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Urology/Second Opinion on Testicular Pain?


Hello.  I am trying to determine if I should get a second opinion on this condition. Three months ago felt a "snap" in my scrotum, right side, while weight lifting. A swollen feeling began that night and a burning pain on the back of the scrotum, right side, began in several days. Visited urgent care and was diagnosed as groin strain. No antibiotics prescribed...just RICE. Pain and swelling continued, including radiated pain to abdomen. 4 weeks later, visited urologist and was diagnosed as epididymitis. Since that time (now eight weeks ago) have been on three antibiotics...doxycycline, bactrim, and now cefdinir (two weeks on this latest AB, condition not improving). Condition continues to flare up on occasion. Urologist manual exams (3) always indicate very localized sensitivity on the epididymis. Ultrasound indicated no tumors but a hydrocele on the left testicle (pre-existing) and an incidental cyst on the right. Urologist is advising patience and minimal physical activity. He is reluctant to prescribe ofloxacin or similar AB due to chance of tendon rupture as I am a long distance runner. Am wondering if a second opinion is warranted to see if there are any other possible treatment options including different ABs. Thanks.

Tom ,
The urologist is most likely on target but lacking one remedy I recommend a cox 2 anti-inflammation drug to reduce swelling and subsequent pain/tenderness.. Call the office and ask if they can please call in Celebrex or Mobic 1X day, you have non-bacterial trauma induced epididymis you may say you spoke to someone at Baylor Urology in Houston and this was the recommendation I can not do that as I am not your treating practitioner but I can not see why you would be told no. This is protocol in our clinic bc all the ABX in the world will do nothing more if no bacteria is present. 30 days at least and you should see good improvement. I hope you have a speedy recovery.  


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Thomas A Suppe RDMS CLT


Invervential urologic radiology , urologic laser surgery, cryotherapy of the prostate and kidney, extracorporal shockwave lithotripsy, holmium laser lithotripsy, urodynamics (video-non video),male infertility, erectile dysfunction, Peyronies disease, hypogonadism ,kidney stones, prostate cancer detection, BPH, voiding dysfunction, bladder cancer and continent diversions.


For the past 20 years performing intervential and diagnostic uro-radiology for a multitude of urologic surgeons from New York, New Jersey, Lousianna and Texas. Founder of DMS medical LLC introducing the Texas Medical Center to the first high power Green Light laser for the treatment of BPH just after its release by the FDA from Laserscope and its sucessful trials at the Mayo Clinc.

American Registery of Diagnostic Medical Sonographers (ARDMS), American Urologic Assocoation (AUA), American Medical Systems (AMS) Laserscope,Oncura, Allergan and Auxilliam pharmaceuticals.

Comprehention of Urologic Ultrasonography for the Resident Physician (Journal of Urology 2012), Author of the syllabus for the uro-radiology residency course at The Scott Dept of Urology at Baylor College of Medicine Houston Texas (2010 to present). Past Clinical Studies: Principal radiology investigator Allergan Inc for "The treatment of BPH with intra-prostatic injections of Botox" with Larry I Lipshultz MD 2011-2012, principal radiology investigator for Allergan Inc for "The treatment of Peyronies disease by intra-lesional penile injections of Botox" with Mohit Khera MD MBA MPH (2011-2012). Current studies: Principal investigator of "Blood pressure risk factors of intra cavernosal injections of Trimix and PGE1 during Penile Duplex's.

BS from Ramapo College of NJ, Registered diagnostic medical sonographer with the ARDMS, 2 year fellowship of Uro-Radiology and intervential sonography at Baylor College of Medicine Houston TX, laser safty officer in state of Texas and certified in KTP, Holmium and Lithium Tri-boride laser systems from Laserscope San Jose, California and American Medical Systems Minnatonka Minnasota, trained and certified by Oncura Inc Isreal in ultrasound guided argon cryotherapy of the prostate and kidney.

Awards and Honors
Honorary instructor of GU ultrasound course 2012 international meeting of the American Urologic Association. Author of the the AUA course for "Ultrasonography of the Testes and Scrotum" 2012.

Past/Present Clients
Baylor College of Medicine (BCM) Lousianna State University (LSU), LSU Medical Center Shreeveport LA, The Methodist Hospital Houston Texas, St Lukes Episcopal Hospital Houston Texas, Memorial Herman Health Systems Houston Texas, Palestine RMC Texas, Doctors Regional Hospital Corpus Christi Texas, Valverde Regional Medical Center DelRio Texas, Current instructor/technologist for two internationally recognized urologists : Larry I Lipshultz MD and Mohit Khera MD, MBA, MPH at Baylor College of Medicine. I served as intervential sonography consultant for Oncura Inc cryotherapy systems. Former lead trainer for Urosource mobile medical services , training new surgeons in PVP or photo-selective vaporization of the prostate for BPH, BNCs and urethral stricture vaporization.

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