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From: B. Harris)
Subject: Re: Testicular Pain
Date: 29 Apr 1998 03:39:11 GMT

In <> (User)

>After an examination (incl. prostate check), testicular torsion was
>ruled out and epdidymitis diagnosed as the likely culprit. After a
>course of antibiotics, the pain disappeared within days.  I have been
>ok since then, until two days ago, when the pain started again, but
>not as strong.
>I'm wondering whether re-occurrance is frequent, or if there could be
>other causes.

    Re-occurance is frequent.  Since some of these infections are
sexually transmitted (not all), re-infection happens frequently, also.
In general, the longer you let it go without treatment, the harder it
is to treat and finally kill, since ongoing infection causes damage
which creates places for microbes to escape white cells and
antibiotics.   Also, the more times you treat unsuccessfully, the
harder it is to kill, since you have the chance of creating a resistant
bug to whatever antibiotic you're taking, each day you treat.  Thus,
like prostatitis, get epididymitis early, or take the consequences.
It's reasonable to use several antibiotics at once.  You should attempt
to culture your semen.

   If you get nothing, there are many possible combinations for
something you have not been able to culture (but which you're fairly
sure is infectious, which you are, from your history).  Depending on
your sexual history, of course.  A reasonable choice for a possibly
sexually transmitted organism would be minocycline and azithromycin
(Zithromax) together, for at least 3 weeks.  Your doc may have other
ideas (perhaps better ones), but do tell him/her that:

1) Cost is no object
2) You will do whatever regimen is suggested, not complain at number of
pills or duration of time, and you want the conservative max treatment
this time.   You need to treat for some time (at least a week) after
ALL symptoms are gone.

>>I will seek GP advice if pain persists,

   Seek it now.

                                 Steve Harris, M.D.

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