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Dr. David
Dr. David, MD
Category: Urology
Satisfied Customers: 42232
Experience:  Experienced physican in Urology
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Hi, I would like to request that this question remains anonymous due to the sensitivity of the issue.
I have had intermittent pain in the prostate/testicle area over the last few years. Although my symptoms have improved significantly over time, there is still a little bit of discomfort which tends to return for some time every once in a while.
December, 2009- I was experiencing very little interest in sex, the fluids exerted during ejaculations were reduced by approximately 50%, and at times 70-80% (it varied significantly.) I didn't let it concern me.
March, 2010- Pain started to emanate from both testicles and the prostate area. At this point, I decided to consult with a general physician. The general physician diagnosed me with prostititus, however, he was unsure if the term "prostititus" was accurate; I didn't have many of the systems associated with prostitius. I didn't, and never had a burning sensation during urination, no blood in the urine, and no fluid discharge from the penis. At the time of the prostate exam, my prostate appeared to be tender rather than enlarged, and the white blood cells which were collected from the fluid exerted from the prostate during examination were of the norm. I didn't have chlamydia, or gonorrhea at the time (march 2010.) The Doctor prescribed for me to take cipro for two months consequently, this, however, made no difference.
May, 2010- Frustrated, I decided to consult a urologist. The urologist essentially told me the same thing. He said I can take advil for anti-inflammatory purposes if needed. Subsequently afterwards, I went to see the urlologists several times. During the course of this time, my condition had been improving slowly and gradually. The issue seemed to be very intermittent. The amount of fluids discharged during ejaculation were also improving. However, I believe that the levels were never fully restored.
The intermittent nature of the situations continued, however, it was gradually improving.
2012 and the majority of 2013 has been very comfortable, however, I don't believe that the amount of fluids exerted during ejaculations have been fully restored.
August 2012- I was experiencing minor pain in the testicles once again, so I decided to go to the doctor, this time, they performed a ultrasound of the testicles. The results from the ultrasound showed that I had a very small vericocele on my left testicle. According to my general physician, and my urologist, this was fairly common. In fact, the urologist told me that he had a similar one since he was 14.
The symptoms slowly disappeared once again and this time I seem to have been better than I had ever was.
July 2013- Discomfort has once again originated from my testes. My sex drive is essentially normal, however, the amount of fluid discharged during ejaculation has decreased significantly.
I went to the general physician and she told me that everything appears to be fine, and for the record, everything has always appeared to be fine from the begining. No bumps, or swollen testicles. At this point, my main concern is if I will have issues with fertility. The doctors have told me that I shouldn't. However, could you also please give me your opinion? And by some miracle, if you have come across this issue and happen to have a solution to my problem. Thus far, no one happens to have an answer to what this is or what is causing it.


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This is Dr. David

sporatic soreness of the scotal area can come from occational epididymitis infection and inflammation of the epididymis. this is a curved structure at the back of the testicle in which sperm matures. sometimes you can also have spermatic cord inflammation and congestion if you haven't ejaculated in a long time. this is commonly called "blue balls"

often scrotal ultrasounds do not show epididymitis infecitons or congestion of the spermatic cord. most often epididymitis is caused by viral infection in the area and the inflammation usually gets better with time, usually on its own. sometimes antibitoics are given for epididymitis and it gets better as well.

the amount of ejaculate volume is not a sign of you being less fertile. the amount of ejaculate can often be affected by how often you are having ejaculations. the more frequently you are having ejaculation, the less the volume can become. often delaying time between ejaculations, the volume of the ejaculate can be increased.

at your age, infertility would be uncommon. you can also have your blood testosterone levels checked as well to see if these might be causing your symptoms, but also at your age, it would be unlikely for it to be low.

if you are planning on having a baby and worried about fertility issues, you can always submit a sperm sample and have them count the number of sperm in your ejaculate and see what percent of them are moving correctly.

does this help?

let me know if you have questions.
Customer: replied 3 years ago.

Dr. David,

you mentioned that epididymitis infections are caused by viral infections in the area. How do I know which infection I have? What could possibly have caused this type of viral infection? Is it safe for me to allow for things to get better with time as they have been?

What causes congestion of the spermatic cord? Could it be due to too frequent sex? At times, I have sex several times a day (2-3 times,) is this safe? Is there a limit one should place on sexual activity?



these are the same kind of viruses that can cause a common cold. often times we don't know what type of virus caused your cold or sore throat. these same kind of viruses can also cause inflamamtion of the epididymitis. some doctors argue that you shouldn't be giving antibitoics so frequently for patients who have epididymitis because since most of them are caused by viral infections, they will get better on their own.

usually lack of sex and lack of ejaculation causes congestion of the spermatic cord.

if you are masturbating very frequently, I would doubt you are having congestion of the spermatic cord.

frequent masturbation can cause decreased sperm volume. the more you masturbate, the less time you give your body to make ejaculate fluid. and thus the less volume you have.

also if you are masturbating that frequently, you could be causing some trauma or soreness to the scrotum itself if you are rough on the scrotum.

yes, it is safe for you to allow things to get better with time. you not not allowing something bad to fester. time is often the best healer. and if things have been getting better over the years, that is a good thing.

it is up to you if you want to place a limit on your sexual activity. there is no right or wrong answer to this. every person is different.

does this help?

do you have other questions?
Dr. David, MD
Category: Urology
Satisfied Customers: 42232
Experience: Experienced physican in Urology
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