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Painful masturbation, cyst, epididymitis, on cirpo. Prevent it?

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I am a 22 year old male. I've been masturbating quite frequently since around the age 14. Never caused any problems or pain until recently. When masturbating about three months ago I could feel my left testicle grow rock hard to the point of being painful, it also shot up pretty high. When I ejaculated it felt pretty painful/uncomfortable only on the left side. I was worried and in pain so I went to see a doctor the next day and had an ultrasound done which came back negative, only note was that there was a small cyst on the left testicle. I then saw my main doctor a few days later who diagnosed me with a form of epididymitis and prescribed me 10 days of Cirpo. The pain subsided after and I was back to normal. This past week it happened again as I was ejaculating and the pain remained for many days after. I didn't go to the doctor but just waited it out without masturbating in that time. Once the pain subsided after 5 days it came right back when I masturbated. What is going on? Could this be some kind of nerve thing from overmasturbation or could it have something to do with the cyst on my left side which happens to be right around the sore epididymis? I find it hard to believe that it is or was ever epididymitis because the pain healed on its own after the second time this happened and that was with no medication. Masturbation seems to be the only factor that randomly triggers these symptoms in the first place. Also STDs can be ruled out because I am still a virgin, any ideas as to what could be causing this or how to prevent it?
Mon, 1 Oct 2012 in Testicle Problems
Answered by Dr. Jasvinder Singh 1 hour later

Thanks for posting your query.

From your symptoms, after masturbation it is not natural to find any swelling or pain in testicles. Based on your symptoms a few important possibilities could be the cause of these symptoms:

1) Infections like epididymitis and prostatitis: At the time of ejaculation, the prostatic fluid is discharged into the urethra where it mixes with discharge from the ejaculatory ducts (containing sperm and seminal vesical fluid) which comprise the semen. Inflammation of the prostate gland (prostatitis) often will spread down the vas and into the epididymis. This may cause pain. Also infection of the epididymitis can cause such testicular swelling and pain.

Epididymitis causes gradual onset of testicular pain that can vary from mild to severe and the course of antibiotics that you have taken probably are not sufficient so that the symptoms are persisting.

2)Second possibility is of partial torsion testis which causes variable pain and swelling and often spontaneously corrects itself by detorsion. If it changes into a complete torsion then it becomes a medical emergency.

I suggest you to consult a urologist and get physical examination and investigations like microscopy and culture of a first void urine sample, Gram stain and culture of fluid or a swab from the urethra, PSA (PROSTATE SPECIFIC ANTIGEN) levels and a color doppler ultrasound done. You may need a prolonged course of antibiotics.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Painful masturbation, cyst, epididymitis, on cirpo. Prevent it? 3 hours later
Thanks for the detailed answer. However, I do not believe it could be partial toersion in the left testical because I already had a testicular ultrasound done on both and the doctor said that blood flow looked good and nothing seemed out of wack. Also as far as pain goes, I would describe the pain I feel as more of a dull soreness than sharp. The pain was almost never sharp at any point. But it was definitely uncomfortable and for the first week after taking Cirpo it felt like I was slightly sitting on my testicle everytime I sat down into a chair.

What now makes me think this is probably an infection rather than a partial torsion is due to the fact that the two times I've experienced these symptoms, they were triggered by masturbation and particularly ejaculation. Correct me if I'm wrong but torsion, be it partial or full just "occurs" spontaneously and isn't necessarily triggered or associated with masturbating. With regard to my symptoms, the way you described the potential development of prostatis and epididymitis sounds more realistic to me.

What worries me was when this originally happened, I remember the extrememly uncomfortable feeling of barely being able to ejaculate as if it was backed up or blocked, then shortly after my left testicle got very noticably swollen. I took ibprofin and went to get an ultrasound later that day because I feared it might have been torsion but the results came back negative. After taking the Cipro for 10 days it felt like I had a full recovery and I proceeded to masturbate just as I had before. Up until last week, for months I was fine with no reocurrance of any symptoms. What happened to me last week was the same type of "ejaculatory constricting" feeling as before on a minor scale.

Also another thing I forgot to mention was both times I went to the two different doctors for these symptoms (one for ultrasound the other for prescription and second evaluation) I never mentioned that I had been masturbating when these symptoms originally occured because I was very embarrased. It obviously seems like it is a main factor in this case so I'm curious as to whether it would have changed either of their diagnoses or made them evaluate what they saw differently.

Lastly, you mentioning prostitis as a potential factor reminded me of something else I've been meaning to ask about that could have something to do with all this. That is, When urinating, I've found that after I finish (and give my penis a firm shake etc...) every now and then theres some significant drippage or even slight continued urination instantly upon putting it back into my pants. This is not a big problem but I figured I'd mention it as it could potentially pertain to everything mentioned above.

Hopefully this is simply an infection that can be cured by antibiotics, and this time stronger ones or as you said a prolonged course

Sorry for the lengthy response, but I feel like I addressed everything I have been thinking about on this matter and I would really appreciate your feedback on my thoughts before I attempt to set up an appointment with a urologist. Thanks again

Answered by Dr. Jasvinder Singh 2 hours later

Thanks for writing back and a good clarification. It is true that semitorsion of the testis is not related to masturbation and it may occur all of a sudden with no history of recent masturbation or intercourse but its chances are more to occur after a masturbtion.

Compiling all the symptoms that you have reported primarily, pain after masturbation, uncomfortabl feeling after masturbation as if it was blocked or backed up and dribbling ofurine even after voiding; the possibility of prostatitis causing these symptoms further increases.

Symptoms of prostatitis includes one or more of the following symptoms: increase frequency of urination, slowing of the urinary stream, burning and pain with voiding or ejaculation, burning in the penile tip unrelated to voiding, sexual dysfunction (such as difficulty with erection), aching in the penis, testicles, and discomfort in the lower abdomen and dribbling of urine after voiding.

The other possibility which arises is of urethritis but it stands next to prostatitis and should be evaluated in the end. It is an inflammation of the urethra which can travel to your bladder, kidneys, prostate and/or testes. It may also cause swelling or a feeling of "heaviness" in the scrotum and testes.

Any obstruction in the flow of urine which can be due to cysts, polyps or growths could have also caused these symptoms but it would have shown up on ultrasound. I suggest you to consult a urologist and get the possibilities of infections: epididymitis, porstatitis and lastly urethritis ruled out.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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