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Urology/testicular pain, swelling, and discoloration

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Question
My boyfriend and I had sex several times over a three day period in which he did not have an orgasm. He noticed that he seemed to have blue balls after this, but since then, his testicles have not been right. This was about a month ago, and since then, he has been to the emergency room twice. The first time he went, they told him he had epiditimytis, but all the tests they did for possible causes (gonherea, chlamidya, etc) came back negative, and the antibiotics he was prescribed, did not solve the problem. He, therefore, went back a second time when they did urine and blood tests, and still nothing was found other than casts in his urine, but when the kidneys were checked, everything came back normal on that as well. The doctor told him that nothing noticable was wrong, and to go buy some briefs underwear instead of wearing boxers. It has been about a month now, since the first problem was noticed, and now every time he gets an erection, his testicles draw up and his scrotum will turn almost black and look like dead skin, like a prune. Also, his testes will move around in all different wierd places, sometimes even above the penis into his lower abdomen, being completely out of the scrotum. His right one seems larger than the left one, but its hard to tell if it is actually swollen or if there is fluid built up around it. He feels moderate pain in his testicles off and on throughout the day, and quite severe pain for a short period of time, after ejaculation. These are the main symptoms that I can remember right now. Can somebody please tell me what's going on!!!????

Answer
Michelle:

First, he should probably see a urologist for a more definitive answer.  he may need a scrotal ultrasound.  I doubt that having sex without an orgasm would cause all of these problems.

He could have prostitis which would explain many of these symptoms, such as pain after ejacluation,but not all.

I cannot explain the discoloration or testicular movement inside the scrotum. This is usually controlled by the gubernaculum (fixed tissue that acts like a ligament to hold the testicle to the inside of the scrotum) and the cremasteric muscle that helps move the testicle in response to temperature so it's tighter when the temperature is cold.

For now, he can try hot sitz baths.  These often help and won't hurt anything.

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Stephen W. Leslie, MD

Expertise

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

Experience

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.

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

Publications
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.

Education/Credentials
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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