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wieyedoc, Board Certified MD
Category: Urology
Satisfied Customers: 11875
Experience:  Over two decades of clinical practice. Completed a medical internship in New York City
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Doctor, past few weeks i was suffering with

Customer Question

Hello doctor, for the past few weeks i was suffering with prostatitis(few occasions of yellowish semen and mild testicular pain) so i have underwent a barrage of test - initial urine cultures showed mixed growths and few WBC, had ultrasounds of my entire tract, showed nothing of ordinary in kidneys or testicles, but prostate had a few calcii deposits, cystoscopy was normal, and blood tests showed kidney functioning was normal. a few days after these initial test i had urinary symptoms still mild and was later diagnosed with UTI and prostatitis due to ecoli. had antibiotics for a few weeks - semen became normal but there were small instances of testicular pain which were on and off. doctor suggested i do a intravenous urogram. which showed a mild UPJ obstruction in my right kidney and no hydroureter. pls note that no pelvicalyecal dilation was discovered in the renal ultra sounds which i had may be 2 months back. the doctor says its not severe and i don't need surgery yet since i don't have any pain/symptoms and the dilation is not big enough. He has asked me to get a check done every year to monitor this. few weeks later i had my CT scan to obtain further information. According to the CT scan the dilation in the pelvis is not a real UPJ but only looks like UPJ in IVP since the kidney is a bit rotated, so no UPJ according to the radiologist doing CT. Blood test for kidney function and PSA test all reveal normal functioning. All these tests were done since the doctor thinks the prostatitis was still not cured and i had intermittent symptoms of pain near the perineum during urination. after a few days i started developing pain in my left testicle and foamy urine which clears momentarily after sex/masturbation which evolved into a lump and was diagnosed with epididymitis. i was put on antibiotics for 6 days after which the infection didn't clear and then doctor put me on another course for 16 days which is currently ongoing. the pain had disappeared quite quickly after 3-4 days but small pain remains only when i touch harder at the epididymitis, however no pain on walking or anything like that, only the swelling remains however i can see that it is much less than what i had before treatment, however the foamy urine still persists and clears up for a few hours after masturbation. the doctor suspects that this could be because of my previous infection of TB in the lungs back in 2008 which could be causing this epididymitis in the tail to persist. can you please explain me what this TB in epididymitis could lead to. Im worried since i have only 1 kidney and i basically want to know what test need to be done to identify the root cause of this problem Optional Information: Person's Gender: Male Person's Age: 30

Submitted: 2 years ago.
Category: Urology
Expert:  wieyedoc replied 2 years ago.
Hi. My name is***** and I am online and available to help you today. Thank you for your patience.Question and answer is just one of the services I offer. I can also provide you with premium services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested. Do you have any other medical problems or take any medications?This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 2 years ago.
Other than the tb which i had in 2008 for which i took proper 9 month course i had no other medical problems or medications
Expert:  wieyedoc replied 2 years ago.
Thank you for that additional information.If, indeed, this is all due to TB causing epididymitis it could lead to scar formation as decreased/stopped sperm output of that testicle.It probably would not spread to your kidney from this area but if you have systemic TB it could, technically, also get to your kidney.So. What should you do?From what you have posted it sounds like you are getting excellent care. If you trust your current doctors, and it sounds like you should, then I would just continue under their care understanding that they are doing everything possible to clear things up.There doesn't seem to be anything else to do at this point as your doctors seem to be right on top of things.Does this make sense to you?It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me. Dr. Rick MD FACS
Customer: replied 2 years ago.

Hello doctor, Can you pls describe the tests used to identify tb in this case. The current doctors have asked for the following tests: Urine microbiology Complete blood count Ultrasounds KUB scrotum prostate Uroflowmetry Chest xray Mantiux test Erythrocyte sedimentation rate Semen analysis Any other tests that need doing? Also i appeared for all the tests other than the semen test for which i just have to deposit it in a container tomorrow morning. The results for all the tests would be out by tomorrow evening including the semen tests. I thought these urine microbiology and sement tests usually take upto 48 hours of culture. Is that the way how its always done? I thought that this would be done through a prostate massage

Also can you pls explain under what circumstances can this TB spread to my kidney, i.e. what does systematic TB mean. the TB i had before was plain pulmonary TB (water formation in lungs) and i had taken the proper 9 month course for this. Also what would be the symptoms to notify earlier if the spread has happened to kidneys?

Also how is it possible for the current antibiotics to actually be of any help since usually stop getting pain after 2-3 days of starting antibiotics. only the swelling is taking time to reduce.

Expert:  wieyedoc replied 2 years ago.
They are doing an excellent job with the testing. I would not add anything at this time.TB can spread anywhere in your body if it gets into your blood streamThere are many symptoms if it goes to your kidneys and your doctors will be looking out for them....Make sure to take your current antibiotics as directed even if the swelling goes down.I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.Thanks in advance,Dr. Rick MD FACS