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Suggest Treatment For Heterogeneous Mass In The Epididymis

Posted on Mon, 12 Dec 2016

Question: I was diagnosed via ultrasound with a heterogeneous .8 cm solid or complex structure at the tail of my right epididymis. I was told to see a urologist and have an appointment in about 10 days. Should I be concerned and should I try to get an earlier appointment?

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Could be due to Benign Epididymal mass needs further tests

Detailed Answer:
) Hello
Thanks for query .The heterogeneous mass in Epididymis reported on Ultrsound Scanning of your scrotum could be one of the following three pathology
1) Non specific Epididymitis
2) Tubercular Epididymitis
3) Benign tumor in Epididymis and need further test called Color Doppler Sonography of scrotum .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) What are your symptoms ?
2) What is the duration of mass ?

Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Color Doppler study of scrotum .

Further treatment will depend upon result of these tests and final diagnosis.

You can certainly wait for a week provided you do not have acute symptoms like severe pain ,fever etc .Till then you can take antibiotic like Cefotaxime and Anti inflammatory medication like Diclofenac twice daily

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

Follow up: Dr. Dr. P. T. Patil (10 minutes later)

Thank you, I was worried it might be a malignant tumor and I should get to a urologist right away. The onset seemed quite quick, I noticed it in the shower, so I think it wasn't there for a while, although for the last 10 years I have had reduced semen fluid flow when I have sex (which has been very infrequent). On first notice, it seemed to hang below the testicle more, but now it seems to have firmed up under the testicle and is harder to notice. There is no pain, only when I massage or press on it. The ultrasound results also said "this does not demonstrate significant flow on Doppler examination and that a small hydrocele is demonstrated." It doesn't say if the hydrocele is near the mass. No varicocele isseen. Could it be caused by atrophy, since I very rarely have had sex in the past many years. I have not had tuberculosis in the past and there is no discharge from my penis.

Answered by Dr. Dr. P. T. Patil (5 minutes later)

Brief Answer:
Likely to be Epididymitis

Detailed Answer:
Hello
Thanks for feedback .

Considering short duaration and acute onset odf symptoms it is likely to be Epididymitis

It seems to be Acute Epididymitis .However start taking treatment and get the tests done suggested in my earlier reply. .

Thanks and Regards
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (44 minutes later)

Thank you. I thought because if was described as "solid or complex" that it might be a tumor. Can Epididymitis cause a solid or complex cyst? I am on amoxicillin for a few more days and then switching over to Doxicycline as a result of recent oral surgery. Are these good medicines for this condition also while I wait for my appointment?

Thanks,

Answered by Dr. Dr. P. T. Patil (10 hours later)

Brief Answer:
ColorDoppler Study of the scrotum must be done to rule out Tumor

Detailed Answer:
Hello
Thanks for follow up .

Epididymis is a diagnosis based on the facts that you have posted However it is suggested to do color Doppler study of the scrotum done to rule out possibility of Tumor which in most of the cases is benign in nature and not to be worried for .,
Thanks and Regards,
Dr.Patil

.

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