Posted by Goran on June 29, 1999 at 11:56:31
I am a 37 year old male, about 8 months ago i went to the local emergency room for a severe pain in my left side, as it turns out i was told it could be a kidney stone, blood was detected in my urine and still is as of 1 week ago. i went back to the emergency room last week for the same type pain but on the other side and lower. both times the doctors asked if i had pain in my testicals, i didn't.
over the past few days the pain is so sharp and intense it's unbearable. it started out very sudden and would go away in secounds, now it's more constent and hurts when i walk. it's isolated to my right testical only. the only comfort i have is from sitting. is this somehow part of the kidney stone which i have not passed?
any help you can provide would be very grateful.
Posted by HFHS M.D.-AK on June 29, 1999 at 13:45:08
Dear Goran,
I’m not there to evaluate you and obtain a full history and physical. Yes I would be worried about a kidney stone, but I think the testicular pain also needs to be addressed. A condition known as epididymo-orchitis (infection of the testis and epididimis) could also account for your symptoms. Particularly because you seem to have relief when you sit down. This position effectively elevates and stabilizes the scrotum which is a one of the treatments for swelling and infection in the scrotum. You doctor would also have to consider the outside possibility of spermatocele, varicocele, hydrocele, hernia, or testicular cancer.
To begin with a good physical exam should be able to differential between testicular pathology versus renal colic from a stone. Renal colic is usually associated with acute intense flank pain with nausea and vomiting. There is often blood in the urine although rarely infection. If there was infection, this would be considered an emergency and you would be given antibiotics and be assessed by a urologist. Initially a urine analysis(UA) and culture should be sent to rule out infection. After the UA is done, an ultrasound of the scrotum and kidneys could be performed simultaneously with an X-ray of the abdomen to evaluate both possibilities. If both ultrasound and KUB(X-ray) are completely negative, further evaluation for radiolucent stones may need to be performed. This would involve an IVP.
You mentioned you had hematuria. If the blood in the urine remains after a completely negative work-up, a cystoscopy with IVP and cytology should be performed.
I think you need to be evaluated by a urologist and he or she can start you on the path to recovery.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Testicular pain
