28-Year-Old Male Experiencing Testicular Pain
A 28-year-old male, standing at 6 feet tall and weighing 180 pounds, has been enduring pain and swelling in his left testicle for the past month. An ultrasound examination ruled out any indications of torsion or infection, and laboratory tests also yielded normal results. There has been no sexual activity or trauma involved. Despite this, a urologist prescribed Sulfamethoxazole at 160 mg to be taken twice daily, which did not alleviate the symptoms. After a follow-up call to the urologist’s office, a prescription for Doxycycline was issued. The patient is perplexed by the urologist's insistence on an infection diagnosis, especially since the left testicle feels denser compared to the right one and seems to contain fluid or experience swelling. Additionally, there appears to be a prominent vein or lump associated with the testicle. In search of further clarification, the patient requested a second ultrasound and tumor marker tests from their primary care physician. The results of the lab tests were normal, and now the individual awaits the ultrasound results. Should the findings be satisfactory, the patient intends to consider additional imaging, such as a CT scan or MRI. The individual expresses skepticism over the infection diagnosis, feeling that the physicians hastily concluded that due to the absence of torsion, they overlooked other potential conditions. Notably, the most recent ultrasound took place at a different hospital and was significantly more extensive than previous examinations, involving a longer duration and many more images taken.
Answers (1)

8/2/2025, 4:31:04 PM
OpenHealth AI
It sounds like you're going through a challenging situation with your testicular pain and are understandably seeking clarity on your condition. Testicular pain can arise from various causes, even when infections and torsion are ruled out. Your concerns are valid, especially with the recent findings and ongoing symptoms.
Explanation
Since ultrasound results ruled out torsion or infection and your lab tests are normal, your symptoms might stem from conditions such as:
- Epididymitis: Inflammation of the epididymis may occur without clear signs of infection.
- Hydrocele: This involves fluid buildup around the testicle, causing swelling.
- Varicocele: Enlarged veins in the scrotum can also lead to discomfort and swelling.
- Testicular masses: Though unlikely given normal tumor markers, they can sometimes manifest in ways that mimic infections.
Your experience of increased density, swelling, and the presence of a prominent vein may indeed suggest non-infectious processes. Additional imaging could help clarify the situation, especially if your symptoms persist.
Next Steps
- Monitor Symptoms: Keep a detailed record of your pain levels, any changes in swelling, and any new symptoms that arise. Note the timing of these symptoms to establish any patterns.
- Communicate with Your Physician: Share your observations and maintain open communication with your healthcare provider. Express your concerns regarding the infection diagnosis and discuss all your findings and the need for further imaging.
- Consider Further Imaging: If ultrasound results don't provide a satisfactory explanation, discuss the possibility of a CT scan or MRI with your doctor. These imaging studies might provide better insight into the underlying condition.
- Stay Informed: Research possible conditions affecting testicular health so you feel empowered discussing them with your physician. Knowledge may help guide your conversations and decisions.
Your persistence in seeking answers is important, and I hope you find the resolution you’re looking for soon. Don't hesitate to reach back if you have more questions or concerns.
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