fever, No swollen epididymis, sensation of incomplete voiding
Testing Done: Whole Abdomen sonography done and found normal
Drugs taken: Levoflux for 5 days & Nafodil for 22 days
24/11/2014:
Symptoms:Pain in left testis
Drugs advised: Zerodol if pain. I didnot take as it stopped paining for around 5 days
02/12/2014:
Symptoms:Pain in left testis since 3 days
Testing Done: Urine routine and micro done and found normal
Drugs taken: Nafodil & pregabalin for 07 days
04/12/2014:
Symptoms: Severe Pain in left testis followed by inflamation of epididymis
Testing Done: USG scortum using 7.5 MHz linear transducer (Test report attached)Both epididymis appear bulky in size with hetrogenous echotexture. S/O Bilateral Epididymitis. Milf free fluid in bilateral scrotal sac.
Drugs taken: Livoflux, Brufen,Nafodil & pregabalin for 15 days
26/12/2014:
Testing Done: USG scortum using 7.5 MHz linear transducer (Test report attached)The epididymis and cord structure are normal bilaterally.
29/12/2014:
Symptoms: Again Severe Pain in left testis followed by inflamation of epididymis
Testing Done: Mantoux test: Positive, AFB Urine 3 days: Negative
Drugs taken: Nitrofurantoin for 21 days
10/01/2015:
Drugs taken: Nitrofurantoin continuing, Bactrim for 10 days, Hetrazan for 20 days
Current Medications
Bactrim DS for 10 days
Hetrazan 100 mg for 20 days
Nitrofurantoin 150mg
Brief Answer:
Need to do Urine and Semen Culture
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted and report of ultrasound scanning of Scrotum it appears that you had Bilateral Epididymitis which was treated with various antibiotics and got resolved .However your symptoms have recurred again .
Please note that Epididymis takes 2-3 months to get cured completely .There is possibility that the organisms causing infection may not be susceptible to antibiotics taken ,
I would suggest to get Urine culture and Semen culture done to find out the organisms causing infection and antibiotics to which they are sensitive to ,So that you can take appropriate antibiotic to control the infection.
In the mean while continue with the same antibiotics along with anti inflammatory medicine like Diclofenac and Serropeptidase and later on switch on to appropriate antibiotic as per culture report .
Please note that you may need to these medicine s for 4 weeks.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Need to do Urine and Semen Culture
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted and report of ultrasound scanning of Scrotum it appears that you had Bilateral Epididymitis which was treated with various antibiotics and got resolved .However your symptoms have recurred again .
Please note that Epididymis takes 2-3 months to get cured completely .There is possibility that the organisms causing infection may not be susceptible to antibiotics taken ,
I would suggest to get Urine culture and Semen culture done to find out the organisms causing infection and antibiotics to which they are sensitive to ,So that you can take appropriate antibiotic to control the infection.
In the mean while continue with the same antibiotics along with anti inflammatory medicine like Diclofenac and Serropeptidase and later on switch on to appropriate antibiotic as per culture report .
Please note that you may need to these medicine s for 4 weeks.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My detailed present Symptoms:
1. Pain in left testis: sometimes dragging pain and rest of the time pressure pain
2. Pain in left epididymis
3. Pain in right testis (occasional but severe (Pulsating)) mainly in epididymis area.
4. Pain in base of penis on both side
5. Pain in lower abdomen area (Stretching feeling)
6. Pain in tip i.e. inside glans sometimes burning sensation.
7. Sometimes feel like something is coming out. Most of the time there is nothing but some time a whitish fluid comes out in a small amount
8. Pain in left leg particularly left thigh
9. Dribbling of urine i.e. after finishing pee, a lot of drops around 5-6 of urine comes out
10. Urine generally passes out in 2 go
11. Condition not improving a bit even after taking so much medicine
12. Pain in the septum of scrotum on pressing or palpating
13. On wearing jeans the pain increased
14. On 5th day onwards of antibiotic (Bactrim) and hetrazan I felt the left testis more painful. In beginning the pain was reducing
15. On prolonged sitting the pain increases
16. Pinching and irritation in tip just after urination
17. On giving pressure while passing stool a very little amount of lubricated fluid came out
Queries:
1. If infection is in epididymis why the penis have pain?
2. After taking so much antibiotics why there is no change in symptom?
3. Will icing or hot bath help?
4. How long it may take to get treated completely
5. What is the possibility of its reoccurrence as I have read from website portals that it reoccurs often
6. How it will affect my future?
7. My marriage is on end of XXXXXXX 2015.
8. What prevention/protection should I need to take?
9. Is this disease transmittable?
10. Will oral wet contact can transmit this disease?
11. How it will affect my marriage life?
12. Can excessive masturbation (2 times a day and 3 times 25% of day) cause epididymis? Sorry to ask you this as you are very elder to me.
1. Pain in left testis: sometimes dragging pain and rest of the time pressure pain
2. Pain in left epididymis
3. Pain in right testis (occasional but severe (Pulsating)) mainly in epididymis area.
4. Pain in base of penis on both side
5. Pain in lower abdomen area (Stretching feeling)
6. Pain in tip i.e. inside glans sometimes burning sensation.
7. Sometimes feel like something is coming out. Most of the time there is nothing but some time a whitish fluid comes out in a small amount
8. Pain in left leg particularly left thigh
9. Dribbling of urine i.e. after finishing pee, a lot of drops around 5-6 of urine comes out
10. Urine generally passes out in 2 go
11. Condition not improving a bit even after taking so much medicine
12. Pain in the septum of scrotum on pressing or palpating
13. On wearing jeans the pain increased
14. On 5th day onwards of antibiotic (Bactrim) and hetrazan I felt the left testis more painful. In beginning the pain was reducing
15. On prolonged sitting the pain increases
16. Pinching and irritation in tip just after urination
17. On giving pressure while passing stool a very little amount of lubricated fluid came out
Queries:
1. If infection is in epididymis why the penis have pain?
2. After taking so much antibiotics why there is no change in symptom?
3. Will icing or hot bath help?
4. How long it may take to get treated completely
5. What is the possibility of its reoccurrence as I have read from website portals that it reoccurs often
6. How it will affect my future?
7. My marriage is on end of XXXXXXX 2015.
8. What prevention/protection should I need to take?
9. Is this disease transmittable?
10. Will oral wet contact can transmit this disease?
11. How it will affect my marriage life?
12. Can excessive masturbation (2 times a day and 3 times 25% of day) cause epididymis? Sorry to ask you this as you are very elder to me.
Brief Answer:
All the varied symptoms that you have are due to Epididymitis and anxiety
Detailed Answer:
Hello
Thanks for follow up .Here are answers to your queries
1) All the genital organs have same nerve supply hence you get referred in penis 2)The causative organisms may not be sensitive to antibiotics taken so far.
3 Hot or cold fomentation will give relief from pain for hour or so.
4)You have to take appropriate antibiotic as per culture report for 4-6 weeks .
5)If not treated properly there recurrence is very common.
6)It will not affect your future It is curable .
7)Go ahead and get married .
8)You have to take medicines religiously
9)Active infection can get transmitted to your female partner and she may get infection of genitals mostly Vaginitis .
10)No oral contact will not transmit the disease.
11) If you are getting good hard erection practicing protected sex will not not have any adverse effect on your sexual life.
12)No masturbation will not cause Epididymitis .
Thanks and Regards.
Dr.Patil. .
.
All the varied symptoms that you have are due to Epididymitis and anxiety
Detailed Answer:
Hello
Thanks for follow up .Here are answers to your queries
1) All the genital organs have same nerve supply hence you get referred in penis 2)The causative organisms may not be sensitive to antibiotics taken so far.
3 Hot or cold fomentation will give relief from pain for hour or so.
4)You have to take appropriate antibiotic as per culture report for 4-6 weeks .
5)If not treated properly there recurrence is very common.
6)It will not affect your future It is curable .
7)Go ahead and get married .
8)You have to take medicines religiously
9)Active infection can get transmitted to your female partner and she may get infection of genitals mostly Vaginitis .
10)No oral contact will not transmit the disease.
11) If you are getting good hard erection practicing protected sex will not not have any adverse effect on your sexual life.
12)No masturbation will not cause Epididymitis .
Thanks and Regards.
Dr.Patil. .
.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Sir,
1. I have observed since last 2 days that the testicles are hanging way below the normal and are well exposed to outside. The skin of scortum has been pulled up and clustered just below the base of penis leaving the testis. So testis is only protected by a layer of skin. Earlier during normal times, the testis is usually covered by a fleshy layer. As the testis are very less protected the testis are paining more than usual.
2. My current medication as per suggestion of my urologist is as follows:
Bactrim total for 15 days (More 7 days)
Hetrazan (For 20 days in total)
Enzoflam (For 5 days)
Pentacid (For 15 days)
Nitrofurantoin (For 21 days total): Advised by another doctor
Kindly confirm me whether the above medications are correct
3. I have given urine for urine test and the result will come tomorrow. As I am in antibiotic dose, will the culture show a correct report?
4. Is it necessary to do a semen culture? As my urologist have asked me not to do anything effecting my epididymis like masterbation and intercourse as it will aggravate the situation. Kindly advise
5. There is a high count of lymphocyte in CBC report. What does it indicate?
6. Sir, I am really frustrated and feeling very depressed. Will I be completely ok?
1. I have observed since last 2 days that the testicles are hanging way below the normal and are well exposed to outside. The skin of scortum has been pulled up and clustered just below the base of penis leaving the testis. So testis is only protected by a layer of skin. Earlier during normal times, the testis is usually covered by a fleshy layer. As the testis are very less protected the testis are paining more than usual.
2. My current medication as per suggestion of my urologist is as follows:
Bactrim total for 15 days (More 7 days)
Hetrazan (For 20 days in total)
Enzoflam (For 5 days)
Pentacid (For 15 days)
Nitrofurantoin (For 21 days total): Advised by another doctor
Kindly confirm me whether the above medications are correct
3. I have given urine for urine test and the result will come tomorrow. As I am in antibiotic dose, will the culture show a correct report?
4. Is it necessary to do a semen culture? As my urologist have asked me not to do anything effecting my epididymis like masterbation and intercourse as it will aggravate the situation. Kindly advise
5. There is a high count of lymphocyte in CBC report. What does it indicate?
6. Sir, I am really frustrated and feeling very depressed. Will I be completely ok?
Brief Answer:
Read detail answer bellow.
Detailed Answer:
Hello
Thanks for writing again.Here are answers to your queries bellow.
1) Hanging of the testicle is insignificant and depends upon atmospheric temperature .
2)The medicines that you have taken include antibiotics and anti inflammatory medicines commonly used in treating infections of Genito urinary organs.
3) It depends upon the nature of bacteria causing this infection and their sensitivity pattern .If they are sensitive to any of the antibiotics that you have taken it may not show growth of the organisms.
4) Normally I do semen culture in my patients .It is discretion of your Urologist I would not like to make any comments on his opinion.
5) High W,B.C count suggests active infection .
6) Do not worry your problem is not serious at all. It can be cured .
Thanks and Regards.
Dr.Patil.
Read detail answer bellow.
Detailed Answer:
Hello
Thanks for writing again.Here are answers to your queries bellow.
1) Hanging of the testicle is insignificant and depends upon atmospheric temperature .
2)The medicines that you have taken include antibiotics and anti inflammatory medicines commonly used in treating infections of Genito urinary organs.
3) It depends upon the nature of bacteria causing this infection and their sensitivity pattern .If they are sensitive to any of the antibiotics that you have taken it may not show growth of the organisms.
4) Normally I do semen culture in my patients .It is discretion of your Urologist I would not like to make any comments on his opinion.
5) High W,B.C count suggests active infection .
6) Do not worry your problem is not serious at all. It can be cured .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Respected Sir,
Please find the attached reports containing Urine C/S, Urine-routine, Complete blood count, Random blood sugar, creatinine, USG for scortum, abdomen & pelvis.Kindly suggest for further action.
Further queries:
1. As the urine test result is negative, does it mean that antibiotics is working well?
2. The ultrasound report says enlarged prostrate but normal epididymis, testis and scortum. However I am feeling pain in epididymis also epididymis is swollen. Is epididymitis a symptom of prostatis?
3. Do I need other tests for distinguishing epididymitis & prostatis?
4. Shall I change the medication like antibiotics, antiinflamatory etc?
5. The prostrate is enlarged as per USG. How mush it is differing from normal?
6. How often you come across patients with similar complain? As I want to know how frequent these disease occur and in what age group it is prevalent?
7. Is taking alcohol during this ok?
8. Now the testis is more painful i.e. it pains even on touching. Do you suspect anything else?
9. What other tests do you recommend to confirm the action of medication?
Thanks & Regards
XXXX
Please find the attached reports containing Urine C/S, Urine-routine, Complete blood count, Random blood sugar, creatinine, USG for scortum, abdomen & pelvis.Kindly suggest for further action.
Further queries:
1. As the urine test result is negative, does it mean that antibiotics is working well?
2. The ultrasound report says enlarged prostrate but normal epididymis, testis and scortum. However I am feeling pain in epididymis also epididymis is swollen. Is epididymitis a symptom of prostatis?
3. Do I need other tests for distinguishing epididymitis & prostatis?
4. Shall I change the medication like antibiotics, antiinflamatory etc?
5. The prostrate is enlarged as per USG. How mush it is differing from normal?
6. How often you come across patients with similar complain? As I want to know how frequent these disease occur and in what age group it is prevalent?
7. Is taking alcohol during this ok?
8. Now the testis is more painful i.e. it pains even on touching. Do you suspect anything else?
9. What other tests do you recommend to confirm the action of medication?
Thanks & Regards
XXXX
Brief Answer:
ReadDetail answers bellow
Detailed Answer:
Hello
Thanks for follow up I have answered almost all the questions that you have raised again.
1) Semen culture or culture of urethral swab will be more appropriate to know the antibiotics that will be more effective.
2)Epididymitis and prostate infection can co exist simultaneously.
3) you can do trans Rectal Ultrasound Scanning for prostate .
4)You have to take antibiotics as per culture report of semen aor urethral discharge .
5)Normal size of the prostate is 2o -22 c,c
6) This is a common problem and we do get cases of Epididymitis and Prostatitis very frequently.
7) You can take alcohol within limits.
8).It may be due to infection of Testuis (Orchitis)
9)Do culture of the Urethral discharge or semen .
Thanks and Regards.
Dr.Patil.
ReadDetail answers bellow
Detailed Answer:
Hello
Thanks for follow up I have answered almost all the questions that you have raised again.
1) Semen culture or culture of urethral swab will be more appropriate to know the antibiotics that will be more effective.
2)Epididymitis and prostate infection can co exist simultaneously.
3) you can do trans Rectal Ultrasound Scanning for prostate .
4)You have to take antibiotics as per culture report of semen aor urethral discharge .
5)Normal size of the prostate is 2o -22 c,c
6) This is a common problem and we do get cases of Epididymitis and Prostatitis very frequently.
7) You can take alcohol within limits.
8).It may be due to infection of Testuis (Orchitis)
9)Do culture of the Urethral discharge or semen .
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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