[Question #8270] Unknown Testicle Discomfort

46 months ago

Hi Doctors, I’ve asked several questions a month ago, and it is solved now. This thread has nothing related to the previous event I experienced. Not sure is it appropriate to ask here (Sorry if it’s not, just delete the thread if it’s not appropriate). I’m quite lost now and doesn’t know where I can get my problem solved, even after I visit my urologist

I’ve been experiencing unknown testicle discomfort for a week, i can’t say it’s “testicle pain”, but discomfort, a weird feeling or maybe “stretching or falling” feel on my left testicle. I visit an urologist 2 days ago and had my testicle ultrasound done yesterday, results came out everything normal, no any inflammation or swelling.

He also order another ultrasound today for my urination system. Which the result also came out everything normal, no kidney stones, bladder and prostate both normal in size and no inflammation.

This is driving me crazy, it’s been a week now, and the discomfort continues like every minute and seconds throughout the day. Not sure what else I can do, seems like I’ve ruled out every possibility.

Now I’m thinking would it be any gonorrhea or chlamydia issue? As you may know from my previous thread, I haven’t had sex in a while, the only “sexual activity” I’ve involved were someone giving me a handjob, not sure will this cause any STIs. But I got no other symptoms, nothing coming out from my penile and no any urinating discomfort. Please help me on this issue. Many thanks to all.

Again, sorry for asking wrong questions in this forum, please just delete and ignore this thread if it’s inappropriate. Thank you.

H. Hunter Handsfield, MD

46 months ago

Welcome back and thanks for your continued confidence in our services.

This sort of testicular discomfort isn't due to any STI. The only STI problem that causes testicular pain is epididymitis resulting from gonorrhea or chlamydia ascending into the testicle. This results in enlargement, pain, and tenderness almost always involving only one testicle, not both; and the pain typically is quite severe. (Sometimes the diagnosis can be suspected just by watching a guy checking in to the clinic, before any other interaction -- because of how they walk, protecting the inflamed and very tender testicle.) In addition, sexually acquired epididymitis usually is accompanied by obvious urethritis, i.e. urethral discharge and often painful urination which usually precede the testicular pain by several days or even weeks; it occurs mostly in men who ignore their urethral symptoms too long, giving time for the infection to spread upward to the testicle. On top of all this, there seems no realistic possibility that you have gonorrhea or chlamydia. You are correct that the massage experience that created your previous concerns about HIV is not a risk for gonorrhea, chlamydia, or any other urethral infection.

You did the right thing by seeing a urologist, and it sounds like you had a proper evaluation for most or all medical conditions that can cause such pain. But did the urologist discuss psychological factors with you? Genitally focused anxiety certainly could be responsible, perhaps especially so in view of the anxieties on display during your three recent forum threads before now. Symptoms like yours are common in men who are anxious about or regret a sexual event. I'm not a big believer in anxiety creating pain or other symptoms, but it certainly can magnify trivial symptoms or even normal body sensations that otherwise would be ignored or not even noticed.

A variation on this is called chronic pelvic pain syndrome, or CPPS (which used to be called "nonspecific prostatitis", although the prostate gland isn't necessarily involved). Google CPPS (spell it out) and see if it fits your experience. The wikipedia article is quite good, and there's also excellent information from the Stanford University department of urology. The pain mechanism in CPPS is believed to be increased pelvic muscle tension, in the same manner that many headaches result from scalp muscle tension due to stress, anxiety, etc. And the pain can involve primarily the testicles, as well as other areas, such as the lower abdomen, rectum, etc. Most urologists are very familiar with CPPS and genitally focused anxiety, and I'm a bit surprised your urologist didn't bring it up. In addition to online investigation, I suggest you ask your urologist about it.

In any case, you certainly can put aside any concerns about STIs. I hope these comments are helpful. Good luck.

HHH, MD

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46 months ago

Hi Dr. Handsfield, again, thanks for your detailed, patience reply. Really learned a lot each time from all your replies. Yeh, I just looked up CPPS on google, but not sure will this be the main issue (I understand anxiety can cause many problems on your body, but linking testicle discomfort to anxiety, umm…. Weird. I mean I understand that this might be a possible issue, but just weird loll).

Forgot to state that I’ve caught the Ureaplasma parvum 3 years ago, but not sure did I really clear the bacteria, since I did not retest for ureaplasma parvum after taking the antibiotics given from doctor. If I did not clear it up, will this be an issue that causes my testicle discomfort?

Other than that, I’ve also experienced foamy urine for years. Every time I urinate it’s just full of lots of bubble (like soap), and takes a long time to clear all bubbles away (sometimes just doesn’t). Due to this issue, Ive regular check ups (around 1 per 2 months) on urine tests, microalbumin/creatinine ratio test and kidney function tests. Every time it comes up normal, negative on protein and blood (I remember a Trace happens once in protein, but it got negative the next time I test), no red blood cells. ACR ratio are good, my blood creatinine moves around 80-87. I also did one 24hours urine protein test last year, of course it came out in normal result.

Then I looked up on google, saying that STIs could cause foamy urine, not sure is this true too?

H. Hunter Handsfield, MD

46 months ago

You're way overthinking all this. And you're focusing on irrelevancies. U. parvum is an entirely normal bacteria in the genital tract. You didn't "catch" it; you probably had it for years. It causes no disease and should be disregarded entirely.

There is nothing abnormal about foamy urine. What outlandish website said it's something to worry about? It is not. And for sure it doesn't suggest any STI, regardless of what a random google search said. Anybody can write anything they want on the web, and no scientifically reliable source ever said such a thing.

Suck it up and move on.

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