I hope that I'm able to post this here, I haven't found anything similar on the internet so I'm hoping that I can get some support here (through assistance in discovering therapies, as well as just being able to have someone understand the issue.) Sorry this is going to be wordy.
So the problem started in May, one morning I woke up in horrible pain. It felt like I had just been kicked in the junk, but only on the left side. It was between a bolt of pain to a constant ache. I called my doctor that morning (a Wednesday) and they were able to get me in on Friday morning, they did say if it felt out of place to go to the ER. There were a few hard lumps that I noticed.
My doctor did an exam, noticed one of the two hard lumps (one had softened). He also performed a full STI/STD panel, which was painful in its own right, and ordered a urinalysis. He put me on a 10 day course of doxycycline as a preventative measure. He ordered an ultrasound, and referred me to a urologist. He commented that men with either a foreskin or a longer remainder tend to get UTIs frequently, and this could have been caused by a bacterial infection.
Ultrasound revealed a benign cyst, doctor said don't be worried about it, but to go to the urologist still. He put me on another 10 day course of doxycycline. Urologist visit was less than stellar. Said, foreskin wouldn't be causing any infection issues. He asked if I could take Advil, and when I said I could to take 800 mg three times a day. I can't take that much. He offered a prescription for naproxen, which bothers my stomach even worse. So I just dealt with it. Some days have been better than others, but other days can be horrible.
So about a month ago, the pain got to the point even walking became difficult. And I called the urology office back to get an appointment, and requested to not see the first doctor again. Saw a CNP (who had a student in tow), explained everything, he checked the ultrasound, did an STI panel again, and did a full exam (twice actually the student nurse did one as well.) He determined that it wasn't urologic, and that I had a few options: a stronger antibiotic (which he suggested not to do as he didn't think would be effective), speak with a male reproductive specialist (in this case it would be a fertility doctor), or speak with a surgeon about exploratory surgery (he mentioned that they would also be performing a circumcision at the same time as that surgeon prefers to do them at the same time to reduce the risk of a UTI or other future infections.) Since antibiotics didn't seem to make sense, and surgery seemed excessive, I went with the fertility doctor.
They were able to get me in the next day, and he had for the most part determined that there was a nerve that was causing the issue. He too had a student (a full MD this time) and performed a full exam (twice). He ruled out prostatitis, and said that he wasn't going to do an STI panel since they did one the day before. Based on what he saw and noticed during the exam he thought it was a chronic orchialgia possibly from congestion. I have not had a vasectomy.
He mentioned that he prefers to treat conservatively first before moving on to any type of surgery. He first put me on nortriptyline 10 mg at bed. I took it for a week before the side effects got to me. He changed me to gabapentin 300 mg ramping up to (as high as) 600 mg three times a day. I'm currently at 1200 mg. I have not noticed any difference in pain.
What I'm experiencing is between a constant dull ache to shooting pains that can be breathtaking in pain. Movement tends to make things worse, so does sitting. Wearing tight or loose underwear doesn't seem to make a difference, nor does wearing a jockstrap or suspensory. I'm at a loss on what to do next. The fertility doctor said he would prefer to not have the denervation done, and only suggests an orchiectomy in terms of cancer. Are there any other treatments that I should try, or therapies that I should ask for? I've hit my deductible for the year, so cost for the remainder of the year is less of a concern. Thanks for reading this.