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Groin pain, lump under testicle after sex with escort.

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Hello Doctor,

I am a 27 year old guy, and had sex for the first time with an escort about a month ago, and then 2 more times after that with 2 other girls within a few days later.
The 3 times that I did it, I used a condom properly for oral and vaginal, and never kissed at all. Ever since the first time I did this, I started getting a terrible groin pain on my left side and this happened following the first time, and also pain on my pelvis left side. A few 2-3 weeks later I started getting a terrible ache on my left testicle, and notice a big lump under the left testicle every single morning after I wake up. Now about 4 weeks later, I notice I get the big lump under both of my testicles but only after waking up in the morning. These lumps are inside of the testicle located in the tail of the epididymis. During the rest of the day I don't feel the pointy lumps but do feel like the left testicle shrinks a bit and feel a mild pain that goes to my groin and inner thigh and a bit behind my leg. I would like to add that I also run very long distances, over 2 hours of marathon running, but had to stop due to the pain. I also did some heavy weight training in certain days. I went to get a color doppler ultrasound and the doctor told me I had a level 1 varicocele, a tiny cyst on top and on the bottom of my left testicle only, and no hernias (maybe sports hernia?), also did a general blood and urine test and nothing showed up, I am not sure if those are different from std tests, or is it possible that they could show up there?
I do not feel any burning pain when peeing nor do I have any leaking from my urethra. Could this be related to an STI or STD? could it be a case of chlamydia (maybe Epididymo-orchitis)? or maybe a muscle strain or injury from sex? Could varicocele cause this inflammation?

Any help regarding this is very much appreciated.

Thanks,
Charles

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: HIV- AIDS Specialist
 18 Doctors Online

Hello Charles,
Thank you for your query at DoctorSpring.com
I understand your concern.
Since you used a condom in all 3 cases, the chances of acquiring STI is really low, but your symptoms are suggestive of an epididymo-orchitis, which happens secondary to Chlamydia. The symptoms of groin pain, pain around the pelvis, the swelling in the testicle, are all suggestive of the orchitis, and I will advise you to prophylactically take a course of antibiotic for 2 weeks, and this should come down. Yes, it could be from the varicocele itself, but the sudden appearance of symptoms, can't be explained by varicocele. Moreover, grade 1 varicocele is present in a lot of males in adult population, and it is an incidental finding. Hence, you can talk to your physician and get a prophylactic 2 week antibiotic therapy. A good choice antibiotic here would be Cotrimoxazole ( TMP-SMX ) twice daily for 2 weeks. This will be able to treat the possible Chlamydia infection. Even, if there is no infection, the epididymo-orchitis will settle down with TMP-SMX.
Hope this was helpful,
Feel free to discuss further,
Regards.


Patient replied :

Hello Doc,
Thank you very much for your response, I would like to try this treatment you mentioned (Cotrimoxazole ( TMP-SMX ) twice daily for 2 weeks), but had some questions.
You mentioned to take this twice daily, how much doze in mg? And how long should I wait until taking the second daily doze?
Thanks and regards,
Charles


Hello,
Yes, you can take 500 mg, the standard dose that is available for adults.
And it has to be taken 12 hourly, so 8am-8pm or 9am-9pm should be fine.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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