Urology/Follow Up- Dislocated Testicle Pain / Delayed Ejaculation
QUESTION: Greetings Dr. Leslie:
I am 46 years old. When I was 7 years old, my bigger cousin kicked me the scrotum so hard that both of my testes were dislocated. The doctor managed to get the left one part of the way back down. However, the cord was "hung up" so it hangs very high. He was not able to get the right one to move and it is still in the upper groin / lower abdomen area. The doctor also said that I would probably never be able to have children. I have always had some sexual dysfunction that is attributed to this. I've had DE since I hit puberty, which I did not do until I was almost 16. I got married when I was 17 and besides the DE, I had no other problems. Whether alone or with my wife it has always taken at least an hour to climax. After 8 years we did have a daughter. I have some nerve damage caused by a botched hip surgery, where they went through the groin. This made the DE worse. Since the surgery 19 years ago, I have had both intermittent ED problems & DE problems. Due to the numbness I have not been able to climax during intercourse, for many years. Then this past year it started to get to the point where, much of the time, I could not reach climax at all, whether alone or with my wife. We would just give up. This would cause a great deal of testicular pain & pain in the lower abdomen, just above the base of the penis. The times that I climax, the ejaculation is very week. The semen just oozes out & there is very little of it, maybe a spot about the size of a nickle or quarter. I have testicular pain and penile pain, similar to being cathed, when I ejaculate. Last fall I went to the doctor because I was having some other problems. They discovered I have "Low T". Since then, the right dislocated testicle has developed a continual pain and anytime ANY pressure is applied to it, I about go through the roof. It seems like my cats & dog always have to step there when they get in my lap. I have also noticed, what may be, some prostate issues. For about the same time period, I have had problems starting a urine stream, then it's weak, and I often feel like I have to go when I don't or can't. I have also seen in some articles on the internet, that the ejaculation problems may be, at least partially, due to the prostate.
I am getting concerned because I have had 3 cousins that had prostate &/or testicular cancer. I have also had 5 uncles that had prostate cancer. I don't know if this is just coincidence or there is a possibility that our genetic line is more susceptible to these cancers.
Do you have any suggestions.
Is this anything to be truly concerned about.
My wife thinks it is no big deal, except for the DE.
She said that she doesn't like making love anymore because I almost always just tire her out.
It's causing some major marital problems.
Any information or suggestions you can give would be appreciated.
Suggestions are easy. Consult with a local urologist. You may be better off without the testicle that is causing pain. If there is significantly low testosterone, then a supplement can be tried.
Delayed ejaculation is usually due to medications but can also be caused by other problems, usually psychological. The exact cause in your case is unclear from the available information provided.
---------- FOLLOW-UP ----------
QUESTION: Hello Again Dr. Leslie:
I have a few follow up questions, regarding my male system dysfunctions.
You stated, "Delayed ejaculation is usually due to medications but can also be caused by other problems, usually psychological."
However, I had some DE problems long before I was on ANY Medications.
As I stated, one of the main causes is nerve damage. I do not know what "psychological problems" I would have. As I stated, I had this problem from puberty, which I believe was a result of the severe injury of getting kicked. That probably damaged more than my testes. Then it got worse after the 1995 Hip Surgery when I got major nerve damage, which has caused very limited penile sensations.
I thought that a quick rundown of my health history regarding these problems would be of some use when answering my question.
I guess I could have been more direct as to my actual question, so
here it is.
Are these symptoms:
1)intermittent ED problems & DE problems;
2)much of the time, I can not reach climax at all;
3)a great deal of testicular pain & pain in the lower abdomen, just above the base of the penis, when I can not reach climax;
4)When I climax, the ejaculation is very week;
5)the amount of ejaculate is very small;
6)testicular pain and penile pain, similar to being cathed, when I ejaculate;
7)Low Testosterone Level
8)The right, dislocated testicle has developed a continual pain and very severe pain, anytime ANY pressure is applied to it, even just moderate touch;
9)problems starting a urine stream;
10)weak urine stream;
11)I often feel like I have to go when I don't or can't.
typical to Testicular &/or Prostate Cancer?
There is another significant health incident that I did not mention, in the first message, because I was trying to keep it as short as possible. I had a moderate stroke in July 2009, then a couple minor strokes in April & September 2013. I have lost some use of my right side, due to these strokes.
The reason I contacted you, is because, at this time, I DO NOT HAVE MONEY TO SEE A DOCTOR.
I have not been able to work since I had the first stroke. I am in the process of applying for Social Security. I applied a year ago and my advocate said that it will be, at least, another year (spring 2015) before the SS makes a final decision on my case. So at this time I have no money of my own. We are living on my wife's income. We also have a daughter in college. So there is just not enough money to cover everything.
If you could just give me a short little answer to the question, "Are the symptoms, listed above, typical to Prostate &/or Testicular Cancer?"
Another reason that I am apprehensive about going to a Urologist, in person, is the tests. I have heard of some real unpleasant tests that are done.
As a Urologist, can you tell me what tests would normally be done, to help determine what is causing the symptoms listed above?
Your symptoms are not suggestive of either testicular cancer nor prostate cancer. However, your strokes may be contributing.
I cannot give you a list of tests as that would be inappropriate and potentially cause you more anxiety. I don't consider any of the testing we do in urology to be any worse than mildly uncomfortable or mild discomfort; nothing in our testing is usually all that terrible.
This forum was never intended to be a substitute for a physician's visit. In the US there are free clinics and university centers that will see indigent patients. If your financial situation is severe, you may qualify for assistance. I would urge you to seek appropriate medical help.