Postop testicular pain, anyone?

about 9 days out from my daVinci prostatecomy, just before getting my Foley catheter pulled,  I suddenly developed an incredibly tender right testicle.  I think this was acute epididymitis, as it was not the testicle itself that was sore, but the testicular adnexal structures along the bottom outside edge.  I received a course of antibiotics for this which calmed things down somewhat, but I am now about 1 month postop and still have quite a bit of nagging tenderness there. 

In the medical literature, epididymitis is not an uncommon complication of vasectomy.  And face it guys, all of us who have had our prostate out have had bilateral vasectomy in the process, although much further downstream than the guys who do this for birth control.  Prostatectomy is reported to have somewhere around 6-10% incidence of postop epididymitis. Still, I have heard nothing about testicular pain on this site and find no hits in the search box.  I doubt that I am the only one putting up with this smoldering tenderness, so how long does this last?

Doc

I am now 3+ months SPO da Vinci and have had no epididymitis but still have a mild tenderness if I handle either testis. I took this to be due to venous and/or lymphatic congestion secondary to the pelvic work done. There should still be some spermatogenisis going on until atrophy sets in due to pressure. Maybe this??

Wow! Between Doc and Brainsurgeon, I missed a fair bit. However, I did pick up on one word in particular: atrophy. Either of you two care to elucidate just a bit on exactly what "atrophies"? I've got enough stuff atrophied already. I sure don't need anything more added to the list.

Thanx,
Garth

That's a relief! Glad to hear my list won't be getting any longer.

Thanx Much,
Garth

wes, when i went through that type of pain, it would come and go with no sense of reason. another reason i was told for the pains soon after surgery, and not sure i believe it nor can i give a legitmate cite for it, is that even though our prostates are gone, the main producer of our ejaculate fluid, the testicles are still producing sperm as normal and there is no way for it to escape. my doctor said it takes a few months for it to adjust to that fact and becomes absorb back into the body.

david in sc

Thanks to all for the information regarding your own experiences with testcular pain. Sounds like this is going to last months, not weeks. Based on your descriptions, I suspect that this is an evolving chronic consequence of backpressure in the epididymis due to continued sperm production (-all dressed up and nowhere to go!), as Brainsurgeon has suggested. For more information, including a description of "epididymal blowouts" due to this, see http://en.wikipedia.org/wiki/Post-Vasectomy_Pain_Syndrome .
Treatment at this point is probably with anti-inflammatory meds, such as advil, naprosyn, etc. If I am still having this smoldering pain after I regain more bladder control, I would like to try wearing an athletic supporter as this should help keep things from rattling around with movement and provide some additional releif.

Doc

My father (73 - healthy 5'8 140 lbs) had the Da Vinci prostatectomy on November 25, 2013. His catheter came out on December 5, 2013 (Day 10 post op). On December 13, 2013 (Day 18 post op) he complained of pain in his right testicle after having walked for about an hour -a slow walk, his first one outside the house since the surgery . He had fever the next morning (100.9 F) and his right testicle was slightly swollen. His leucocyte count was 16.32 the same morning. Started a course of antibiotics. Sa the urologist/surgeon on December 17th, and it was diagnosed as Epidymitis-orchitis. Antibiotics extended for another week. Doctor says the antibiotics will do the trick in a week but the swelling may not subside for a month or so.

I don't understand why would the swelling not subside if the primary infection has healed? Thanks

Post Edited (prostatic edification) : 12/17/2013 12:46:11 PM (GMT-7)