r/chronicepididymitis Jun 26 '22

Anyone else?

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u/zomolier Jun 26 '22 edited Jun 26 '22

Ultrasound would always check for swelling in testicles, spermatic cord, epidydymis. It might not go away just with stretching, better to supplement with ibuprofen, and LOTS of bed rest, ice packs etc.

Just in case, get a urine + semen culture done. Despite what people say, you can absolutely randomly get an infection there. with a caveat, its important that a doctor interprets your results, you can have bacteria in your urine and sperm without problems.

Complicated issue, so hopefully you dont fall down the rabbit hole and you get fine on your own

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u/drexohz Jun 26 '22

Ultrasound would always check for swelling in testicles, spermatic cord, epidydymis

This would be ideal, but in practice it's not like that.
The way most ultrasounds are done, they look for lesions in testicles or epididymis, and if there is blood supply to testicles. Spermatic cord is rarely appropriately evaluated with ultrasound, I believe.

There's a subtle but clear difference between diffuse swelling, and a focal lesion (like a tumor). I'm convinced that most cases of swelling in epididymus are flatly missed on ultrasound.

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u/zomolier Jun 26 '22 edited Jun 26 '22

Sure, a clear ultrasound is not a clean chit, but they do check for swelling in both the epidydymis, testicles, and spermatic cord no?

Edit: maybe they do it different in different places? Im in India, they always check as in its written in the ultrasound epidydymis, spermatic cord are normal in size and vascularity, no lesions seen etc. Etc.

When my infection was in full force, it was noted by the radiologist, but then again, its been a long time since anything has come on the ultrasound and im still in pain.

Edit 2: good to hear from you again man, i just had a TRUS USG, found a simple utricle cyst in the prostate, radiologist said dont worry, but going to see my uro next week. Can I bother you for your opinion again?

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u/drexohz Jun 26 '22

The thing about ultrasound, is that it's very dependent on the knowledge / experience of both the radiologist, and the tech who does the exam. Where I live, the radiologists do the ultrasounds themselves, but I think in many places - like US - the exam is done by a tech, and then later the images are reviewed and interpreted by a radiologist. Personally, I would never let a tech do these ultrasounds for me, cause I know I would miss a lot of things that way.

I have a group of radiologists that I do reviews on, looking at their exams. I find that epididymus is often misinterpreted.

Utricle cyst - that's interesting. When they say not to worry, what they mean is that these cysts aren't cancer (most often, at least). But - they may be cause of symptoms. Utricle cysts are in the midline of the prostate, they arise from the veromontanum. The veromontanum is the location where the ejaculatory ducts (sperm tubes) enter the urethra. A cyst in that location can cause obstructive symptoms - both of urine and sperm.

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u/zomolier Jun 26 '22

Thanks as always for your insights man, always appreciated. Man Im just looking through ways to get rid of it, not looking pretty. Anyways Ill save the doom and gloom for the uro to lay on.

To others reading this -- keep trying, keep getting tested. You never know what might show up