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Testicular tenderness post prostatectomy

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romneyj
romneyj

I had my prostate removed (robot assisted prostatecyomy) nearly three weeks ago and 8 days ago had my catheter removed (11 days post op). Coincidental with the catheter removal, I began to get very sensitive testicles which have got no less sensitive over the eight least eight days.

Looking up vasectomies (another procedure where the spermatic cord ends up with a dead end!) I discovered that in one study 18.7% and in another 14.7% of men had new onset scrotal pain post vasectomy (due, it seems to: increase in pressure within the vas deferens on the testicular side; the epididymides of vasectomized men often being swollen and distended from backpressure effects; and the efferent ducts and seminiferous tubules of the testes beingimpacted by backpressure).

Talking to my nurse, she says very few men complain of tenderness. I'd be fascinated to hear how many of you have experienced this and for how long (it can be very long tern in casectomised patients).

My own tenderness by the way does not result in continuous pain but demands careful touching when washing and protection from being squeezed in any way. My explanation for it beggining 11 days post surgery is that that was the time needed to begin to build up back pressure.

0 likes, 45 replies

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  • n-mac
    n-mac romneyj

    Posted

    Regardless of prostectomy, there is a non-specific infection that guys can get that causes a testical (or both) to feel painful and tender. In my case, it also felt like a strained feeliing, like something was constantly tugging the right one up into the socket (not descending all the way).  This was the initial reason for visiting a urologist who mis-diagnosed it as a hernia.  However, 2nd much more competent urologist quickly diagnosed it as a very common infection, perscribed a 14-day antibiotic regime, and the condition cleared.  Perhaps, you could have picked up this sort of infection as a result of all the biological disruptioin caused by the RALRP.

    In my case, coming down with this infection may have been a Godsend in that the initial suspiciion of a hernia led to a pelvic CT scan that detected a nodule on the base of the left lobe of my prostate. Next, a PSA test, followed by a 3-D Tesla MRI, and finally a needle biopsy resulted in my diagnoses of G7 prostate cancer localized to the rear base of the left lobe, 3 out of 16 cores positive.

    • romneyj
      romneyj n-mac

      Posted

      Thanks n-mac. The fact that it is even, consistant and bilateral leads me to believe that it is much more in line with a pressure buildup in the same way that has been reported with vasectomies as sperm is manufactured and has no way out. My real question was how widespread this is - is it about 1/6 prostatectomy patients (as in vasectomy patients) or is it, as my nurse suggests, much less frequent?
  • robertV
    robertV romneyj

    Posted

    It's been 3 weeks for me too and mine are sensitive also. I was thinking that this is part of the normal healing process. 

    • romneyj
      romneyj robertV

      Posted

      Interesting - I suspect the question is not asked.
  • MK51151
    MK51151 romneyj

    Posted

    Yes. I am 15 weeks post RP and my testicles are very sensitive and painful to touch and manipulation. I hope it will change to prior to surgery.

    MK

    • romneyj
      romneyj MK51151

      Posted

      Even at 15 weeks? It's following the same pattern as in vasectomies which can be long term (relieved by epididymectomy in a high percentage of cases).

       

    • barney34567
      barney34567 romneyj

      Posted

      I had the same issue after my RARP.

      While you were correctly told that few men experience such pain, a urologist with a big patient caseload WOULD have seen this.

      In my experience the problem of tenderness is due to a part of the urethral being cut to remove the prostate and the balance reattached. In so doing the testicles and scrotum are yanked UP and there is less room for the testicles to freely move.

      The solution in my case was a drug called Amitriptyline. When given in douses of 75 mg twice a day it's used to treat depression but some trials showed, and I can attest to this, that at very low doses, being 10mg twice a day, it removes bladder/scrotum pain.

      Get your doctor to prescribe this and in 2 days, ie after four doses you should feel instant relief.

      Best wishes.

    • romneyj
      romneyj barney34567

      Posted

      I know amytriptyline well as it is used largely (nowadays) for neuropathic pain. I shall try it this morning.

      In addition I have very taut, swollen tender epididymides (I believe to be the pleural of epididymidis) and believe that to be due to being very full os sperm with nowhere to go. Under such back pressure sperm will be resorbed but I guess the level of back pressure needed for this to happen varies from person to person?

    • barney34567
      barney34567 romneyj

      Posted

      The tenderness you mention could well be epididymis or retrograde ejaculation (sperm travelling to the bladder).

      Both I understand are fixable and common.

      I haven't looked into the source of occasional pain I have. I suspect the odd sensations are retrograde ejacularions.

    • romneyj
      romneyj barney34567

      Posted

      A very interesting comment Barney. Many thanks. I had assumed that the vasa deferentia, or at least the ejaculatory ducts, had both been ligated since the seminal vesicles had been removed along with the prostate. Nice explanation.

       

    • romneyj
      romneyj

      Posted

      Hi Barney,

      I met with my surgeon last week and he confirmed that the vasa deferentia are ligated and cut. The issue is very much the same though. Sperm blocked in the epididydimes with nowhere to go! For me the tenderness is going.

    • barney34567
      barney34567 romneyj

      Posted

      As mentioned earlier, I too had tenderness. Often. Amitriptyline 10mg twice a day for a few weeks and then once a day was all it took to get rid of such tenderness.

      I then used it sporadically.

      In recent weeks I barely use it.

      In your position the objective is to rid yourself of the tenderness and not so much to diagnose exactly what it is and why it is.

    • romneyj
      romneyj barney34567

      Posted

      Lol, true to some extent but the treatment requires a level of diagnosis first. I did try amytriptyline to no effect. If constant back pressure reduced sperm production then that would explain why the tenderness is disappearing. It also might  explain why I am now very limited as to how many orgasms I can have - perhaps 3 x /week at most.
  • n-mac
    n-mac romneyj

    Posted

    I'm sorry to hear that all 3 of you fellows are going through that.  Prior to reading this new post, I'd not been aware of this yet one more possible negative side affect from RP.  All these fairly probable and highly detrimental side affects from RP makes me hope more and more that I'm a good candidate for focal theraphy.  So far it is looking like a good fit and far less risk alternative.  Should know more within next few days.

  • john80670
    john80670 romneyj

    Posted

    I have had this since feb asked 4 doctors one sent me for scan found nothing, but they are so tender to touch. This week i went to hospital to see the urologist about my prostate i told him about them and he did check and said perhaps you had an infection, but never give me anything or said what to do ? unless he's sent a report to my doctor for him to sort out.

    • romneyj
      romneyj john80670

      Posted

      I have the same problem as your urologist - I can't imagine what might be causing your tenderness. Problems in health do seem to bunch somehow. I hope it disappears as fast as mine did.

      (Mine disappeared and seemed to have been be associated with 'ejaculations' that were contained within the epididymis due to the vas defferens tubes being cut as part of the surgery.)

    • john80670
      john80670 romneyj

      Posted

      Had it 4 months so not sure how or if it will clear, but you think one of them would know what's wrong.

    • romneyj
      romneyj john80670

      Posted

      You would have expected one of them to have had experience of that. 4 months is a long time. Have you done any internet searches? The only thing that makes sense is infection, but how and why bilateral?
    • john80670
      john80670 romneyj

      Posted

      I have looked yes and all it says is infection, the right one hurts more than the left loll Doctors and hospitals are useless down here perhaps i need to move or go private.
    • romneyj
      romneyj

      Posted

      You might want to identify whether it is mainly locallised (eg at the epididymis) or general... I have been briefly checking out the Mayo clinic site and the emdicine site and there is a long list of possibilities. A case for the GP I think, but make sure you write down all the main points eg, timing, type of pain, location of pain, whether it it just tenderness or constant ache etc.
    • john80670
      john80670 romneyj

      Posted

      Thanks yes i will talk to the doctor i have a lot to ask him and this time not going to give in until i get an answer to my problems. But it is just tenderness where the pipes join the testicles.
    • john80670
      john80670 romneyj

      Posted

      Hi 11 days since hospital and had sex 3 times first all fine second and third brown sperm blood do you think this could be from him poking around ?
    • romneyj
      romneyj john80670

      Posted

      I am not a medical doctor (I am a biologist and work in vaccine research). As I believe you have not suddenly volunteered for a biopsy(!), it sounds not like poking around but like an infectiion. The most common infection is of the epididymis (epididymitis) and this would explain your tenderness and the blood in your semen. Talk to your doctor!!! It needs treatment.
    • john80670
      john80670 romneyj

      Posted

      Yes will call today but had tenderness since feb and the specialist at hospital knew and never even give me anything. The tenderness is loads better since feb it's gone from 100% tender to about 20% but it could still be that.

    • john80670
      john80670 romneyj

      Posted

      PS only had blood since he poked around unless he disturbed the infection or something strange.
    • romneyj
      romneyj john80670

      Posted

      I'm afraid that that's one of those imponderables.

    • romneyj
      romneyj john80670

      Posted

      It would seem more probable to be blood from a prostate inflammation than from a testicular inflammation unless he also squeezed your testicles!! That then does not explain your testicular tenderness. You need proper diagnosis.
    • john80670
      john80670 romneyj

      Posted

      He did check my testicles, i thought i went to the hospital for a proper diagnosis ? they either missed something or it a coincidence
    • romneyj
      romneyj john80670

      Posted

      Hmm, the good news is that it is beginning to get less tender but the question is whether that is becase the cause is resolving or you are becomming inured to it!

      Check out "Mayo Clinic testicular pain" on google and you'll see many different potential cuases - make sure that the dictor eliminates all the irrelevant ones and works out how to confirm which of the remaining ones is the cause!!

    • john80670
      john80670 romneyj

      Posted

      I think i am going ot fall our with my doctor today this is not the first problem i have had.
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