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Undiagnosed pain in testicle

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Hi - I've been to several doctors but have not gotten a real diagnosis. I've gotten ultrasounds, and MRIs of pelvis and lower spine. I suddenly began feeling pain in testicle region in October 2012 and am still experiencing symptoms. It's mostly on right side but it's hard to locate exactly and I've felt pain on left side too. There is pain when I pat the top part of my right testicle with my hand; the pain occurs exactly where I tap it almost as if it were bruised. Along with the pain, the shaft of my penis became numb. Sensation of the penis shaft has improved but it was very numb for a long time. It's hard to desribe but it took on more of a wirey and numb feeling. Currently, the bottom part of scrotum feels numb. Furthermore, the force of the ejaculation is much, much weaker than it was before all this happened. This is probably the worst symptom. Less fluid comes out and it dribbles instead of shooting. At times, there was no sense of orgasm during ejaculation. Other areas can cause sharp pain if I press hard in the right spot. For example, applying hard pressure to a certain spot in perenium and upper groin will cause sharp pain. Lastly if Im sitting on a hard surface a certain way on my tailbone, sometimes when I stand up there is numb, tingling feeling around tailbone. When I'm standing up and I squeeze upper glutes together, there is pain right all around tailbone area. It almost seems like inflamed nerves and I'm wondering if the tailbone is involved. Thank you.


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hello, Thank you for your query at DoctorSpring.com.

I have noted your complaints and appreciate the detailed account that you have provided.

The nerves involved are mainly in the lower lumbar and sacral region, especially sacral (S2-4) nerves.

The common causes for the involvement of nerves in this region include tumors, infections, vasculitis and injury. Most of these can be seen on routine MRI of spine and pelvis, but contrast injections are required.

Also, detailed nerve conduction studies and electromyography (NCS and EMG) are also helpful.

In terms of treatment, medications such as pregabalin or gabapentin are useful.

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Patient replied :

As per the attached documents, I have gotten 2 pelvic MRIs (one was 3T), and 1 lumbar/sacrum. If I have an issue with S2-S4, will it show up on either of these MRIs, or do I need to get one that focuses on coccyx? I researched and am worried about chordoma, or some other pinched nerve around coccyx. Thank you.


Expert:  Dr. Sudhir Kumar replied 3 Days.

Thank you for getting back.

These problems would have been seen on the 3 tesla MRI, however, the radiologist reviewing the MRI should be told about the clinical picture and also what to look for in the MRI, as these symptoms are uncommon and we commonly do not look at sacrum or coccyx region. So, it would be better to get a second opinion from a radiologist after mentioning all the details. Also, the MRI should be done with contrast injection.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)


Patient replied :

The MRI on back said "L4-L5: there is disc bulge and right foraminal herniation. There is bilateral foraminal impingement more prominent on the right than on the left. There is no thecal sag impingment." Also, MRI of pelvis said there is nonspeciifc fluid in the deep pelvis of unclear etiology. Can you please help understand these findings. Thank you.


Expert:  Dr. Sudhir Kumar replied 2 Days.

Thank you for sending the MRI reports.

L4-5 disc bulge means there is slipped disc at that level (lower back), causing minor compression or pinching of nerve at that level. This is a minor abnormality and generally would improve with pregabalin capsules and physiotherapy.

Non-specific fluid in deep pelvis could mean a local infection there, or it could also be due to inflammation. It would require further evaluation including clinical examination and repeat MRI with contrast if necessary.

I hope it helps.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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