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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Discomfort In Pelvis After Ejaculation Or Masturbation, Burning Pain In Testis. Urine Analysis Normal. Relief With Tavanic, NSAIDS

For about ten days ago I had a feeling of discomfort in my pelvis after ejaculation or masturbating with some burning and pain in the left testis.But it was mild and I thought its from pelvic congeston. Then one week later I had severe pain in my left loin-testis-tip of the penis-perineum and sometimes in the anus.I could not close my legs or sit comfortably pain was so bad. However there was no fever. AT first I thought its a renal colic, Urine analysis was NORMAL. I was started on antibiotic called Tavanic for 5 days and NSAIDS, pain intensity reduced but did not go completely. I had a rebound of pain on day 6 in the testicle and loin. Ultrasound to kidney showed no stones but the prostate was mildly enlarged and the seminal versicles were dilated too mildly.(But the ultrasound I think I lead the operator as I told him I think I have congestion and so on).. My andrologist examined me but I was in pain, he recommended Testicaular doppler that showed epidydomorchitis in both sides. I started Levofloxacin 500 mg daily and IM Rocephin. Dr says I should remian on levo for at least 14 days. I still feel pain in my lion and tenderness in the testis after 3 days of antibiotics. This situation has recurred 3 times in the past 3 years but always resolved with a short course of antibiotics, this time it is the worst. I always notice that it is percipitated by masturbating too much and by working out. I dont know if this is related. I also wonder if this could be a hernia? My dr first said it could me a small hernia that causes recurrent irriattion to the epidydmis. But the testicular doppler and sonar showed no hernia(see attachments) So you think its just epididmorchitis and I should remain on the antibiotics or do I need more inverstigations (3 days on the antibiotics stilll feel discomfort and loin pain)
Sat, 9 Nov 2013
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Psychiatrist 's  Response
Thank you for your query and such nice and detailed presentation of your medical history. It appears to be a case of epididymoorchitis none the less, but the issue is its regular recurrence.
I would like to assure you, it does not appear to be related to a hernia.

Secondly, you need to continue antibiotics for the prescribed period of time religiously, to cure your infection and prevent further worsening of the same.

Thirdly, since there is recurrence, and precipitated by masturbation, there may be some defect in the uro-genital system, causing reflux of urine into the seminalpathway, which may lead to recurrence of the problem. To diagnose this condition, uroflowmetric studies are needed.

Another explanation may be that every time, the infection is not eliminated completely and hence recurring repeatedly.

You may need to test the bacteria (culture sensitivity) for antibiotic resistance and also the uroflowmetric studies. I would suggest you to consult an experienced urologist for a detailed evaluation and management for the same.

Hope I've been able to satisfy your query. Please feel free to ask for any further clarifications. Best of luck.

Dr. Sourav.

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Discomfort In Pelvis After Ejaculation Or Masturbation, Burning Pain In Testis. Urine Analysis Normal. Relief With Tavanic, NSAIDS

Thank you for your query and such nice and detailed presentation of your medical history. It appears to be a case of epididymoorchitis none the less, but the issue is its regular recurrence. I would like to assure you, it does not appear to be related to a hernia. Secondly, you need to continue antibiotics for the prescribed period of time religiously, to cure your infection and prevent further worsening of the same. Thirdly, since there is recurrence, and precipitated by masturbation, there may be some defect in the uro-genital system, causing reflux of urine into the seminalpathway, which may lead to recurrence of the problem. To diagnose this condition, uroflowmetric studies are needed. Another explanation may be that every time, the infection is not eliminated completely and hence recurring repeatedly. You may need to test the bacteria (culture sensitivity) for antibiotic resistance and also the uroflowmetric studies. I would suggest you to consult an experienced urologist for a detailed evaluation and management for the same. Hope I ve been able to satisfy your query. Please feel free to ask for any further clarifications. Best of luck. Dr. Sourav.