Hello, I'm 43 and I've been having multiple sources of pain, but I'm unsure of where to go from here. I'm going to explain my current pains first, and then my history with these pains.
1) I have a left dull ache (slight pressure feeling) on the left side of my scrotum. I'm not sure if it's coming from within my scrotum, my testicle or my abdomen. I think it's probably coming from within my scrotum, possibly an ejaculatory tube. This started two months ago in conjunction with left testicle pain I was having. I saw my primary doctor for the testicle pain, he thought it was Epididymitis. He gave me a two week course of Cipro and it went away. However, the dull ache on the left side has continued off and on. Ejaculation, and even arousal, triggers the pain, and the pain lasts for daysand dissipates each day until I ejaculate again. I ejaculate about two days a week. This has been going on for two months.
2) I have pelvic pain across my pelvis which I would describe as a dull cramping feeling. The pain comes and goes, and is usually accompanied by more frequent urgency to urinate. This pelvic pain started about four months ago, two months before the testicle pain episode and scrotum episode. When I first saw my primary doctor about it, it was also accompanied with loose stools. I feel that when I'm less stressed, the pain is much less. It seems to have gone away several times, only to return. My primary doctor did a urinalysis, bloodwork, digital rectal exam, hernia check and testicular ultrasound. The urinalysis showed no signs of an infection, the dre showed no signs of an enlarged prostate, and no signs of hernia. The ultrasound showed a few hydrocells, an epididymal cyst and no masses. Basically, he said everything looked good. When I told him I was still having the left side scrotal ache, he referred me to a urologist, which I haven't seen yet.
1) Twelve years ago I had an inguinal hernia repair with mesh on the left side. (seven years before that I had one was as well on the same side, but without mesh). The first 14 months after my surgery, I had the exact same pain on the left side of my scrotum, which was also triggered by ejaculation. Since that first year, I usually get at least one or two flareups of pain per year whenever I do something different, like lift something heavier than normal, and the pain can last anywhere from a week to 4 months. However, since the end of that first year post-op, the pain has been triggered by straining/lifting, not ejaculation. It's the same pain I'm feeling now, just with a different trigger.
2) Ten years ago I was diagnosed with chronic prostatitis by a urologist. Initially, the pain was a pressure/ache in my perineum, as well as a stinging feeling in the tip of my urethra. Ejaculation was also a trigger when this was at it's worst. Several courses of antibiotics solved the issue, but I occasionally get flare ups if I eat too many peppers or other spicy food. But for the most part, I've had it under control. And it's important to note, the pain associated with my prostatitis flare ups feel NOTHING at all like my current pains.
So this is where I stand. I feel like my left side scrotal pain may be related to the old hernia repair, however I've never had testicle pain associate with it like I did a couple of months ago. And ejaculation hasn't been a trigger for the hernia-repair pain for many years, just the first year of post-op. The pelvic pain I feel could be stress related, as my work as been a little more stressful, but the urinalysis did not show anything as far as infection.
My questions are these:
1) What different conditions could I be facing here? I will see a doctor eventually, but I'm trying to educate myself first as to the possibilities.
2) What types of tests might I encounter going forward? I've read about cystoscopy and to be quite honest it makes me very nervous and reluctant to race to the doctor.
3) Could this be related to the old hernia repair, possible nerve entrapment getting worse?
4) What type of doctor should I see?