Chronic nerve pain in the testicle and anterior thigh, frequent nighttime urination, and lumps in the semen for two years - #19789
Hello Doctor, I would like to consult you regarding a chronic health issue I have been experiencing for approximately two years. I am seeking a comprehensive evaluation and appropriate treatment. Here are the details of my condition: 1️⃣ Nerve Pain: The pain started after a strong injury to the left testicle during a fight, causing severe pain at the time of the incident. Initially, the pain was in the testicle, then after about a year it began to spread to the anterior thigh and from the left foot to the right as well. The pain has persisted in the thigh for about 7 months, and occasionally I feel mild residual pain in the testicle after thigh pain improves. The pain slightly decreases after a warm shower or applying warm compresses, but it returns after a few hours. Pain increases sometimes when lying on one side or sitting for long periods. 2️⃣ Nighttime Urination: I wake up to urinate approximately every 4 hours at night; this is real urine output, not a false sensation. There is no significant pain or burning during urination, but frequent urination disrupts sleep. 3️⃣ Lumps in Semen: I have noticed lumps in the semen for about 7 months, and they have not disappeared. There was blood in the semen only once immediately after the original injury; currently, there is no blood. 4️⃣ Previous Tests: Testicular ultrasound showed good veins, and the testicle appears normal externally. No issues with the lower back or kidneys according to previous examinations. 5️⃣ Medications and Supplements Tried: Eximal: reduced pain slightly. Etnoplex and Inibrex: helped reduce pain further, especially in the thigh. I have not yet started nerve medications or prescribed bladder medications. 6️⃣ Other Symptoms: Pain temporarily improves after a warm shower. No other symptoms such as weight loss, fever, or recent swelling. Questions for the Doctor: What is the most likely diagnosis for these symptoms? What medications or treatment plan would be suitable to relieve nerve pain, nighttime urination, and semen lumps? Is it possible for the pain to completely disappear, and what is the expected duration of treatment? Are there any home exercises or tips that could help accelerate recovery?
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Doctors’ responses
Hello,
Ok , 1) Likely cause: Chronic post-traumatic nerve pain from your previous left testicle injury, with possible pelvic floor/prostate involvement : explains thigh pain, urinary frequency, and semen lumps.
2) Tests needed: Need Urologist review, repeat scrotal ultrasound + Doppler, urine test, semen analysis, prostate evaluation; spine/pelvic assessment if needed.
Treatment: Nerve pain medicines (pregabalin/gabapentin or amitriptyline/duloxetine), pelvic floor relaxation therapy, warm compress, avoid prolonged sitting. Bladder/prostate medicines may be added depending on findings.
3) Recovery:
Possible with proper treatment; improvement usually gradual over months.
4) Home tips / exercises Warm baths / warm compresses Supportive underwear Avoid tight clothing & heavy lifting Avoid long sitting; cushioned seat Pelvic floor relaxation exercises (not Kegels) Stress control + gentle stretching
I trust this helps Thank you
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