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Urology/epididimytis

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QUESTION: Hi Stephen
Age of 60. No risk of std.
I have had left sided scrotal pain for about 4 weeks.  Dr. has tentative diagnosis of epididimytis.  Low grade fever at night but no day time fever.  
The pain is worse when  I wake and then gradually lessens throughout the day and sometimes disappears in the evening
Ultrasound showed no torsion or obvious enlargement of epididimys. Some evidence  of fluid seen. Tried ofloxacin for 2 days but stopped due to affecting bowels
Question: should I persevere with ofloxacin and tolerate mild diarrhoea?
Is it worth investigating if I have BPH?
Would the symptoms of pain on waking subside after about 3 days of ofloxacin?
Any other thoughts appreciated

ANSWER: Shailesh

Epididymitis is the most likely cause based on your description.  Relief may or may not be seen in a few days.  The longer duration of the problem and the fluid collection may extend trreatment. Call your physician to see about changing your antibiotic.

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

QUESTION: Dear Stephen
I finished the 2 week course of ofloxacin about 2 weeks ago. I still have some discomfort in the left scrotum.  The pain level is about 1 on a scale of 1 to 5. I don't fancy more antibiotics. What is the prognosis and what options are now available to me?
Regards
Shailesh

Answer
Shailesh:

If the problem was epididymitis and it's been treated, then it should continue to slowly improve.  The pain would be expected to gradually diminish; meanwhile it is usually controllable with ibuprofen.  When it is finally healed, the testicle may have some extra lumps or it may be otherwise different than it was before the infection.  There is usually not much that can be done for that.  If the testicle continues to be bothersome without improvement, contact your physician.

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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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