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General Surgery/Hernia detection

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Question
Hi,

I'm a 63 year old male with a long history of abacterial prostatitis. About 3 months ago I did an enormous amount of lifting over a 3 week period while moving our household. Several weeks later I slowly began to feel strong discomfort in my right testicle, as if it was being squeezed. At that time the cremaster muscle was occasionally flexing, like it wanted to lift - or needed to be supported. I found some relief lying down. So I went to a very experienced family physician, believing I had a possible hernia. The doctor palpitated and checked very carefully for hernia, but could find nothing but the sensitivity. He gave me doxycyclene in case it was an infection and I made an app't for a physical 4 weeks later. By now the symptoms had eased about 40%. He examined again and because of more localized sensitivity diagnosed epidiymo-orchitis. I then went on 4 weeks of Cipro. I continued to slowly get better, but at one point I felt aching in the epidymis and some lower ab pain. Now that aspect has resolved, and that cremaster twitching has gone away. I would say that I am at least 90% better. However, I am still experiencing some sensitivity when walking or crouching. Symptoms also bother me a little more when I am tired, or when I get out of a hot tub (which I do to help the prostatitis). At those times I use ice packs to firm things up, so to speak...and that invariably helps. The symptoms I have are mild, but annoying and anxiety producing. It does feel a little better when I lay down, but I thought that might be because nothing is rubbing, as in walking, etc. Can you tell me please if you think this is a possible hernia that the doctor could not feel? If so, how could it have improved so much - and is there any reason to believe it won't continue to improve? I have some issues with us switching insurance within the next 45 days, so I prefer not to incur multiple co-pays if this requires lengthy investigation. So I especially appreciate your advice at this time. What I am wondering is if this is some reflex or abacterial prostatitis triggered by the lifting, and referring variable discomfort to the testicle. Or does it perhaps sound like a hernia that can only be detected...how? Thank you so much for your time and expertise.

Answer
Dear Sam,

Have you had an ultrasound, a rectal examination, or a CAT scan? There are many things that this could be. However, hernia would be at the top of my list of differentials. It is unclear if the symptoms subsided because of the antibiotics or rest. If you can collaborate on the tests that you've already had, I will be able to give you a better idea of what I think this may be.

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Dr. Pamela M. Cipriano, DNP, ACNP-BC

Expertise

GENERAL SURGERY Intestinal obstructions; Perforations; Ostomy; End ileostomy; Hemicolectomy; Take down ileostomy; Ostomy reversals; Diverticulitis; Chrohns Disease; Appendectomy; Cholecystectomy (gallbladder); Ventral hernia repair; Inguinal hernia repair; Umbilical hernia repair; Chest tubes; Pleurex catheters; Lobe-ectomy; Pneumonectomy; Thoracotomy; Pleuradesis; Thyroid surgery; Mastectomy; Lumpectomy LAPAROSCOPIC - LAPAROTOMY - LAPAROSCOPIC ASSISTED

Experience

My name is Dr. Cipriano. I am a Hospitalist on the Medical Staff. I round, admit, discharge, consult and assist with surgeries in the OR. I manage patients in the ICU and Med/Surg floors. I also work in the emergency department. I am certified critical care nurse (CCRN). And ACLS certified. I

Organizations
Society of Hospital Medicine American College of Nurse Practitioners Connecticut Advance Practice Registered Nurse Society

Education/Credentials
Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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