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Epididymitis is a medical condition characterized by inflammation of the epididymis, a curved structure at the back of the testicle. [1] Onset of pain is typically over a day or two. [1] The pain may improve with raising the testicle. [1] Other symptoms may include swelling of the testicle, burning with urination, or frequent urination. [1]
Chronic testicular pain may be caused by injury, infection, surgery, cancer, varicocele, or testicular torsion, and is a possible complication after vasectomy. [2] IgG4-related disease is a more recently identified cause of chronic orchialgia. [4] One author describes the syndromes of chronic testicular pain thus:
Chronic scrotal pain (pain for greater than 3 months) may occur due to a number of underlying conditions. [3] It occurs in 15-19% of men post vasectomy, due to infections such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele, spermatocele, polyarteritis nodosa, testicular torsion, previous surgery and trauma. [3]
Upon a physical examination, they found the scrotum to be enlarged, soft, red and painless. Initial sonographs detected possibility of inflammation of the testis and epididymis. The patient received anti-inflammatory and antibiotic treatment, and was examined again one week after treatment. [13] The testis were still painless and now hardened.
In most cases where orchitis is caused by epididymitis, treatment is an oral antibiotic such as cefalexin or ciprofloxacin until infection clears up. In both causes non-steroidal anti-inflammatory drugs such as naproxen or ibuprofen are recommended to relieve pain.
The cause of post-orgasmic pain determines the course of treatment. Antibiotics and non-steroidal anti-inflammatory medications are prescribed if infectious or inflammatory processes are thought to be the cause. [25] Transurethral seminal vesiculoscopy is the preferred method for treating pain associated with seminal vesicles. [26]
A number of medications can be used which need to be tailored to each person's needs and types of symptoms (according to UPOINTS, S = sexual: e.g. erectile dysfunction, ejaculatory dysfunction, postorgasmic pain). [56] Treatment with antibiotics is controversial. A review from 2019 indicated that antibiotics may reduce symptoms.
Post-vasectomy pain syndrome (PVPS) is a chronic and sometimes debilitating genital pain condition that may develop immediately or several years after vasectomy. [ 1 ] [ 2 ] [ 3 ] Because this condition is a syndrome , there is no single treatment method, therefore efforts focus on mitigating/relieving the individual patient's specific pain.