Enter Dear Dr. I have a condition where I have strains in my Testical tract. I had it checked out in all medical tests, and nothing was found. I know the cause. Being that my wife hates sex, and I am married 19 years, and a few years ago, I was waiting no

Hello, Welcome to the AMD forum of doctors. The condition has been very well explained by you and from the symptoms I can understand that you have dysuria. Dysuria is when there is any pain, discomfort, or burning sensation during urination. Any source of irritation or inflammation of the urinary tract, especially the bladder, prostate or urethra, can cause dysuria. The first possibility is of urinary tract infection. Any infection in the urinary tract can cause burning and painful micturition and to rule it out, a complete urine examination and urine culture are required. Second possibility is of prostate pathology. It can be due to prostatitis or benign prostatic hyperplasia (BPH). Recurrent UTI�s are symptoms of chronic prostatitis and hence this also needs evaluation. A prostatic ultrasound/CT and PSA (prostate surface antigen) levels are needed to confirm the diagnosis. Third possibility is of any obstruction in the flow of urine which may be caused by an enlarged prostate, urethral stricture or any benign or malignant changes in the genitourinary tract. A cystoscopy is the best test to diagnose that. In this a small tube carrying a viewing piece at the other end is passed through the urethra upto the urinary bladder and any abnormality is visualized in the genitourinary tract. To rule out all these possibilities, I sincerely suggest you to consult a urologist and get these investigations done. Treatment is diagnosis specific and depends on the confirmation of diagnosis. I hope it helps. Take care and please do keep me posted in case you have any additional doubts. Kind regards. You can find more relevant information about this from the following site: http://www.aafp.org/afp/990901ap/865.html

Follow up:

Thu 19, Nov 2009 09:30pm

Hello, I am glad that any of us doctors at AMD have benefitted for you. Regarding the symptoms of blue balls, the only effective treatment is ejaculation either through intercourse or through masturbation. Some of the drugs like alpha blockers(lik terazosin) and antimuscarinics(tolterodine) can be used to relax the smooth muscles but they are not without side effects and should be taken only after consulting a physician/ urologist. Common side effects of alpha blockers include orthostatic hypotension, ejaculation changes and nasal congestion. Hope it helps. Take care and regards.

Comments:

Dr.Kokil Mathur

Wed 18, Nov 2009 10:24pm

Hi! Dr Bhupinder has clearly defined some things for you. There is one simple explanation for your problems: sexual arousal that does not end in ejaculation can cause congestion in the sperm carrying tubes. This causes a dull aching sensation in the testicle also called �blue balls�. This is harmless and usually the pain disappears within a few hours. Some relieve the pain/discomfort through masturbation. You should not hold back the ejaculation as holding on to it on a regular basis can cause infection, painful urination, prostatitis etc. If you cannot have a normal intercourse, try masturbation to take care of sexual stimulation. If this does not help, consult an urologist. Please let me know if there is any thing else. Take care!

Unregistered

Thu 19, Nov 2009 11:15am

The response did not help me out because I did all those tests. However, the response from Dr.Mathur hit it on the nose. He understood me and gave me what I need to know what to worry about, I am not allowed to masturbate because my Religion does not allow it. Is there any medicine that hits the spot that this congestion happens? Thank you.