[Question #10880] Testicle Pain - concern for partner

19 months ago

Pain in my left testicle, chronic, feels like it's burning, causes discomfort. It comes on slowly after ejaculation, remains about an hour or two (first time for 8 hours).

History:

- 7 weeks ago, protected vaginal sex with SW, condom removed and handjob given, no idea of any body fluids on her hand

- 6 weeks ago, protected vaginal sex with SW

- About 4 weeks ago, got a gf and had unprotected sex. She was tested and clean

Last few weeks she had pelvic pain. Did a urine MCS culture test, diagnosed as an UTI, given Cepholexin.

Next day, I felt the pain. Immediate MCS test, all negative. I did an STI test last week (Chl, Gon, HIV, Syp, Hep), everything negative.

Was admitted to hospital to check for testicle torsion, negative. Ultrasound done, nothing found. Prescribed Augmentin.

Currently waiting for Ureaplasma results. MGen test not done yet.

Having high blood pressure, likely due to anxiety. Asked if it was all in my head, but pain is there after ejaculation.

H. Hunter Handsfield, MD

19 months ago

Welcome to the forum. Thank you for your confidence in our services.

However, I really can't help much. No STD causes the kind of pain you describe. Although gonorrhea or chlamydia can cause the testicular infection called epididymitis, that doesn't fit with this kind of pain; and your negative gonorrhea and chlamydia tests are conclusive.

Ureaplasma is harmless. Regardless of what you can find online, it is an entirely normal bacteria in the genital tract, rarely causes disease or symptoms, and positive test results do not require treatment. Mycoplasma genitalium can cause nongonococcal urethritis (NGU), but you describe no symptoms that suggest urethritis; and M gen has not been reported to cause epididymitis, testicular pain, etc. (There are claims to the contrary online, but no science behind such symptoms.) Probably that test result will be negative -- but a positive result will not necessarily explain this problem.

As for your sexual history, you can discount the first two events described. Your new gf's UTI probably is unrelated to any of this: UTIs can be triggered by sex, but it's not an STD and male sex partners of women with UTI are not at risk for any infection.

We are experts in STDs only, not all genital symptoms or infections. Prostatitis or the chronic pelvic pain syndrome (CPPS) are possible, but these are not STDs. However, with sufficiently severe pain to require hospitalization, ultrasound, etc, it seems clear your doctors were genuinely concerned, perhaps about epididymitis, acute prostatitis, etc. However, these things are not necessarily due to infection, and you can rely on the negative STD tests so far and I am confident no STD is responsible. If you are not seeing a urologist, that should be your next move.

Sorry I can't give you conclusive answers, but I hope these comments are helpful. Good luck with it. Let me know if anything isn't clear.

HHH, MD

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19 months ago

Thank you, I appreciate your opinion regardless! I can add symptoms to this.

1-2 weeks after the last encounter:

- Sore throat

- A small, painless, non-itchy, pimple-like bump on the bottom of the palm of my left hand. Mostly gone, no scarring, no ulcer, no crust, the spot is still red and visible, but no longer a bump

3-4 weeks

- GF had reported vaginal discharge once - nothing since and pelvic pain was intermittent, nothing in the last 48 hours

- Noticed something clear in my urine (one time) - looked like oil in my urine, about 2cm, looked clear in yellow urine.

- Never had severe drenched night sweats, but did sweat a few times in my sleep

- Nausea is recurring, could vomit, haven't

- Headaches, but likely due to blood pressure

- Rectum burning

5-6 weeks

- My right knee (since two days ago) is twitching - I can feel a pulsing sensation there.

FYI, HIV test was 4th gen at 36 days, so I should be clear there.

I'm leaning towards your diagnosis - couldn't be Trich either?

19 months ago

Forgot to mention, I do have issues urinating. Frequently need to go, very little comes out.

H. Hunter Handsfield, MD

19 months ago

Thanks for all the additional information. From STD or genitourinary perspectives, I have no concerns about your sore throat, the hand bump, your knee "twitching", or your partner's symptoms. I am confident they are unrelated to your testicular pain problem. However, frequent urination with small volumes could go along with a prostate problem, or seminal vesiculitis. I haven't previously mentioned the last; it's an uncommon problem but one that, with epididymitis or prostatitis, might explain what's going on. It also is not due to STDs, and also is something to discuss with a urologist.

Your symptoms and sexual history don't fit with HIV at all, but indeed your negative antigen-antibody test (4th generation) proves your symptoms are not due to HIV.

All in all, my overall judgement and advice remain the same. I hope you're in the care of a urologist or will be soon.

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