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Suggest Treatment For Testicular Pain

Posted on Tue, 16 Aug 2016

Question: On Niftran, Potrate SF for 3 months post left testicular pain. Now have mild burning feeling while not urinating in urethra. No pain on urination. USG normal but min postvoid of 46 cc, prevoid 493 cc. Prostate 23 grams, 38 x 35 x 34 mm. Doc prescribed Urimax x 1 month. Should I take Urimax?? Any negative effects if I don't take??? Worried about unpleasant side effects of this med in a relative. Don't want to take unless absolutely necessary. Please advise. Followup scrotal USG normal with minimally dilated veins of pampiniform plexus both sides, 1.2/1.6 mm and 1.6/1.7 mm pre and post Valsalva. Maybe had mumps orchitis initially in April, symptoms were similar (my opinion). Doc at that time initially prescribed Hetrazan and Pruflox for 21 days followed by above mentioned 3 months course of Niftran and Potrate SF. Can I do without Urimax (tamsulosin hydrochloride) ? Male, 38 yrs.

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
You seem to have Bladder Neck Obstruction(BNO).

Detailed Answer:
Hello
Thanks for query .

Based on the facts and report of your USG It seems that you have obstructive voiding symptoms due to Bladder Neck Obstruction .

Urimax (Tomsulosin ) acts by relaxing smooth muscles in prostate and bladder neck and helps to improve urine flow .However as yo have rightly pointed has a side effect of retrograde ejaculation .

Considering your age I would suggest you to consult qualified Urologist and get endoscopic Examination of the bladder (Cystoscopy ) done to confirm the diagnosis of BNO and take a call whether to take Tomsulosin or not .

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

Follow up: Dr. Dr. P. T. Patil (7 hours later)

Thanks doctor for your answer. Did consult a qualified urologist all through. If it's BNO, is it self limiting? Can it be managed conservatively? If I do take the Urimax, is it supposed to work in providing permanent relief or temporary? Also, is the side effects reversible once you stop the med? I'm actually feeling better last couple of days (burning is almost not felt) without having started on Urimax. Am on Niftran and Potrate SF all through (three months course). Does minimal bladder retention of urine cause any problems health-wise? I don't get up at night to urinate. Basically, this condition is not making my quality of life bad. I can live with it. I'm just wondering if there's anything to worry about in managing it conservatively? I'm wary of invasive procedures as there's the chance of inadvertent injury which may cause other problems.

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

Brief Answer:
Our primary goal should be the confirm the diagnosis of (BNO)

Detailed Answer:
Hello
Thanks for follow up .

Our primary objective in your case should be to confirm (BNO) as the cause of 43 ml of Post Void Residual Urine .

The treatment modalities for BNO whether with medicines or surgery has its own hazards .Since you are young (38) years old sexual side effects of either Tomsulosin or Surgery has to be thought over many times unless it is disturbing quality of life and should be kept as a last resort to carry on .

Effects of Tomsulosin are temporary and will be there as long as you take the medicine so is true with side effects .

I would suggest you to consult XXXXXXX experienced Urologist before taking decision about the treatment which includes to confirm the diagnosis of (BNO) first .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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

Thanks for your answer, doctor. I will do so, but please do answer the question regarding whether minimal postvoid residual impacts health adversely apart from the inconvenience of it in the long term? Whether it can be coped with? Secondly, do patients generally have to be on Urimax long term or a one month course resolves the problem in your experience?

Answered by Dr. Dr. P. T. Patil (16 minutes later)

Brief Answer:
P. V. Residual urine causes increased frequency for urination and UTI.

Detailed Answer:
Hello
Thanks for follow up .

Post void residual urine leads to increased frequency for urination and nocturia and may lead to frequent UTI if not taken cared off .One has to monitor it by doing Scanning at frequent intervals of say six months .

As I have stated Urimax helps to improve urine flow and minimize PVR and it does cause Retrograde Ejaculation However it does not affect sexual potency or getting pleasure of feeling of Orgasm during sex .

The action of drug is only for 24 hours and one can ejaculate after you stop the drugs.It does not cure the basic cause BNO. and has to continue for long time to get symptomatic relief .

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