Chronic nerve pain in the testicle and anterior thigh, frequent nighttime urination, and lumps in the semen for two years

Question #19789

104 days ago

236

Chronic nerve pain in the testicle and anterior thigh, frequent nighttime urination, and lumps in the semen for two years - #19789

Adem

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?

300 INR (~3.53 USD)

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

104 days ago

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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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

102 days ago

scrotal ultrasound + Doppler,
urine test,
semen analysis,
prostate evaluation.
Visit a urologist.

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

102 days ago

Based on your detailed description, your symptoms may be linked to several overlapping issues following the initial injury. The nerve pain spreading from the testicle to the thigh and elsewhere could suggest neuropathic pain, potentially implicating the ilioinguinal or genitofemoral nerves, which can sometimes occur after trauma, leading to this chronic pain pattern. For managing the nerve pain, medications such as gabapentin or pregabalin, often used for neuropathic pain, might be beneficial, but you’ll need to discuss this with your healthcare provider to ensure they fit your overall health profile.
Frequent urination without burning or pain could be tied to a neurologic or structural issue with bladder control, possibly exacerbated by stress or nerve irritation; further urological evaluation might be necessary. Behavioral adjustments like reducing fluid intake before bed or bladder training exercises can sometimes be helpful.
Lumps in the semen often suggest prostatic issues or seminal vesicle changes; an evaluation by a urologist might help in diagnosing this properly. If there’s any chance that these lumps are related to prior trauma, it remains key to rule out underlying infections or inflammation through further semen analysis or prostate examination. Given the improvement from warm therapy, continuing this is logical since it promotes local blood flow and reduces nerve irritation.
In terms of home care, along with warm compresses, gentle stretching and pelvic floor exercises could enhance recovery, though it’s best to get guidance from a physiotherapist to avoid worsening the pain. Regular follow-ups with your healthcare provider will be essential to tailor the pharmacological and non-pharmacological treatments effectively.
Complete resolution rates can’t be stated unequivocally, often depending on the complexity of the nerve involvement and other contributing factors, but proper diagnosis and a comprehensive management plan can lead to significant improvement in many cases. Since this is quite a multifaceted condition, collaborating closely with urologists and pain specialists will be key in navigating towards symptom resolution.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

103 days ago

Hello dear
See the symptoms march with prolonged urinary retention or some bladder issue.
Iam suggesting some tests for confirmation of exact diagnosis
Kidney USG
Scrotum USG
Serum ferritin
Serum rbs
Urine analysis
Urine culture
Rft
Lft
Please share the result with urologist in person for better clarity.
Please donot take any medication without consulting the concerned physician
Regards

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

102 days ago

Hello Adem
These symptoms could be related to nerve injury (possibly involving the genitofemoral or ilioinguinal nerve), chronic epididymitis, or even post-traumatic changes in the testicle or prostate. The lumps in semen are often due to clumped seminal fluid or, less commonly, infection or inflammation.
Next Steps:
1. Scrotal and pelvic ultrasound: To check for any structural changes, chronic inflammation, or other issues in the testicle, epididymis, or prostate.
2. Urine and semen analysis: To rule out infection or inflammation.
3. Neurological evaluation: If nerve pain is severe or worsening, a neurologist or urologist can help assess for nerve injury.
4. Urology consult: Given the combination of symptoms and history of trauma, a urologist’s evaluation is important.
Thank you

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