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Urology/Epididymitis, success rate etc


QUESTION: Hey doc, earlier this week I had to go into the ER and get a testicular ultrasound because my testes were so warm, swollen, and sore. The doctor diagnosed me with epididymitis. The problem ha already been occurring for a week and I was given doxycycline which had not helped in 8 days, I am now on both doxy and levoflaxin but if I walk around at all during the day my testes feel heavy and painful and inflamed. I've read that the only treatment is anti inflammatories ad antibiotics. I'm 19 if that's relevant, no stds, no known bacteria in the urine samples I've taken. Is epididymitis easy to get rid of completely or is this something I might have to adjust to living with. Also, if the bacteria cannot be killed or whatever is causing this cannot be fixed... Is surgery to remove the epididymis relatively successful in rendering these problems obsolete?

The predicament has gotten to the point where I had to quit sports, my job which includes strenuous activity, even going out with friends. I had a new sexual encounter with a female, protected, just days before the onset of symptoms... But no std has been found.

ANSWER: Concerned:

Epididymitis can be difficult to treat.  Even after the bacteria are dead fromt he antibiotics, the inflammation remains and can take a long time to heal, sometimes weeks or even months.  The best initial treatment is ice to slow the inflammation but it sounds like you are beyond that stage now.

Surgery is only done in extreme cases. You are on the correct medications and have to give it some time to work.

---------- FOLLOW-UP ----------

QUESTION: I was able to get into to a URO, he told me my testicles were normal, and my prostate felt normal and didn't hurt upon examination. He told me I probably had epididymitis and since I'm young and healthy it's of no concern... but he wouldn't diagnose me and dismissed the fact that my testicles were extremely red and warm. He told me I should start playing basketball or running even with the pain as it will be "good for me." He said in a few months epididymitis "will be gone if that's what you have." Should I be concerned that he wasn't interested in knowing what's causing this?

If the antibiotics do not resolve my pain over the next few weeks to months, what are the next steps you would recommend to resolve this issue and what tests are best to pinpoint what's causing these problems. It's quite painful at this point, I've stopped taking hydrocodones and I'm trying relaxation techniques, warm baths, and ice. Just trying to have a solid plan for treatment.


This forum is not intended to give specific treatment or diagnostic advice; just answer general questions.  If you do not agree with the assessment of your urologist, I would suggest you get a second opinion.  In general, if the scrotum appears red and warm, ice and cold would usually be the logical treatment.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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