Having had a similar issue and done substantial research, I can speak
on this topic- please accept my sympathies as I know how painful it
is, and how awful that nobody can help it.
First, any competent physician would probably have ruled out acute
testicular torsion very quickly- it presents as an acute abdomen and
is not easily ignored. Pain from a torsed testicle would likely keep
you from doing anything, and in addition it usually presents very
quickly and becomes a medical emergency within hours, as shown in this
document.
http://www.emedicine.com/emerg/topic573.htm
Testicular torsion, whether intermittent or acute, is ruled out by an
ultrasound, which shows if the testicle has blood running into and out
of it, and is usually ordered immediately upon presentation of an
acute testicle. In your case, had you had a torsed testicle, you
probably would not have had the time or inclination to ask a question
from Google. :)
The most common differential diagnosis is epididymitis, which is an
infection of the epididymis. This is very common and can be caused by
several things, and is usually treated successfully with antibiotics,
although it occasionally requires lengthy therapy to fully cure the
problem. Please see: http://www.emedicine.com/EMERG/topic166.htm
Other differential diagnoses might include hernias, which are easily
checked for via the "turn your head and cough" test, a hydrocele (a
collection of fluid in the spermatic cord or epididymis) or, oddly
enough, appendicitis. (I was especially shocked when they checked me
for this one, but apparently it is very common for a low grade
appendicitis to present as something in the testicles. Funny.)
Seeing a proctologist, as suggested, is probably not necessary if
you've seen a urologist. Prostate problems can also encourage
testicular pain, but a comptent urologist should be able to check for
that.
This does not sound like testicular cancer, and I'm sure you've been
checked for it, but it's worth the discussion with your doctor if
you've not already had it. Usually testicular cancer presents as a
painless lump, which does not resemble the symptoms you've described.
Please see:
http://www.menweb.org/fdatesti.htm
My personal problem was finally diagnosed by an especially wise
urolgist, and you might consider getting checked for it. The reflex
that causes the testes to rise when cold or the leg is stroked is
called the cremasteric reflex. It ordinarily lets the testicle sit
when it is not invoked, but in my case, it is overactive, and
continually makes it rise and pulls on it. It is rare in adults and
quite painful, but makes sense in some cases, including quite possibly
yours. The only real treatment is pain management and careful care. I
have spoken with surgeons about it, and they have all agreed that
removal of the testicle is not the answer, as the muscles and reflex
remains and it doesn't solve the problem. Please review:
http://www.tiscali.co.uk/lifestyle/healthfitness/menshealth/part1_2-1.html
A novel therapy may be on its way to fix this particular issue- botox
injections to the cremasteric muscle. I'm not particularly excited
about the idea of a neurotoxin being injected there, but if it helps,
all the better.
A word of warning: in my conversations with a close friend who is a
surgeon, there are many issues where there is pain in the testile
that is not traceable to a specific cause. The conventional wisdom is
that it is best in these cases to leave well enough alone- surgery to
attempt to fix these cases can cause more problems than they fix and
often affect other things. If pain management or lidocane pads help,
by all means continue.
I truly feel your pain and hope that you're able to find a good
solution to the problem.
Of course, as the Google disclaimer says:
Answers and comments provided on Google Answers are general
information, and are not intended to substitute for informed
professional medical, psychiatric, psychological, tax, legal,
investment, accounting, or other professional advice. |
