Aching testicles

Hi Richard, I've got no insights into what may be causing the pain although I have heard that stress and tension can manifest itself as pain in this area. (ladies have headaches, gentlemen have pelvic pain - there's a book about it if you search).

I'm replying to you with a word of caution - if your doctor thinks it may be an infection he may want to prescribe an antibiotic for it. If he does he may well suggest either Ciprofloxacin of Ofloxacin as these are the recommended ABs. Given your age, he should really not offer either of these two to you as they are fluoroquinolones which shouldn't be given to the elderly (yes, I know 65 isn't elderly but...).

There is a lot going on in the media about the fluoroquinolones as they can cause serious and disabling side effects in some people (there is a forum on this site if you want to learn more). The older you are the more likely it is you will get these adverse side effects, although there are very many young men whose lives have been changed because of them - not trying to sound alarmist here but it's true.

Your doctor can also prescribe Trimethoprim if you are unable to take Cipro or Ofloxacin. My advice would always be to go for the Trimethoprim. It would be a good idea to make the doc do a proper check for an infection first though. You don't want ABs if there's no infection for them to cure.

I'm sure someone will post a more relevant reply although, if this saves you from the pain of an unsuitable antibiotic, I will have done a good job!

Good luck.

Hi Richard,

I recommend the following article by Tatem and Kovac, "Chronic scrotal pain and microsurgical spermatic cord denervation: tricks of the trade". You can google that title and the paper is free. Please review figure 1 as it is most imformative for those of us with scrotal pain.

I have had BPH for over 20 years and never had any scrotal pain until about 18 months when I had a failed varicocele embolization that let some chemical sclerosant get into the right testicle. This resulted in severe inflammation of the epdidimys which was brought under control at that time by an antibiotic called Cephalaxen (Keflex). I have had many flare-ups since that time usually brought on by sex which has been very unfortunate.

I concur with Miriam to avoid Cipro and all Quinolone AB even though they are recommended as they penetrate the testes easily. I had Cipro before prostate biopsies over the years and had a terrible reaction. I am 69 now.

You might ask for a scrotal ultrasound, complete with color doppler to check if you have a varicocele as this can cause scrotal pain. While I have never heard of epididimytis being related to BPH in any way I have heard of the reverse where prostatitis and STDs and UTIs can cause infection of the epididymis.

The problem is to figure out if your pain is caused by just inflammation due to other causes or if it is caused by an infection. You might just take some NSAIDs and see if that helps.

Varicoceles have been implicated as a possible cause for BPH according to the Gat-Goren theory. This was why I had my varicocele repaired - to see if it would help my BPH. Unfortunately my doctor botched the procedure but other men have been helped in this regard. And varicoceles do cause scrotal pain as well.But varicoceles are associated with venous blood flow between the prostate and the testes whereas the epididymis is associated with fluid flow (sperm) between the testes and the prostate via the Vas Deferens tube.

I would ask you if sex aggravates the pain as that is important. Also does stress increase the pain as Miriam mentions?

It is very complicated and required careful detective work. I recently had a scrotal nerve block injection into my cord and it helped a great deal for a few days. So my next step will likely be a scrotal denervation procedure like the one described in the paper - in fact Kovac may perform it! Good luck. Howard

Thank you both for your comprehensive responses.

I will be going back to my doctor when I can get an appointment and will try and avoid antibiotics but will definitely take heed of the warning about Ciprofloxacin or Ofloxacin.

The pain is not bad enough to make me want to do anything about it unless it is an indication of something more serious underlying it.

The pain manifests itself as very sensitive area which I think is the body and head of the epididimus. It is a bit painful when I touch it and I'll often catch it when I cross my legs or similar actions. The area is quite hard as well which I am not sure if this is normal or not. I referred to epididimytis but I am not sure that it is inflamed or just sensitive.

Looking up varicocele on the internet, I have a feeling that this might be the problem as I can feel what seems like quite hard tubes above my left testicle. The article I read suggested that they rarely cause pain though so I'm not sure.

I think I will ask my GP about that.

Thank you again for your, very helpful, responses.

Richard.

Sounds similar to what i'm experiencing. Were you able to get any answers from your doctor?