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Epididymitis - Other Concerns?

Last Sun I had pain in right test. Upon feeling had a swollen epididymus, size of a pea bottom of my right testicle. I had been wearing tight sport underwear. I switched to looser underwear that evening and the pain subsided.

Injured my Knee that tuesday and ended up in the emergency. Mentioned swollen epidid and they did an Ultrasound. Person doing the exam said did not see any masses. Clearly swollen epididy and some fluid around left testicle. They said to see primary care physician. My understanding is that the ultrasnd would go to a urologist who would review that and provide summary. That summary has not yet been provided. To this point, early Wednesday I had not had any pain since changing underwear.

Went to prim  doctor Wed afternoon and he did a simple exam of my testicles (hand). Prescribed Cipro under the assumption it is Epididymitis. The dr had not seen the ultrasound result, did not order any tests. To this point I had no testicular pain since Sun evening after changing to looser underwear, just the bump on the right.  Started taking cipro on Wed, twice a day for 10 days is the rx.

On Thu I started pain in my left testicle and have had that pain consistently through this point, Sun morning. The pain will sometimes extend to pelvis, upper abdomen and yesterday a little bit it lower left back. When standing or lying down holding my scrotum so my testes are closer to my body but not squished does seem to feel better.

I'm concerned that I may have testicular cancer that is going undiagnosed. I guess primarily since my prim dr didn't order any types of tests.

I think I have this concern because 3.5 days into the medication and I still have the pain. However, the fact that I have the swelling on the right and pain on the left makes me think epididymitis. Swelling on the right side seems slightly diminished but still readily apparent through self examination. Slight pain in left testicle is relatively constant.
2 Responses
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,

Thanks for posting your query.

I can understand your concern for the testicular pain and swelling.
From your post I understand that you had pain and a small swelling in the right testicle and now you are having pain in the left testicle as well despite starting with antibiotics for the right sided testicular lump and pain.

I can understand your concern for testicular cancer. It is the most common cancer in males aged 20–39 years and is rarely seen before the age of 15 years. It usually presents as a lump or swelling in the testes which may or may not be painful. Other symptoms may include sharp pain or a dull ache in the lower abdomen or scrotum, feeling of heaviness in scrotum or a lower back pain. However diagnosis can be done only after an ultrasound scrotum or CT scan of the scrotal sacs. Sometimes blood tests for tumor markers specific for scrotal ultrasound are done which include AFP alpha1 feto protein, Beta-HCG, and LDH. You have got an ultrasound done which has ruled out any testicular mass and has depicted only testicular swelling and some fluid around epididymis which can be due to infection caused due to epididymo-orchitis. Hence possibilities of any testicular mass or testicular cancer are very less.

From the symptoms and ultrasound findings, there is a strong possibility that it is due to epididymo-orchitis. It usually presents with unilateral scrotal pain and swelling of relatively acute onset but the pain and swelling may extend to other testicle as well and then may be bilateral in nature.

Other than that, considering your symptoms another possibility although less likely which is of an inguinal hernia should be ruled out. It causes bulges along the pubic area that can increase in size when you stand up or cough. It can also cause testicular swelling. Varicocele and hydrocele can also cause testicular swelling and pain but these possibilities can easily be ruled out by an ultrasound which has been done in your case.

Hence it looks like an epididymo- orchitis. other tests which may be needed are a urethral swab and smear. If the symptoms persist then a color doppler of the ultrasound and if the lump grows then a FNAB ( fine needle aspiration biopsy) which is ultrasound guided may be done.


Hope that this information helps and hope that you get better soon.

Wishing you good health.




Avatar universal
Additional info:


Anyway, I would like to get a pro opinion based on this information if my concern for testicular cancer is just paranoia? Also, are there other tests I should be demanding to be done?


One final note I did have a sigmoidoscopy about a month ago. Some hemmoriods, which have gotten better. Two tiny polyps sent in and both were negative for any type of cancer. Dr scheduled colonscopy for 2019.

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