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Had Inflammation In Testicles. Prescribed Zithro. Had Random Oral Sex. On Augmentin. Having Pain In Groin And Back.

Posted on Thu, 24 Oct 2013

Question: Hey Doc I have had inflammation in my testicles for over 3 years now I have cured it each time w a course of cipro ... The last two occurrences haven't been the same or easy to cure . The first episode was inflammation in both testicles burning while urination, itching around the pupic area smell n cloudy weak urine but this time I was have a pain in my right testicle which I never had before , I was tested for stds across the board and everything was negative as usual and I was give 1 dosage of Zithro and I think some cipro again and all the pain and symptoms cleared up ! Well four months later I had random oral sex again and everything came back so I was prescribed a z pack of 5 days and nothing happened I also been on augmentin for 2 week and the symptoms seemed to clear up again before having oral sex w my gf and the pain symptoms came back so I was told to go back on cipro from my urologist and doxycycline for three weeks this hasn't helped I have been having a throbbing pain in and out of my testicle and a lil groin n back pain . I have an appointment to get a 4 glass stamey smears glass culture test but I am told that after all of these antibiotics it will probably be negative . So my question is what do I do ? Do I try another antibiotic ? Like bactrim or levoflaxicin ? This really worrying me cause I feel like the symptoms may be getting worse and I know their has to be a resistant bacteria in my prostate some where ?

Answered by Dr. Manuel C See IV (6 days later)

Brief Answer:
I suggest going ahead with the 4 glass Stamey test

Detailed Answer:
Good Day!

Thank you for your query. I would assume that you had bacterial orchitis and urethritis the first time you felt your symptoms. I say this because the pain disappeared after treatment with antibiotics. The bacteria may have harbored inside the prostate and develop some resistance. This is the reason why the same antibiotics wouldn't work anymore if the bacteria was not completely eradicated.

This bacteria may also develop some form of inflammation in the prostate causing chronic prostatitis, some form of allergic reaction thereby causing recurrent pain and swelling. Oral sex may worsen or trigger the pain and symptoms since there will be retropulsion of fluids from the outside inside the penis and different ducts.

If you consulted in my clinic I would give you pain relievers (NSAIDS, Tylenol etc.) to relieve the pain and inflammation which may cause scarring and problems in the future. Secondly I would hold off with the antibiotics and will go ahead with the 4 glass Stamey test. If your doctor didn't explain it you it is basically getting fluids from different location in the urinary tract by doing some maneuvers. It gets fluid and urine from the urethra, bladder, prostate and post prostate massage fluid. The fluids will be checked for bacteria and Pus cells.

If bacteria grows then we can treat you with the appropriate antibiotics to eradicate it completely. If nothing grows but you have pus cells then it means you may have a bacterial prostatitis and you will be given anti-inflammatories and prostate medicine to relax the prostate. A lot would be determined with the 4 way Stamey glass test to guide your clinician on how to approach your recurrent problem.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.

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

Follow up: Dr. Manuel C See IV (3 hours later)

Hey Doc your answer was very detailed and helpful ... I have been on bactrim for almost a month now and have felt less pain and the pain has been less frequent I have also notice my semen has become more white and more quantity since the antis ... How come my testis would feel pain and and I don't feel pain in my prostate or anywhere else how could my prostate cause these symptoms if there isn't any bacteria ? I also feel a lot less pain after I masturbate ? Is chronic prostatitis cureable ? Or just manageable ? I have also been giving Tylenol 3 which seemed to have helped recently ? Can I eradicate this pain in my testicles for good (mainly the right one ) coukdnt this be chronic bacterial prostatitis instead of chronic prostatitis ?

Answered by Dr. Manuel C See IV (27 hours later)

Brief Answer:
It could be orchitis and prostatitis.

Detailed Answer:
Thank you for your follow-up question. Youc could be having 2 different disease entities (chronic orchitis and chronic prostatitis) or two symptoms of one disease which is pain syndrome is having pain in the pelvic area (scrotum, testes, groin area, or at the base of the scrotum). The etiology or the cause of the pain is very hard to discern and it is like having asthma in the pelvic area and it comes and goes and is associated with triggers.

You may also need to have a scrotal ultrasound with Doppler studies to check for varicocoele and maybe a testicular abscess which may not show in your urine culture. It may also be good to have a culture of your semen just to have a complete work-up. Once we know if the pain in your testis is primary testicular or just radiated pain from the prostate the. we can address the problem and we could eradicate your testicular pain.

It could still be chronic bacterial prostatitis with resistance to the usual medicines already that is why it remains in your system. It could also be chronic abacterial prostatitis in which like I said before antibodies attacking your prostate causing inflammation ( like some auto-immune disease e.g asthma, scleroderma, psoriasis, allergies) . The 4 glass Stamey test would classify your prostatis and will give us the direction in your treatment.

Chronic prostatitis can be managed and in some cases cured by staying away from triggers (infection, spicy food, maybe In your case antibodies present in the saliva of your partner) . Anti-inflammatories will help a lot decrease pain and inflammation.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.

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

Follow up: Dr. Manuel C See IV (15 minutes later)

Is chronic pelvic pain syndrome the same as chronic prostatitis ? CPPS can it soley be in the testicles ? From the information I have givin you what does it sound like my diagnosis is in your opinion

Answered by Dr. Manuel C See IV (2 hours later)

Brief Answer:
CPPS is a more specific diagnosis.

Detailed Answer:
CPPS is a more modern terminology, before everything was called chronic prostatitis. CPPS can be felt anywhere in the perineum, penis, scrotum and testis. In my opinion from what we have talked about, I still think you are suffering from chronic bacterial infection which have grown resistant to usual antibiotics. Unless proven otherwise that is my diagnosis to your case.

Thank you very much.

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

Follow up: Dr. Manuel C See IV (7 hours later)

Me to Doc . I have been to 2 urologist specialist 1 at the university of XXXXXXX and 1 at XXXXXXX U in Philadelphia and both won't do the four glass test / eps culture would you know any Doctor in my area that does this ?

Answered by Dr. Manuel C See IV (4 hours later)

Brief Answer:
I'm so sorry but No, I dont know anyone.

Detailed Answer:
Good Day Sir!

I am very sorry but I don't know any doctor in your area. I am unable to help you on this. Again I am sorry and Wishing you good health.

Yours truly,

Manuel See IV, MD DPBU

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