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Pain in perineum and left testicle is quite tender at times. Is it related to prostate?

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Practicing since : 2007
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I'm a 33 year old, Caucasian male.
I recently visited my local GP due to a burning sensation on a small part of my left scrotum. There was no sign of rash and was eased by sitting on a cushion. I was also getting a slight feeling like I was sitting on a golf ball. I no longer feel these sensations except a slight pressure in my perineum.

Upon inspection by my GP, he could find no problems with my testicles. No sign of rash.
I also explained to him that I had a strange feeling in my upper groin that felt like what I imaged a hernia to feel like. He examined me, no bulges, but said I have the start of a bilateral inguinal hernias. So, referred me to surgery and suggested I wear a truss.

All was fine, sitting on cushion and the burning sensation when sitting went away.
I saw the surgeon who questioned the hernia diagnoses and sent me for ultra sound. The ultrasound of my inguinal areas showed no abnormalities.

Since all this I have been getting the feeling like I need to go to pee quite often. This seems on and off and actually stopped once I stopped wearing the truss. Still feel I need to pee more often than normal. But more issues have arisen.

Main one being that my left testicle is quite tender at times to touch. Along with a pain in my left groin that seems to radiate around to my pelvis and left hand bum cheek.
This was uncomfortable for a good week so, I went to see a different GP who again examined me down there and said nothing to worry about and referred me back to neurology, ( she thinks a possible muscular issue as I may have myotonic dystrophy type 2 ). This pain however has eased a lot over the last few days to virtually gone. But my left testicle still feels ( not to touch ) a little odd.

I am positive this has nothing to do with my muscles and more a urology issue.

Rarely, when standing from sitting I get a really sharp pain in my perineum. Like someone has stuck a knife up there. This only lasts 15 seconds then goes.

But over the last few days I have noted that when I masturbate my ejaculate has gone from a normal white semi thick consistency to now containing thick yellow jelly like globules. And it feels thick when coming out of me. No discomfort when peeing or ejaculating. Although I do have a slightly itchy penile head. Not the urethra but the part around where the foreskin is attached. I am not circumsized.

I am not sexually active and do not masturbate a lot but do every other day or so. I have noticed also that I seem to be producing a lot more precum then I would normally.

I have not had a prostate exam but I feel this is related to my prostate?

Posted Fri, 1 Nov 2013 in Urinary and Bladder Problems
Answered by Dr. Srikanth Reddy 5 hours later
Brief Answer:
Could be due to a torsion of the cord

Detailed Answer:

Thanks for choosing health care magic for posting your query.

I have gone through your question in detail and I can understand what you are going through.

Most of the problems you suffered have settled down and you are left out with some. Change in tbe consistency of your semen and more of precum should not bother you as this chang is very normal.
The pain in your testis is something which i am bothered about. Form the information that you have stated there are two main possibilities
1. Inguonal hernia
2. Partial torsion of testis

Inguinal hernia is still the prime diagnosis. Hernia is a clinical diagnosis and it need not show up on usg. Infact CT abdomen will be a better diagnostic modality when looking for abdominal defect.
Other possibilitu is partial torsion of testis casing twisting of spermatic cord and the strange discomfort. You should try doing a dopler USG of the spermatic cord to confirm the blood.flow of the cord. This discomfort is more when the testis hangs and reduces when provided a support like sitting.

Hope I am able to answer your concerns.

If you have any further query, I would be glad to help you.

If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:

Wish you good health,

Kind regards

Dr. Srikanth Reddy M.D.
Above answer was peer-reviewed by
Follow-up: Pain in perineum and left testicle is quite tender at times. Is it related to prostate? 17 days later
Thanks for the repsonse.

I will go back to the gp soon and get him to refer me back for more US scans.

I have found the ache in the groin and testicle can be eased almost completely by wearing fairly tight breifs. If i wear loose boxer shorts then i get the ache come back within a few hours.

I do wonder if this is something to do with the cords that connect the testicle to the rest of the body?

When i wear briefs / tight underwear i am aware something is not quite right but testicle far less sensitive. It still feels more tender to touch than my right testicle but it does not particularly bother me.

I have noticed my urine to have a slightly, perhaps, fishy and eggy odour to it. I did give a urine sample for culture but heard nothing back so i guess all was fine.

Thanks you.
Answered by Dr. Srikanth Reddy 18 hours later
Brief Answer:
Cord problem

Detailed Answer:
Thanks for the follow up query.
From what you have stated it appears for certain that the problem is in the cords. While you are going for USG its better if you go ahead with the doppler test as well.
There is no connection of your spermatic cord and the urine smell.
As such there was no organism in your urine sample

So nothing to worry as such.
Dr. Srikanth Reddy
Above answer was peer-reviewed by
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