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Suggest remedy for inflammation and pain in testicles caused by epididymitis

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9946 Questions

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Posted on Wed, 28 Oct 2015 in Urinary and Bladder Problems
Question: I was diagnosed with epididymitis-orchitis ( thats what my doc believed so ) before 3 weeks ago . I took anti-inflammation and ciprofloxicin and anti-bacterial medicine . testicular ultrasound and Doppler test was normal, but even after 3 week I have tenderness and pain ( pain comes and goes, it has gone down a bit but it is still there ) in my left testicle . and I can even feel the inflammation on the head of epididymis and it is painful if I try to press it a bit ( which causes elevation in pain as well later on ). I can clearly feel the inflammation by comparing between the epididymis of right and left testicle ( which is tender) Should I go for any other tests ? or is it really an epididymitis?

tests done:
1: USG Doppler scorutum - Normal
2 :Culture : No growth of bacteria found
doctor
Answered by Dr. P. T. Patil 47 minutes later
Brief Answer:
It is epididymitis .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you were diagnosed to have Epididymo-Orchitis and was treated with appropriate antibiotics and anti inflammatory medications .

Though your symptoms have reduced to satisfactory levels you still get dull pain in Lt testicle and epididymis is still tender .

Please note that though there is improvement as far as infection is concerned as detected on lab tests and scanning ,it takes long time up to 3 months for complete inflammation to subside hence one needs to take antibiotics and anti inflammatory medication till you yourself observe clinical improvement on palpation.

Continue taking antibiotics and anti inflammatory medicines for 2 more weeks .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil






Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 10 minutes later
Hello Sir,

These tests were done preliminary i.e before diagnosis . Which is why I am bit confused because no bacteria was show in urine culture report ( which normally should show in case of Epididymo-Orchitis which is the reason my after taking prescribed medicine for 2 weeks , my doctor suggested a surgical diagnosis which I am not willing to go after .

Do you think it can be a case of STI/STD ( I am not sexually active outside my partner ) or tuberculosis or varicocele .

doctor
Answered by Dr. P. T. Patil 30 minutes later
Brief Answer:
It is likely to be Non bacterial Epididymo-Orchitis .

Detailed Answer:
Hello
Thanks for follow up and highlighting the facts ..
Tests done before prescribing drugs were negative for infection .

But many a times it is a clinical findings that consultant relies upon than positive laboratory evidence in making diagnosis.

Many a times it is very difficult to prove infection based on lab findings but in such cases it is due to non bacterial inflammation of the testicle and epididymis .
..
There is no possibility of Varicocele as it can not be missed on Doppler Scan done earlier .

Tuberculosis of Epididymis can be diagnosed easily on clinical examination by presence of nodules in epididymis what is called as beaded appearance of epididymis .

Use scrotal support .It will help to give relief from pain .

Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 16 minutes later
Hello sir,

Thank you for clearing my doubts , I would like to know you suggestions regarding medicine ? and for how long more ? . Should I abstain from any sexual activity .And if the pain and inflammation does not go even after taking another 2 week round of medicine, what should be my next step after that ?

Regards
doctor
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
Repeat ultrasound scanning if no response to medicine.

Detailed Answer:
Hello
Thanks for follow up .
If there is no satisfactory results repeat urine culture and ultrasound scanning of scrotum.

You have to continue medicines for 3-4 more weeks .

Thanks and Regards.
Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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