[Question #5064] Epididymitis diagnosed but no cause found yet

26 months ago
Hello again, around 10 months ago i wrote to you guys about my testicular pain, i got it 2 years ago 1 ½ month after i had unprotected sex with a girl at a party, 1 month after the party i got into a relationship with a girl im still with today, i've been struggling with testicular pain, and didnt get diagnosed till October 2018 where it got really swollen, i've been through a lot of tests but nobody can find the cause, the problem is doctors tell me it isnt a STI, but i cant see why i should get it otherwise, im really scared, and my mental health has been really bad for a long time now, like i mentioned in the last post, the reason im back is that i got the diagnose of epididymitis after an Ultrasound, and i told you guys i didnt have the diagnose last time, so you thought it might be something else, i wanna share what i've been tested for

Chlamydia and gono several times negative
Mycoplasma genitalum negative
Mycoplasma hominis negative
ureaplasma came back without answers twice cus there were no bacterias found but couldnt confirm or something like that
Tricho negative
Hiv negative
Syphilis negative

I just cant see why i would get epididymitis 1½ month after unprotected sex and it isnt caused by a STI

right now im kinda in a lot of stress because all of this and the doctors who cant find a reason and has given up on helping me
i have tried antibiotics and it actually worked the 4th time i took it like i mentioned in the last post, but it came back 1 month later on the other testicle
my family doctor and i have talked about trying a 2-3 months antibiotic cycle, but im just scared that it might be a STI and im causing resistance to both me and my girlfriend, after having taken so much antibiotics.

Also this guy wrote to me that he has been through the same thing and it was Chlamydia but he was tested negative several times because of something with the test and told me i should take a DFA test for chlamydia, but its not possible here, and it got me freaking out aswell, i wanna
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
 Welcome back to our forum. I am sorry that your problem continues and that you have not been able to determine what is causing it.  My assessment of your situation however has not changed, this is not a complication of an STI following a sexual exposure about six weeks before it's onset.  It is a coincidence.   Your multiple negative tests for STI's prove this. Currently available STI tests are amongst the most sensitive tests in all of medicine. While I suppose it is possible that one specimen might have missed an infection with multiple tests that is simply just not a realistic possibility.  Further, where this and STI it would be most unusual for the infection to move from one side to the other.  The fact that you may have responded to a recent course of antibiotics is hopeful. This may mean that there is a chronic non-STI infectious process present (not all epididymitis occurs due to STI's),  or that this is not an infectious disease process but a chronic waxing and waning process. 

 I have several additional questions which may give us a clue to what is going on: 
1.   What was the antibiotic that you took and how long were you improved after taking it. 
2.   Although I believe you have seen two urologist who have not provided a satisfactory answer as yet, I believe her urologist may be the answer to your problem. I hesitate to suggest what the urologist might do however one thing that is very helpful in sorting out difficult chronic problems is seeing the same patient repeatedly  over the course of their illness. A second question for the urologist is whether or not the next time your problem flares up a biopsy or other somewhat invasive tests should be done. 

My suspicion is that this is either a very unusual, atypical problem or a very unusual manifestation of a more common process. Either way, the only way to get to the bottom is with repeated examinations with the same healthcare provider who is willing to work with you to sort it out.

 I hope these replies provide some direction for you. This however does not sound at all like an STI. Take care. EWH
26 months ago
Okay, so i have a couple questions i just want you to clarify, since the internet is so unreliable sometimes
is it possible to get/create a STI from having sex with 2 different girls at once (like gardnerella or something)
is it possible something like  that would cause my condition?
what do you think is the chance for this to be contagious and im litterally playing ping pong with my girlfriend when im taking antibiotic?

Sadly the last thing the urologist told me was the last thing they could do for me was a surgery, and they didn't sound to confident on that, which really hit me hard aswell, its messed up to go through this shit for 2 years, also at my age. Like everything has been a question for me for the past 2 years.
Is there anything you would recommend, besides the things you already did ofc.
to the question about the antibiotics, i think i took amoxicillin or levofloxacilin, i can check it out ofc, and it was for 2 weeks for sure.
again thanks for your help, it means the world to me, cus i really need all the help i can get right now
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
1.  Of course its possible to get an STI from having unprotected sex- one girl, two etc.  that however does not change that your tests are negative and antibiotics have made no difference. Gardnerella is a normal bacteria found in the genital area.  It is not a know cause of epididymitis.   Despite the coincidental timing, you need to get over the idea that this is STI-related epididymitis. 
2.  There is no reason for you to think that you are contagious with an STI, ping-ponging with your GF, with or without antibiotics.  
3.  Find our which antibiotic seemed to help. that doesn't change my suggestion no. 4 below but it may be helpful.  
4.  I understand the concern about genital surgery.  Did he say what kind?  A biopsy, other?  I would not let someone operate until I had a second opinion that told me what kind of surgery, for what purpose, etc.  As I hear your history, the salient features are:
A.  Testicular swelling, first one testicle, later the other (I presume symptoms were identical)
B. A list of what antibiotics had been taken, for how long and which ones you seemed to respond to.
C.  A written list of what STD tests were performed (as above) and the results.

T5. The final suggestion might be, depending on where you are working, to go to an Infectious Disease specialist with the same information as listed above.

Hope this helps.  EWH
26 months ago
Thanks for the reply Edward what i meant with the first thing is, if you have sex with a girl and then another one before showering or anything, is there a way you would be able to create a STI like gardnerella or something? that is something that has really been on my mind

Right now i just got Doxyciclin 3 months cycle from my doc, is there anything you would suggest me for getting tested before i start the cycle or should i just jump right into it? like semen analyse, analyse prostata or something? i dont think there is any point of getting more STI tests.

also is it normal that semen seems a bit yellow, just a tiny bit though.

im definetly gonna save your replies and show to the doctors, because your suggestions are really good.

im gonna try to explain the way the surgery works as best as i can. What they wanted to do was move my testicle to somewhere else in the scrotum, because they said there could be pressure on it from where it is positioned now.

I think this is all i wanted to talk about, there is ofc so much and i cant make it all fit and remember everything, but again thank you so much for your help, im so glad you guys do this and it really means a lot what you guys think, cus you been in this business for so many years, and the internet is just full of uncertain things, so its great to be able to come here and get some facts, again thanks for helping me out!
26 months ago
did my thread get lost?
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Thanks for the follow-up- I missed it earlier.  Let me provide replies:

1.  No, going from partner to partner would still not cause symptoms or the sort of problem you describe, given your negative tests for classical STIs.
2.  I agree that there is no reason for more STI tests.  I think a semen analysis might be helpful since if it showed inflammation, while it would not tell you what was causing the inflammation (not all inflammation is due to infection) it would help to direct further evaluation.  Ejaculate color can be quite variable but again, with yellow ejaculate, getting the semen analysis might provide useful information.  I might do this before starting the doxycycline. That way, if there is inflammation, you could then do a follow-up semen analysis to determine if the medication was changing anything.
3.  I am not familiar with this sort of surgery and do not understand how it might help but I am not a urologist.  I would ask for further explanation, either from your urologist or as a second opinion.

thanks for your thanks- I'm sorry I was not more helpful.  As this is my 3rd response, as per Forum guidelines, this thread will be closed later today.  EWH