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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29653
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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About 5 months ago I had a subinguinal varicocele ligation

Customer Question

About 5 months ago I had a subinguinal varicocele ligation surgery performed on me to get rid of my left sided varicocele. I had not been in pain before the surgery the only issue was constant discomfort. Surgery went well and 4 days after the surgery I got an erection and maintained it for about 15 minutes. This gave me discomfort in my scrotum. Later that night I thought it would relieve the discomfort to masterbate, therefore I did so. After ejaculation it became sore and painful down in my scrotum. Now like I said I didn't have pain before my surgery so this concerned me. The pain and soreness slowly went away but not completely. I then ejaculated several days later. I had to go to the urgent care later that day because my scrotum had swollen up and it hurt to walk. I was prescribed more pain medication and diclofenac for inflammation. I went back to my urologist a month later and he suggested just taking ibuprofen and it should go away eventually and that it is too early to consider it a varicocele reoccurance. I took his advice, but still everytime I masterbated something in my scrotum would begin hurting a few minutes after and my left leg seemed to become sore (perhaps related) and stay until I slept and woke up the next morning and sometimes longer. I stopped masturbating for two weeks and the pain wasn't as bad but it got to a point where it wouldn't feel any better. The pain occurs when a spot on the testicle is touched and of course the soreness is awful. I visited my urologist again and he recommended a varicocele embolization by a radiological interventionalist. I had that operation performed and there was literally no change in the pain or soreness I had been feeling. I recently went back to my urologist and explained everything to him and he said we might be looking at an unrelated issue. So I mentioned I had epididymitis before. My epididymitis never hurt me and was actually detected in an unrelated urine test (about a year before). He said he doubts its an infection but put me on a 21 day run of doxycycline 100mg just in case. He also wanted me to have another ultrasound done 2 weeks from the day I was in. I'm near the end of my antibiotics and I don't think its making a difference and I also stopped masterbating (masturbating) even before the last appointment. But I still feel the pain and soreness. My testicle is very tender and painful to the touch in one area of it which seems to be the epididymis. This is 5 months after surgery and I feel like I'm getting nowhere! This problem is ruining my life and causing me to be depressed all the time because I can always feel it. Any advice would be greatly appreciated.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello Nick,

I am sorry about your prolonged persistent symptoms.

Was any culture test or blood work done?
When is your ultrasound scheduled?

Dr. Arun

Customer: replied 1 year ago.


No culture test or blood work has been done. I had it done last Tuesday and haven't gotten a phone call. I don't know how a varicocele could be causing the pain at this point because prior to the original surgery it was just discomfort. Now its sharp pain and soreness. Thank you for getting back to me so quickly!

Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello Nick,

Your symptoms are suggestive of epididymis (termed epididymitis) infection. A prostate (prostatitis) infection can be concomitant with the epididymitis. To diagnose them, following investigations are necessary;

1) a semen culture
2) a culture of the fluid expressed from penis after prostate massage.
3) blood counts which may show high counts of WBC and neutrophils / lymphocytes.
4) ultrasound of testes and epididymis.

The culture tests not only confirm the infection, but also pin point the right antibiotic which would eradicate the infection. Doxycycline in your case may not be the sensitive for the causative organisms and thus had not given the resolution of the symptoms.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

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Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29653
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 6 other Health Specialists are ready to help you
Customer: replied 1 year ago.


I talked to my doctor after the doxycycline was up and he had seen the newest ultrasound. He said the only things he saw in the ultrasound were that the varicocele had been fixed and that I had 3 epididymal cysts. He said that he could perform the cultures, but believes they would be a waste of money. He also said he would research more and look for someone else that could help me out. Do you have any suggestions at this point?

Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello Nick,

I still feel that just the epididymal cysts are not much likely to be responsible for your symptoms. An infection is the most likely explanation for these symptoms. So culture would have been a worth trying to ascertain the cause, with the blood work..

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