Hello,
Thank you for your consult at DoctorSpring.com.
Ibuprofen shall not help to decrease the size of cysts. However, it can certainly reduce the inflammation, reduce the pain and thus improve your symptoms for a considerable duration of time. You should continue yourself on ibuprofen.
Surgery for such small cysts is not desirable. There is a good possibility that the pain shall persist even after the surgery. I want you to use scrotal support and start yourself on amitryptline under the care of your doctor. Surgery for epididymal cysts should be earned. If your pain does not subside even after all conservative measures then only you should consider surgery as an option.
Hope this helps, please feel free to discuss further.
Take care
Sincerely
Dr Rajiv Goel
MS (AIIMS), MCh (AIIMS), DNB ( Uro)
Fellow, Urooncology and Robotic urology, Australia
Fellow, Laparoscopic urology, Germany
Consultant Urologist
Patient replied :
Thank you, Dr. Goel! Following-up on your advice, I'm concerned about high dose Ibuprofen due to stomach bleeding, stroke, and heart-attack risks. I also have a remote medical history of colitis, in remission. What Ibuprofen regimen (or alternative anti-inflammatory regimen) would you recommend on a permanent basis?
Given that Amitriptyline is an anti-depressant, can you tell me what you hope this might ultimately achieve in combination with continued Ibuprofen?
Can you explain why there is so much "back and forth" with the mildly recurrent pain, from one testicle to the other? This sensation makes me wonder whether a bacterial infection of some kind has not been properly ruled out. Perhaps that's wishful thinking on my part, as I dream of an easy fix. That said, I am a monogamous man in a 6 year marriage with no STDs.
If I follow all suggested conservative measures, how likely is it that my pain will ever dissipate to the point I can have a normal sex-life, and what kind of timeline do you think I can expect?
Going on a long plane trip to Malaysia (wife's homeland) in mid-December. Worried about prolonged sitting on a flight.
Thanks again for your thoughtful reply,
Paul
Hello,
You should take ibuprofen or 5-7 days and such short duration of ibuprofen shall not cause you any major side effects or the remission of your ulcerative colitis.
Amytriptyline is an antidepressant but it is a neuromodulator also working at the level of spinal cord and improves a lot of unexplained pains and is one of the proven and efficacious methods of controlling the pain.
I believe that your urologist has not done your prostate examination. Kindly get per rectal examination to rule out prostatitis. Kindly rule out prostatitis as prostatitis patients also can experience similar symptoms and the treatment is entirely different. You don't seem to have STD's; stop worrying about them.
With conservative measures the symptoms usually settle in 1-2 weeks and I believe you shall be in position to travel to Malaysia.
My apologies for the exceptional delay with the reply, Take care.
Sincerely