? Epididimytis/18 yr old son

Hi all,
Can't find another group relevant to this question, so thought I'd try here
and hope some have older children or perhaps there are some MDs on this group.
My 18 year old son finally told me yesterday that he'd been having pretty
severe left testicle pain for over a week! He was too embarassed to tell me
sooner. His pediatrician was unable to see him yesterday and advised we get to
the ER. So, we did. After 4 hours, labs, urinalysis and ultrasound, he was dx'd
with probable epididimytis (sp?). No masses or torsion present. He was
prescribed Cipro and Vicodin, with advice to see a urologist immediately
because of something he'd not told me before. His left testicle is much smaller
than his right and has been for as long as he can remember. He thought it was
normal and never mentioned it til yesterday. The ER doc was very concerned
about this. The testicle is descended, but, appears to be atrophied. She (and
myself!) wondered why his ped never picked up on this and is concerned about
cause and his future fertility. She referred him to a urologist and
hopefully, we'll be able to get him in there today or tomorrow. My questions
a 1) does anyone have any experience to share on this? 2) is it possible a
groin injury/pull which happened when he was 11 years old could have caused
this? 3) will this severely affect his fertility? and, 4) how could his ped
never have noticed this? I wasn't present for the ER doc's physical exam, due
to son's embarassment issues, so didn't see...but, ER doc said testicle is so
small, it's the first thing she noticed. He's had every required well visit,
including one just a few months ago. Hernia's are always checked for and, I
assumed, visual examination of the genital area was part of this. I guess this
was a sad and sorry assumption on my part. I love our ped, but, I am very
disturbed about this. Apparently, if this had been caught sooner, something
might have been done to preserve his fertility.
Anyway, we will be getting to a urologist ASAP. But, I was hoping someone
else could shed some light and/or comfort on this. Thanks in advance for any
help you can give.
-------------
Hoping your hills are never too steep!
Be well, Patty

On 24 Jun 2004 12:42:40 GMT, (Patty ) wrote:

Hi all,
Can't find another group relevant to this question, so thought I'd try here
and hope some have older children or perhaps there are some MDs on this group.
My 18 year old son finally told me yesterday that he'd been having pretty
severe left testicle pain for over a week! He was too embarassed to tell me
sooner. His pediatrician was unable to see him yesterday and advised we get to
the ER. So, we did. After 4 hours, labs, urinalysis and ultrasound, he was dx'd
with probable epididimytis (sp?). No masses or torsion present. He was
prescribed Cipro and Vicodin, with advice to see a urologist immediately
because of something he'd not told me before. His left testicle is much smaller
than his right and has been for as long as he can remember. He thought it was
normal and never mentioned it til yesterday. The ER doc was very concerned
about this. The testicle is descended, but, appears to be atrophied. She (and
myself!) wondered why his ped never picked up on this and is concerned about
cause and his future fertility. She referred him to a urologist and
hopefully, we'll be able to get him in there today or tomorrow. My questions
a 1) does anyone have any experience to share on this? 2) is it possible a
groin injury/pull which happened when he was 11 years old could have caused
this? 3) will this severely affect his fertility? and, 4) how could his ped
never have noticed this? I wasn't present for the ER doc's physical exam, due
to son's embarassment issues, so didn't see...but, ER doc said testicle is so
small, it's the first thing she noticed. He's had every required well visit,
including one just a few months ago. Hernia's are always checked for and, I
assumed, visual examination of the genital area was part of this. I guess this
was a sad and sorry assumption on my part. I love our ped, but, I am very
disturbed about this. Apparently, if this had been caught sooner, something
might have been done to preserve his fertility.
Anyway, we will be getting to a urologist ASAP. But, I was hoping someone
else could shed some light and/or comfort on this. Thanks in advance for any
help you can give.

Some comfort to take in all this is the very fact that men start off
with two testicles. Whatever caused his testicle to be small, be it
inadequate development to begin with or atrophy from a varicocele, if
his other one is fine, he should remain fertile.

PF

if his other one is fine, he should remain fertile.

Thanks PF. That is comforting. He has an appt with a urologist tomorrow
afternoon. Guess we'll know more then. The ER doc kinda said the same thing as
you, but, we're still worried. He's our first 'baby' (we have 3 others) and
this was like a punch in the gut, ya know? I guess the infection was a blessing
in disguise as it allowed the problem to be recognized.
-------------
Hoping your hills are never too steep!
Be well, Patty

"Patty " wrote in message
...
Hi all,
Can't find another group relevant to this question, so thought I'd try
here
and hope some have older children or perhaps there are some MDs on this
group.
My 18 year old son finally told me yesterday that he'd been having
pretty
severe left testicle pain for over a week! He was too embarassed to tell
me
sooner. His pediatrician was unable to see him yesterday and advised we
get to
the ER. So, we did. After 4 hours, labs, urinalysis and ultrasound, he was
dx'd
with probable epididimytis (sp?). No masses or torsion present. He was
prescribed Cipro and Vicodin, with advice to see a urologist immediately
because of something he'd not told me before. His left testicle is much
smaller
than his right and has been for as long as he can remember. He thought it
was
normal and never mentioned it til yesterday. The ER doc was very concerned
about this. The testicle is descended, but, appears to be atrophied. She
(and
myself!) wondered why his ped never picked up on this and is concerned
about
cause and his future fertility. She referred him to a urologist and
hopefully, we'll be able to get him in there today or tomorrow.
My questions
a 1) does anyone have any experience to share on this?

Nope not really,

2) is it possible a
groin injury/pull which happened when he was 11 years old could have
caused
this?

I would dobut it,

3) will this severely affect his fertility?

I know someone whom has one desended testicle and one that didn't desend at
all and fathers two children.
(and has no problesm with fertility) If Im correct this was a hernia as a
young child and was fixed with surgery but the testicle went back to its old
postion many years later. The doctor said they do operate again but it might
go back again so my friend declinded the second op. My male friend still to
this day has one hanging lower then the other one and it doesn't affect his
erections or sperm count (or anything else like that)

and, 4) how could his ped
never have noticed this?

Maybe it didn't look that abnormal. Kinda like woman, some left breasts
are slightly bigger or smaller then the right breast but you wouldn't really
notice unless you were wearing a bra. (or mentioned it to someone)
Maybe there was other issues' the ped was dealing with and it got pushed
aside.


I wasn't present for the ER doc's physical exam, due
to son's embarassment issues, so didn't see...but, ER doc said testicle is
so
small, it's the first thing she noticed. He's had every required well
visit,
including one just a few months ago. Hernia's are always checked for and,
I
assumed, visual examination of the genital area was part of this. I guess
this
was a sad and sorry assumption on my part. I love our ped, but, I am very
disturbed about this. Apparently, if this had been caught sooner,
something
might have been done to preserve his fertility.

Anyway, we will be getting to a urologist ASAP. But, I was hoping
someone
else could shed some light and/or comfort on this. Thanks in advance for
any
help you can give.

I hope this helps

Nik
-------------
Hoping your hills are never too steep!
Be well, Patty

On 24 Jun 2004 18:36:50 GMT, (Patty ) wrote:

if his other one is fine, he should remain fertile.

Thanks PF. That is comforting. He has an appt with a urologist tomorrow
afternoon. Guess we'll know more then. The ER doc kinda said the same thing as
you, but, we're still worried. He's our first 'baby' (we have 3 others) and
this was like a punch in the gut, ya know? I guess the infection was a blessing
in disguise as it allowed the problem to be recognized.

And it may in fact be related, if there is an anatomic abnormality
that led to both the testicular atrophy and the epididymitis.

PF

On 24 Jun 2004 14:36:46 -0700, (CBI) wrote:

(Patty ) wrote in message ...

Anyway, we will be getting to a urologist ASAP. But, I was hoping someone
else could shed some light and/or comfort on this. Thanks in advance for any
help you can give.

You are right that it shouldn't have been missed.

We shouldn't rush to judgment without knowing the whole story. Perhaps
he had a torsion previously that resulted in a shrinking testicle and
at the time of a recent physical exam the asymmetry wasn't impressive
enough yet.

PF

"Patty "
Maybe it didn't look that abnormal. Kinda like woman, some left breasts
are slightly bigger

I would have agreed with you until my DH looked for himself. I know in
most/many men/women, one testicle/breast is slightly larger/smaller than
the
other. To put my son's problem into perspective, DH said one testicle is
the
size of a raisin and the other is the size of a golf ball. I can't imagine
why
his doctor didn't notice this. And, while nothing may have been fixable,
it
still seems to me that it should have been noticed by his doc.
Thanks for your thoughts, Nik.

Ok now that you say that...I am amazed that the doctor didn't notice or say
anything earlier.
I would be most upset if my doctor didn't notice something like tthat.

I hope you get it fixed soon and with a postive finish.

Nik



-------------
Hoping your hills are never too steep!
Be well, Patty

On 25 Jun 2004 10:22:11 -0700, (CBI) wrote:

My son had bilateral hydroceles when he was an infant. I noticed them
while changing him but the nurse practitioner that had seen him for
his first few visits didn't. It became kind of a joke between my wife
and I to see if she would before they resolved. She never did.

How do you know she didn't notice them but just chose not to mention
them?

PF

PF Riley wrote:
On 25 Jun 2004 10:22:11 -0700, (CBI)
wrote:

My son had bilateral hydroceles when he was an infant. I
noticed them
while changing him but the nurse practitioner that had
seen him for
his first few visits didn't. It became kind of a joke
between my wife
and I to see if she would before they resolved. She never
did.

How do you know she didn't notice them but just chose not
to mention
them?

It is possible but judging from the lack of of specific
attention to them we don't think it is likely. They also
were not documented on at least two of the early progress
notes.

Also, if she was noticing them but not mentioning them I
would say that is unwise. I find it is better to mention
that you are watching things like that early so that it is
not so much of a shock when you later announce that it is
time to see the specialist and consider surgery. Also, it
really upsets a lot of people if someone else mentions it
and you haven't.

--
CBI, MD

On Mon, 28 Jun 2004 03:33:57 GMT, "CBI" wrote:

Also, if she was noticing them but not mentioning them I
would say that is unwise. I find it is better to mention
that you are watching things like that early so that it is
not so much of a shock when you later announce that it is
time to see the specialist and consider surgery. Also, it
really upsets a lot of people if someone else mentions it
and you haven't.

I feel the same. Although practice styles differ, you may be right.