instruction: hi doctor I am having pain in my right testicle but it is a dull pain and it is hard to pinpoint exactly which side but I would like to say it is my right testicle that gets swollen and also has that fullness feeling in the entire sac it normally flair up every single morning for the past four months and I seem to have an increase in sexual dreams since it has been happening it is not the worst pain in the world but it is discomforting I really do not want to see a doctor as it is very embarrassing for me throughout the day it will become swollen and sometimes not hot baths and masturbation are the only things that help with the pain I normally have to masturbate every single morning to take the pain away I do feel like I can feel something down there on my right side behind my testicle that feels like a smooth tube not sure if this is normal as I also feel it on my left side but it is not as big on my left side a few other symptoms I have experienced with this are lower back pain and nausea but once again this has been ongoing for four months now can you help me I am currently on melatonin and allegra
output: hi I appreciate your detailed description testicular pain can be apparent and have a cause or can be idiopathic unknown also testicular pain can be secondary to the inflammation of tests epididymis or both it can be associated with a hernia which not necessarily appears to you if it is small it can as well be due to hydrocele fluid collection around the tests moreover varicocele dilated veins around the tests testicular tumor can also cause pain testicular hematoma blood collection beside the tests or epididymal cyst referred pain from lower ureteric stone lastly idiopathic the accuracy of diagnosis depends on history and examination ultrasound of scrotum and ultrasound rub to role out any abnormality in your urinary system moreover urine tests to rule out urine infection from your presentation I doubt varicocele or hernia but cannot exclude other causes regarding your back pain it might be a referred type of pain from tests so I hope treating the tests pain relief it you will need an ultrasound of your scrotum and urine analysis post ejaculation urine for culture then to follow up with results at the moment for the pain you are advised to take naproxen sodium 500 my twice daily for 30 days do not worry about it I hope I can find the cause and give you the proper treatment after investigations further you can follow up with me at your convenience scrotal support wearing fit underwear will reduce your discomfort I hope this helps ultrasound scrotum ultrasound rub kidney ureter and bladder urine analysis post ejaculatory urine culture naproxen sodium 500 twice daily for one month fit underwear after investigations