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Eepididymal cyst on left testicle. Sudden pain on right testicle. Prescribed with decet and levotec. Necessary to take medication?

DOCTOR OF THE MONTH - May 2014
May 2014
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Sir, my age- 32 years and sex- male. I am having an epididymal cyst on the left testicle. The report of my scrotal ultrasound has been attached. When I was sleeping last night a sudden pain was felt on my right(not at the left) testicle for which I was wake up. The pain was like as if striking my testicle by finger tip repeatedly after an interval of 10/12 seconds. After 3/4 minutes the pain disappeared . sir, is it testicular torsion or some other serious condition ?

I consulted one urologist in my locality. After hearing these symptoms . He said that this is not testicular torsion and nothing to worry about. But he didn't examine me physically only he saw my ultrasound report which was done on 28/09/2013 ( much before this incident which happened to me last night). He told me that no treatment is required for now. But he prescribed me certain medicines which I have written below.

1. Decet BD
2. Levotec 500

Sie, I am confused these medicines are for which disease ?
Am I having any chance of any testicular torsion or any other serious condition in future and these medicines are to prevent it ???
Is it necessary to take these medicines (I am having asthma so I am presently taking Montek LC tablets every day which I forgotten to say the local urologist).
Sir , the most important query is that am I more prone to testicular torsion in future due to this incident ?
I intend to learn martial art in future and may do physical exercise. Am I allowed to do so (I afraid if I am more prone to testicular torsion after this incident then I may not be allowed for learning martial art or doing physical exercise)

Please help me sir...
Posted Fri, 8 Nov 2013 in Men's Health
 
 
Answered by Dr. Vivek Chail 50 minutes later
Brief Answer:
You are not more prone to torsion testis

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.
Your present medications are:
1. Decet BD tab: diethylcarbamazine citrate 150 mg, cetirizine dihydrochloride 5 mg.
2. Levotec 500: levofloxacin.

These medicines are to protect you from any ongoing bacterial infection and infections like filariasis.

Within the scrotum, the testicles are secured at either end by a structure called the spermatic cord. Sometimes, this cord gets twisted around a testicle, cutting off the blood supply. Symptoms of testicular torsion include sudden and severe pain, enlargement of the affected testicle, tenderness, and swelling.

This condition, which occurs most often in young males less than 25 years of age, can result from an injury to the testicles or from strenuous activity. It also can occur for no apparent reason.

Since you did not have torsion testis, there is no reason that you should feel more prone than the general population.

Torsion of the epididymal cyst can occur but is extremely rare with only a handful of cases reported.

As it is known that torsion testis can occur even due to no apparent reason, learning martial arts does in no way make you more prone to torsion testis.

You must have the medicines to control possible infection in your right testis.

Hope your query is answered.
Do write back in case you have doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
Follow-up: Eepididymal cyst on left testicle. Sudden pain on right testicle. Prescribed with decet and levotec. Necessary to take medication? 4 hours later
Thank U sir.
my age -32 , sex- male.

sir, I have done two different ultrasound of the scrotum by two different doctors the reports of which are attached with this. (one in April 2013 and another one in September 2013).

In the ultrasound which was done in last April there has been mentioned about a large epididymal cyst in Left testicle and a small epididymal cyst in right testicle. But in the ultrasound report of last September it has not been mentioned about the small epididymal cyst in right(although it detected the left epididymal cyst like last report). Sir is the small cyst is undetectable or it has been gone automatically or the report may not be proper ???

Sir, can ultrasound predict that whether one person can or can't have testicular torsion in future ??? If so then can I have testicular torsion in future based on these reports???

Since some days I often have a habit to pull my scrotum a bit forward by stretching it from the skin attached to right testicle when I go for sit/walk/sleep etc. Can it cause testicular torsion ??? can my such activity affect the fluid around the right testicle or by making any other change which can change the phenomena of not having testicular torsion which can be predicted by the previous ultrasounds ??? I have left this activity since yesterday after the pain in my right testicle which I have mentioned in previous query. I am much afraid since last night about testicular torsion.

Can I take the above medicines while I am taking Montek LC tablets for asthma ??? (I have forgotten to ask this to the Urologist who prescribed the medicines).

Hope U will be kind enough to help me.

 
 
Answered by Dr. Vivek Chail 5 hours later
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi,
You are welcome and thanks for writing in with an update.

Torsion occurs most commonly in boys age 13 to 17 years. There is also an increased incidence in neonates. However, it can occur at any age and it is the most common cause of acute scrotal pain and swelling in boys from birth through age 18. It is not clear why spermatic cord torsion, caused by the congenital bell clapper deformity, often occurs years after development is complete.

Since you have never had torsion, Bell clapper's deformity in your testis is unlikely. Bell clappers testis may cause recurrent partial torsion. Your activity of pulling the testis might cause infection in the scrotum, which has happened on the right side now. This should be avoided as any repeated pulling of testis can cause pain as testis is sensitive.

I thing the epididymal cyst on the right side is very small and therefore possibly not mentioned in the second report.

Montek LC does not cause problems when taken with Decet BD tab and Levotec 500. Please take your medications without any hesitation.

Hope your query is answered.
Do write back in case you have doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
Follow-up: Eepididymal cyst on left testicle. Sudden pain on right testicle. Prescribed with decet and levotec. Necessary to take medication? 8 hours later
My age-32 , Sex- Male

Sir, can ultrasound reports predict that whether or not I have any chance of testicular torsion in future ??? If so then can I have testicular torsion in future based on these ultrasound reports ??? (Both Ultrasound reports which were done in April and September are attached with this query).

can my habit(Since some days I often have a habit to pull my scrotum a bit forward by stretching it from the skin attached to right testicle when I go for sit/walk/sleep etc. and I left this habit from last night‘s incident ) affect the situation of my testicles and other parts in scrotum which may have been found normal in ultrasound report and can lead to torsion or any other thing similar to torsion ???

Does my case in that night (pain in right testicle while sleeping for which I woke up and the pain went away automatically after 3/4 minutes. The pain was like striking my right testicle by finger tip in an interval of about 10 seconds) resembles intermittent torsion and de-torsion.(Twisting and untwisting) ??? If so then will it lead to torsion in future ???

Thank U sir.
 
 
Answered by Dr. Vivek Chail 22 minutes later
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi,
You are welcome and thanks for writing in with an update.

After seeing ultrasound report 26-04-2013, the cyst in right epididymis is 2 x 2 mm and very small so it was not mentioned in the ultrasound report 28-09-2013. I have mentioned the same thing in my earlier reply.

Ultrasound report cannot predict torsion testis. Ultrasound testis is only done when a person has pain in testis. This ultrasound needs to be done within 6 hours for proper management if there is torsion. Torsion can happen for apparently no reason
so you must go to doctor whenever you have pain in testis which is increasing in severity.

Your habit of pulling scrotal skin regularly can cause infection. The pain in torsion detorsion does not resolve in 3/4 minutes and there is lot of swelling in the testis. Please remember that torsion occurs more in children and young adults. You had pain in right testis probably due to infection and your doctor has given you medicines for that.

Hope your query is answered.
Do write back in case you have doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
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