Ball pain can't wait! - Dr. Dick

Ball pain can't wait!

Dear guys,
I got a frantic call this week from "Thomas," who had severe pain in his left ball, and pain when peeing. I told him to drop everything and haul ass to the ER--ball pain can't wait! Thomas followed up with me a couple days later, and confirmed my suspicions: he had epididymitis that was caused by an STD. After talking with Thomas, I realized that I don't talk about epididymitis, loyal readers, here's what I can tell you about this "itis."
Happy Reading,
Dr. Dick

First and foremost, if you have pain or swelling in your ball(s), don't ignore it! Ball pain can be caused by a number of conditions, and some of them need immediate treatment to prevent permanent damage. If your pain is severe, go to the emergency room ASAP.

The epididymis is a coiled tube at the back of the testicle that stores and carries sperm. When this tube gets inflamed, it's called EPIDIDYMITIS.

This "itis" is often caused by bacteria. Bacterial sexually transmitted diseases like gonorrhea and chlamydia are common causes. Epididymitis can also be caused by:
• A urinary tract infection or prostate infection
• A backflow of urine into the epididymis--often caused by heavy lifting or straining
• A groin injury

• Swollen, red, or warm scrotum
• Pain and tenderness in the testicle
• Pain when you pee or the urge to pee a lot
• Pain with sex or when you cum
• Lump on the testicle
• Lymph nodes in the groin that are bigger than normal
• Pain in the lower abdomen/pelvic area
• Blood in the semen
• Fever (not as common as the other symptoms)

Get seen by a medical provider so you know what's up. Your medical provider will probably do a variety of tests to identify the cause of your ball pain. Most likely the visit will include:
• A physical exam
• A urine test
• A blood test
• An STD test
• Possibly a rectal exam to check for an enlarged or tender prostate

• Antibiotics are used to treat epididymitis that's caused by bacteria
• If the cause of the epididymitis is an STD, your sex partners need to get treated too
• Take the entire course of antibiotics, as recommended by your medical provider, otherwise, the infection might not clear up completely, or you could develop resistance to the antibiotics
• You and your partner(s) should avoid all-types of sex until seven days after you have completed the full course of antibiotics. If you must have sex, use condoms and other barriers to reduce contact with sexual fluids
• Many people start to have less pain after 2-3 days of taking the antibiotics, but it might take several weeks for the tenderness to disappear completely

Epididymitis can be pretty painful. Here are some tips for faster healing:
+ Rest in bed when you can
+ Lie down so that your scrotum is elevated. This helps blood flow out of the testicle,
which will reduce swelling and pain
+ Apply ice packs to the scrotum based on your medical provider's recommendations
+ Wear an athletic supporter. This can help reduce jostling!
+ Avoid heavy lifting/straining
+ Avoid sex that could cause pain to your ball(s)! Ouch!

If you don't get treated for epididymitis, you could develop:
• An abscess in the scrotum. An abscess is a hard, red, painful lump filled with pus. Abscesses are serious and need medical attention!
• Reduced level of fertility (this is not very common, but it is possible)
• Epididymo-orchitis: when the inflammation spreads to the testicle

• Use condoms for anal and vaginal sex
• Use an oral sex condom when going down on a penis
• Use a dam for rimming
• Talk to your partners about your STD and HIV statuses, and how you want to keep each other safe
• Get tested every 2-3 months for STDs, AND get treated if an STD pops up

Here's to healthy balls!

Dr. Dick

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