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What Causes Redness On The Urethra And Swelling In The Testicle?

Posted on Tue, 20 Dec 2016

Question: Symptons: pain to the right testicle and swelling at the top of the right testicle plus some redness on the urethra especially after ejaculation, I have at the moment.

Background:
I had Chlamydia about 18 months ago, was tested positive and treated with the two antibiotic pills taken once which seemed to cure it. 6 months on something still didn't seem right so I was tested again but it came back all clear, they also tested for syphilis, gonorrhoea and HIV. All came back clear.

Syphilis IgG/IgM by EIA Negative
Hep B surface Ag (HBsAg) Negative
Hep.C Ab ELISA (3rd Gen) Not detected
HIV 1 & 2 ABS/P24 Ag screen Not detected

Chlamydia Trachomatis DNA (PCR) Not detected
N.gonorrhoeae DNA (PCR) Not detected
Mycoplasma gentitalium DNA (PCR) Not detected
Ureaplasma species DNA (PCR) Not detected
Trichomonas vaginalis DNA (PCR) Not detected
Gardnerella vaginalis DNA (PCR) Not detected
Herpes Simplex Type I/II DNA Not detected

6 Months further on to January 2016, I started to experience the symptoms outlined at the top and it back very irritable and swollen on the right testicle, I went to the doctors explained above ref Chlamydia and they gave me a 9 day course of doxycycline as they suspected epididymitis. Which seem to clear it up in about 5 days and I was even cycling and running again.

A week after the finishing the course of doxcycline, the symptoms came back, I read online the bacteria which can find itself in all sorts of places as the tubes in the testicles can be like a network of caves and it can be hard to completely kill off. I visited sexual health clinic who gave me a 14 day course of Ofloxacin but this slightly reduced the symptoms but they never went away. They seemed reluctant to run a doxycycline course again as they said it came back after taking it first time round, but from experience online the course may need to be longer for doxycycline to really work?

I had a UT scan to reveal I had a epididymal cyst but currently no pain, the doctor advised it would cause no harm and I would have to live with it. It is about the size of a pea.

Over the last few months, the epididymal cyst and redness remains ont he scortum in that area and slight rash/redness on the penis glad. A urologist put me on 6 weeks of cipro which seem to lower the irration and symptons by 60 % but never really cleared it up. Since then I have had a urine culture test which came back with the following:

Please note the following antibiotics:Augmentin, Cefpodoxime and Ciprofloxacinshould not be used as first choice if alternativesare available.

URINE CULTURE 1) >100,000 cfu/ml Mixed growth of organisms with a predominant growth of 2) Escherichia coli

S Trimethoprim S Ciprofloxacin S Amoxicillin R Augmentin S Nitrofurantoin S Cephalexin

I am a bit lost where to go next as after 6 weeks of cipro I still have the e coli culture coming back as positive, redness/rash on penis glad and someones flares up after ejaculation.

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
You have landed up with Chronic infection of Epididymis(Chr.Epididymitis)

Detailed Answer:
Hello
Thanks for query .I have gone through your history and treatment taken so far .

There is no doubt that you have landed up in Chronic infection of Epididymis (Chronic Epididymitis) .With any chronic infection the bacteria always change their sensitivity pattern very frequently making it difficult to get infection getting eradicated completely even with antibiotics to which they are reported to be sensitive .

In a given situation I would suggest you to take two drugs like Nitrofurantoin and Bactrim along with anti inflammatory medication Diclofenac twice daily for 4-6 weeks.

Ensure to drink more water to keep your urine dilute .

I am sure it will work for you

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)

Thank you. Please can you confirm dosage for the two antibiotics please. Is this more effect than Ceftriaxone plus Levofloxacin for example?

I really appreciate your advice you have given me thank you

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

Brief Answer:
Take both antibiotics twice daily

Detailed Answer:
Hello
Thanks for follow up .

Take Doxicycline 100 mg and Nitrofurantoin 100 mg twice daily along with Diclofenac twice daily ..

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (12 minutes later)

Sorry I thought you recommended Nitrofurantoin and Bactrim originally ?

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
Sorry for change of prescription It happened through oversight .

Detailed Answer:
Hello
Thanks for follow up .

Since you have already taken Doxicycline .I would suggest you to take Bactrim and Nitrofurantoin twice daily .

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Can you confirm Bactrim dose please

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

Brief Answer:
Inqire with local Chemist

Detailed Answer:
Hello
Thanks for follow up

Bactrim is a combination of Sulphmethoxazole and Trimethoprim and is available all over the world under different brand names .You will have to find out with your chemist as regards the brand name and availability in U.K .

Thanks with Regards.
Dr.Patil.

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