Possible Chlamydia/Epididymitis

[anxiousallen]

Hello Doctors -

Unfortunately I am not new to this forum - as always - thank you for your work here on this forum. Last week in the shower I noticed that my left testicle was sagging quite a bit. I felt it, and there appeard to be a lot of "extra stuff" below the testicle itself. Since then, I have had a general ache in the left testicle area. No shooting pains or burning, just a dull ache.

I am hetero male. Today, I went to the doctor and he performed a physical inspection of my testicles. I believe he said there was some swelling or inflammation of the epididymis and told me that I need a scrotal ultrasound, urinalysis rflx micr rflx culture and a chlamydia/gc rrna. I have never had any discharge or burning or discomfort with urinating or ejaculation

Almost a year ago to the day I tested negative for all STDs. Since then, I have slept with three women. 2 of them once (June and early September) and my current girlfriend on a weekly basis - starting from about January 1. All of which was unprotected. I trust that my current GF has had minimal partners.

Could this be an STD and if so - would it be from my GF or from the previous women? The sagging and aching appears to be more prominent in the night time hours.

Thank you

[H. Hunter Handsfield, M.D.]

I think you're on exactly the right path.  Follow the urologist's advice about whether or not to have a testicular ultrasound examination.  I predict it won't be necessary, i.e. that the urologist will find your examination to be normal.  Various irregularities of the testes often become more prominent, or more noticed, as men age.  I doubt any of this has anything to do with your back pain.

[anxiousallen]

Dr. Handsfield -

I just received a message from doctor and my laboratory tests were all normal, including my chlamydia/gonorrhea screening test (negative) and urinalysis.

The reason I went to the doctor was that I wasn't sure what the "extra stuff" hanging under my testicle was or what was causing it (as well as the general ache in the area). When he suggested potential STDs, I became nervous.

I didn't tell my dr when I saw him, as I had truly not put two and two together, but I had some serious back pain (above the center of my left buttock) a couple months back and it actually came back today! I am now wondering, because of some additional online research, if this could be prostatitis. I know this condition can be caused by both stress and anxiety, both of which I suffer from.

I plan to cancel my scrotal ultrasound for next week and make an appointment with a urologist. I know this now falls outside of a STD issue and therefore out of the scope of this forum, but can you advise if this approach makes sense?

Thank you,

AA

[H. Hunter Handsfield, M.D.]

I don't know the cost of scrotal ultrasound, but I would guess several hundred dollars.  But I would be surprised if insurance doesn't cover it.  However, you might have a conversation with your physician about how important the test is.  If I had your symptoms, I wouldn't have it done (indeed, based on your description, I probably would not have even seen my doctor).

[anxiousallen]

Thanks Doctor - I am going to follow up with my GP early next week regarding my test results. I will follow up with my results.

Also - I know this a bit out of scope but could you please let me know (if you know) the estimated cost of a scrotal ultrasound if insurance doesn't cover it? I am a grad student and my coverage is terrible.

In addition - you are correct that I do not have any history with this screen name. My email account that was used for this site was compromised and I no longer have access to it. I did not know how to get my sign on information so I created a new one. I assure you I did not do this for any ill intent purposes like asking additional questions.

Thank you

[H. Hunter Handsfield, M.D.]

Welcome back to the forum -- but I cannot find any other questions under this username.  Multiple usernames are against MedHelp policy.

No STD is a likely cause of the mild symptoms you describe.  Your symptoms don't sound suspicious and I am surprised your doctor suspects epididymitis.  I have to believe s/he is just being very cautious -- i.e. covering all bases, without really expecting to find very much by the recommended tests.  Of course he has examined you and I have not, but my guess is that the ultrasound and all other tests will be normal.

Based on both symptoms and your exposure history, I would be extraordinarily surprised if your gonorrhea or chlamydia test is positive.  If one of them is positive, that would be the time to begin to think about when and from whom you were infected.  But I very much doubt this is any STD at all and I would say nothing to any current or past partner at this point.  And if I were in your situation, I would continue unprotected sex with my current partner.

Regards--  HHH, MD