DH - pain and problems in sensitive areas

[ConsummoAmorNonBellum]

This is a sensitive topic, but I'd really like some advice, so I'm just going to be blunt and hope no one is offended.

My husband has been experiencing testicular pain for several months now. He says it feels as if something may have "let go" inside the scrotum, and he tells me "they're hanging lower than they used to." He's only 38 -- they shouldn't be hanging that low quite yet!   He can't wear boxers anymore, and requires the support of briefs just to be able to function. It's physically painful for him to be nude at all anymore; even in the bathroom or bedroom, he has to keep his underwear all the time except in the shower.

The other thing (and this is even more sensitive) is that after our "bedroom time," he gets penile pain. Not chafing or anything; more like the muscle itself hurts.  This is accompanied by a certain amount of erectile dysfunction (it doesn't get very hard, and doesn't stay erect for very long) during the "bedroom time."

We won't have medical insurance for another two months, and he's already been suffering with this for a few months already. I am hoping to get some information about herbal supplements or something like that, to help relieve his pain and provide him with some support (figuratively speaking) until he can get in to see a doctor.

(I'm also concerned that a doctor is just going to throw random drugs at him, and treat the symptoms instead of finding the solution to the problem. We don't want a prescription for Viagra -- we want to find out and fix whatever is making him hurt and not function properly! So I'm open to suggestions for long-term treatment as well. Thanks!)

[HOMEFree]

I am sorry that he is struggling with this issue.
I definately think that going to a doctor should be top of the list. This is nothing to screw around with. And IF perchance your doctor is not really listening, find another doctor. Even a naturopath that is not into eastern religion junk.

As far as natural remedies, there are several men friendly herbs that are commonly used. Some are nettle, pygeum, yohimbe, saw palmetto, gingko biloba. A little research will turn up plenty.

Of course, he will definately need to stop any use of coffee (caffeine), alcohol and tobacco immediately. Big triggers for these problems.

If you do go the herbal route, make sure your doctor knows what he has tried herbally, is using herbally and how much. Bring bottles in to the appointment.

[DHW]

The first thing that comes to mind is prostatitis (or other infection).  It can cause back pain, leg pain, pelvic floor pain, difficult/painful urination, and of course pain during intimacy.  It is painful, all the way around, in areas both near and far.  There is usually significant internal inflammation.

Prostatitis needs to be treated consistently for a lengthy period of time, and treatment should include (natural/herbal) antibiotics or anti-virals, dietary changes, nutrition and supplements to address specific symptoms, as well as physical medicine (frequent warm sitz baths, massage of the prostate gland, frequent times of intimacy with eja*****ion, etc).

The second possibility is chronic pelvic pain caused by a persistent contraction of the pelvic floor muscles.  Kind of like a forever charley horse, except in the pelvic floor.  One treatment involves releasing trigger points.  This is closely tied to stress, and worsened by stress.  I believe chronic pelvic pain is a multi-faceted ailment, and should be treated by several different modalities (allergies, chiropractic/massage, nutrition, natural medicine, stress management, etc).

None of the treatments are especially pleasant, but...

I am sure there are other possibilities, some quite serious.  Please ask your dh to get a clear diagnosis (exam, blood work, urine, PSA, etc), or at least rule out some things.  I would not delay, nor would I begin conventional medical treatment without a considerable amount of prayer and research.  Once you have that you can examine the treatment options.

Herbs can be a great part of treating male reproductive health, but you need to know what you are treating in order to select the right herbs (and vitamins, minerals, diet, etc).

Be encouraged.  You can be a wonderful help to your husband through this.

[healthybratt]

I don't have any experience or advice, but I found this on google.

  WHEN TO SEE YOUR DOCTOR

* Pain in the testicle or scrotum is accompanied by any of the following: swelling, nausea, vomiting, abdominal pain, redness, penile discharge or difficulty in urinating.

What Your Symptom Is Telling You

There's a good reason why instructors in self-defense classes show women where to aim their knees. For a man, there are few pains that match the numbing agony of a direct hit in the family jewels. But not all testicular pain has an external source. Sometimes the body itself is doing the dirty work.

The likely cause of testicular pain depends on how old you are, according to Bruce H. Blank, M.D., a clinical associate professor of urology at Oregon Health Sciences University School of Medicine in Portland. When adult males develop pain in the testicles, Dr. Blank says, they're likely to have epididymitis, a bacterial infection of the epididymis—a spaghetti-like tube coiled up behind the testicle inside the scrotum. Not only will the scrotum hurt but you probably will also feel a swelling of or lump on the epididymis.

Children and teens with testicular pain are probably suffering from torsion, a condition that develops when the testicle virtually strangles itself by spinning, somehow, on the spermatic cord to which it is attached. Almost as frequently in kids, but much less serious (though maybe no less painful), is a similar twist that develops in a body part called the appendix of the testicles or the epididymis.

Whatever spins, the cruel twist of fate usually happens spontaneously, Dr. Blank says. The child could be physically active when it occurs, or he could just awaken with it in the middle of the night.

Testicular pain can also be caused by mumps. In addition, it can have indirect causes, such as pinched nerves in the back, kidney stones or varicose-type veins in the spermatic cord.

Symptom Relief

There's no time to lose when you're doubled up with excruciating scrotal pain, for if torsion's twisting at your testicles, you have breathing room of maybe four to six hours before the organ dies from lack of blood. And until you get to the hospital, knowing whether it's torsion of a testicle, torsion of a testicular appendage, epididymitis or a hernia doesn't help at all. They all hurt just the same, Dr. Blank says, and diagnosis can be difficult even for physicians. "Having acute scrotal pain requires you to see the doctor right away, because you could lose the testicle if it's not corrected in just a few hours."

See if a lift alleviates. A simple, though never foolproof, test may determine the cause. Elevating the swollen scrotum, either by lying down with a pillow under your rump or wearing an athletic supporter, or changing position might temporarily ease the pain of epididymitis but will worsen torsion's torture. Males with torsion also may feel nauseated or vomit.

Let the doctor give it a whirl. A physician may try to untwist the spermatic cord without surgery, Dr. Blank says, but that often is too painful. Normally, surgery is necessary. The doctor unwinds the testicle, then stitches it and its partner to the inside of the scrotum to prevent future torsion. If it's untangled without surgery, the doctor still may want to operate to affix the testes to the inside of the scrotum, Dr. Blank says.

Take some cold comfort. No surgery is necessary if the doctor finds torsion of an appendix of the testicle or epididymitis, Dr. Blank says. While still as painful, torsion of an appendage is not dangerous. Doctors usually recommend ice compresses, elevation of the scrotum and pain medication for a few weeks, although most of the pain will naturally subside over two to three days, he says. You can raise the scrotum with the lift of an athletic supporter or by lying down with a pillow tucked under your tush. If the ache lingers, surgery may be necessary.

The Germs of Pain

You'll be saved a visit to the operating room—but not the doctor's office—if epididymitis pains your privates. The bacterial or sexually transmitted infection—usually from an unknown bacteria but sometimes from chlamydia or gonorrhea—causes pain to increase gradually over hours or maybe even days. While most of the men who get the infection are sexually active, sexual intercourse isn't the only way to catch it. "Any bacteria, possibly one responsible for a urinary infection, can cause testicular pain," says E. Douglas Whitehead, M.D., a urologist, co-director of the Association for Male Sexual Dysfunction in New York City and an associate clinical professor of urology at Mount Sinai School of Medicine of the City University of New York.

Once infected, a lump will emerge inside the scrotum, which may be red and feel hot to the touch. You may have trouble urinating or you may notice a discharge from your penis.

Epididymitis isn't the medical emergency that torsion is, Dr. Blank says, but the pain probably could be enough to drive you to the doctor's office as quickly as you can get there. In addition to taking any antibiotics that are prescribed, here's what the physician may tell you to do.

Take a load off. Bed rest is just what the doctor ordered for epididymitis, Dr. Whitehead says. Raising the scrotum eases the pain.

Take a bath. Reclining in a tub of warm water "soothes the swelling and pain and stimulates blood flow," Dr. Whitehead says.

Glide some ice on the ache. Ice compresses also will help reduce the swelling and inflammation, Dr. Blank says.

Get some support. Wearing a jock strap, along with staying off your feet for a few days and applying ice, will be prescribed if mumps is causing your testicle pain, Dr. Blank adds.

from http://www.mothernature.com/library/bookshelf/books/16/224.cfm

[healthybratt]

...and this.

Topic: Sexual Dysfunction

Thanks in advance for your advice. I am 26 years old, and
I've been experiencing two separate problems that
may be related.

The first problem is: For the past four years I've been
experiencing testicular pain. At first, it only happened when
I would wear tight pants, like jeans. Over the course of the
day, my testicles would get very sore and swollen. Eventually,
it got to the point where it happened all the time, and it was
so bad that I would be in sheer agony anytime I had to sit down
for extended periods of time, like on long car rides or airline
flights. I went to see my regular doctor who said it sounded
like a prostate infection. He massaged my prostate and gave me
an antibiotics prescription. The prostate massage cleared up
the problem almost instantaneously. However, a month or two
later, the problem came back. My doctor gave me the same
treatment again, and it went away. A few months later, it came
back again (though not nearly as badly as before),
and this time my doctor referred me to a urologist.
The urologist examined my prostate and said it was normal. He
said he thought I might have experienced some trauma to my testicles
(at that time I was doing a lot of long-distance running, so
that seemed like a possible explanation). He suggested I switch from
boxer shorts to briefs and wait and see if it clears up.
Wearing briefs helped somewhat, but not completely. Around a
year later, I went to another urologist who said my prostate
felt normal and that some people just have sore testicles...

Here's my other problem: For the past few years I've been
having weaker erections than I used to... My penis
rises to about straight out (instead of pointing upward). It
doesn't seem like it gets fully engorged like it used to.
Another thing I've noticed is that I almost never wake up in
the morning with an erection anymore, and the few times that I do it
is also weak.

In addition, I've also noticed that my urine stream is weaker
than it used to be.

I know this was a long message. Thanks for reading it, and I
am really grateful for any thoughts you may have.

---------------------------------------------------------------
Dear Bill,
Men with prostatitis syndromes are frequent patients in the urologic office. Initially, they should be screened with urine analysis, urine culture, urine cytology, and uroflowmetry. If no bacterial pathogen is found then a special urine analysis with three samples should be performed. There are several types of prostatitis, infectious prostatitis, either acute or chronic, nonbacterial prostatitis or a third category known as prostadynia. The three part urine sample with prostate massage would put you into a category of which type of prostatitis you have. I will briefly discuss each type below.
Acute bacterial prostatitis accounts for less than 5% of cases. Symptoms would include fever ,chills, malaise, and myalgia. Local symptoms are frequency, urgency, low back pain and outlet obstruction(difficulty urinating). Digital rectal exam is exquisitely tender. The most common pathogens are E. coli, Klebsiella, Proteus mirabilis, Enterobacter, and Staphylococcus aureus.
Chronic Bacterial prostatitis is defined by recurrent Urinary tract infection and persistence of pathogenic bacteria in prostatic fluid. Primary complaints consist of genitourinary pain(61%),dysuria or painful urination(16%), clear urethral discharge(12%), recurrent UTI(9%), and sexual dysfunction(1%). Physical exam is usually normal, however the three part urine analysis shows a high number of white cells on one of the three samples(>10 WBC/high power field in the expressed prostatic secretions) The most common organism found is E.coli in 80% of cases. Chronic bacterial prostatitis is simply a bacterial infection that recurs. Treatment with Bactrim or one of the Fluoroquinolones for 4-6 weeks is successful 30-50% of the time.
Nonbacterial prostatitis is an inflammatory condition of unknown etiology. The symptoms are similar to those with chronic prostatitis and this group of patients outnumber all other patients with prostatitis. Again the physical exam is unremarkable however on the three part urine test there is not only high numbers of white blood cells, but all lipid laden macrophages. These are cells not characteristically seen in the prostate secretions filled with fat. There may be a chemical irritation as a basis of this disease.
A trial of antibiotics should be tried but conservative measures such as over the counter anti-inflammatory agents(Motrin, Advil, Aleve), hot sitz bathes and support should be offered.
Prostadynia is a term used to define patients with prostatitis type pain without specific findings related to the prostate. Typically these patients are younger and have variable urinary complaints. There is no etiology of this disease established and therefore a generalized work-up should be done. Again conservative measures should be performed in addition to some limited dietary restriction of caffeine, alcohol, and spicy foods. Other talked about treatments include Zinc and saw palmetto however neither of these therapies have been proven.
As you can see the prostate infection can go on for a long time. At different times, the urinary problem may subside with antibiotics however it will often return. My recommendations are, follow with a urologist and make sure you get a full coarse of therapy. If you specifically read the paragraph under recurrent prostatitis, you will note erectile dysfunction (weak erections) can occur. You mentioned that if you hold back on your climax this causes you more pain. I would suggest that you give your system a rest for 48 hours and then resume without holding back. It is possible with recurrent prostatitis to continually infect your urine, epididymus and testicles. I also believe that wearing briefs can help stabilize the testicles and reduce your discomfort.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

Sincerely,
HFHS M.D.-AK
*keyword: Prostatitis

from http://www.medhelp.org/forums/urology/archive/1821.html