Help diagnose me? left upper groin area / testicle dull aches since Jan

Male pelvic pain, prostatitis, IC
Euphoric-Lake586
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Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by Euphoric-Lake586 »

Hello, I would really appreciate any help to narrow down my issues. I'm really anxious... TLDR is an ultrasound scan found that I do have dilated veins in the left testicle (mild I believe as not visible to naked eye and doesn't really feel that different). But I'm wondering -- do I have another issue, given not all the symptoms exactly match varicocele? I want to be really sure before I go for any operation on the varicocele. Thank you so much for any advice.

Long version:
  1. I started having some strange sensations around my left testicle in Jan this year. I was masturbating a lot at the time, much more than ever -- a lot porn induced and unnatural, sometimes forcing it back-to-back (which is not natural for me, always had a long refractory period). I say unnatural because after the 1st ejaculation, I could probably only get hard again because of the porn. It was minor, dull ache came and went (still comes and goes). Dull ache is sometimes left testicle, sometimes more left upper groin area
  2. pain has hit me rather sharply twice -- 1st time in Feb after I ejaculated from oral sex while laying down (2nd time see below in July, also same position). Pain/discomfort lingered for maybe 5 days. I was concerned, ER doc ruled out torsion. I got STI and urine tests (both nothing), and was put on antibiotics anyway (doxycycline) but not sure if antibiotics helped or not. Around the same time, I got a rash on my left hip + some weird nerve sensations in that dermatome, which the Dr told me was shingles. I'm 100% sure this was actually shingles (due to the rashes and the weird nerve feelings went away after a few weeks), but I think the shingles were triggered by something else...
  3. After that, mild left testicle / upper groin discomfort continued on-and-off. Discomfort area moves around a bit, sometimes scrotum area sometimes upper groin area. From March - July, I masturbated on/off but less so (sex also reduced). In June, I was kneed playing sports in the upper groin area where I typically feel discomfort -- just to the left of the pubic bone. That bruised feeling went away after about 1 week
  4. 2nd time I got sharper pain was in July -- like in Feb, it occurred after I ejaculated from oral sex while laying down. After that day, it's mostly rather dull... do these symptoms say anything? -- it hurts when I cough or sneeze. It hurts when I do certain lower ab movements (e. G. Leg lifts) but it's mostly ok when doing any other exercise - lifting weights, playing sports. The pain related to these movements is in the left upper groin area, NOT as much the scrotum
  5. Because of those symptoms, I started thinking hernia. Went to a Dr a couple weeks ago... Did ultrasound for inguinal hernia (nothing) and testes. Had a 2nd ultrasound on testes which found minor dilated veins in left testes, so urologist has said it is varicocele. Got a 2nd opinion from another Dr, who felt pretty confident it's not a hernia. He identified well the sensitive spot and thought it was maybe a strained ligament. He is pretty sure it's not epididymitis and recommended a MRI, which I'm waiting for
  6. I played sports for about 2 hours continuously this past Sunday, which is longer than usual. Usually I don't have much pain after sports (but also don't play that long continuously)..... But this time I had a pretty strong ache, which this time WAS in/around the left scrotum (moreso than the upper groin area). I was better though come Monday
Overall I do not always have the dull ache after intercourse, but sometimes I do. Same with masturbation - sometimes yes, sometimes no. I definitely have a varicocele, but the Dr isn't' sure if it was already there / was an incidental finding. Might I have something else in addition to the varicocele? I want to be really sure before I go for any operation for the varicocele.
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by webslave »

Hurts when you cough or sneeze suggests hypertonic pelvic floor. Have you had a pelvic floor assessment from a physiotherapist who specialises in pelvic pain?
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Euphoric-Lake586
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by Euphoric-Lake586 »

No not yet. Are a tight pelvic floor and a hypertonic one the same thing? Some symptoms match up (urination frequency and urgency- tho I drink a LOT of water; pelvic pain), but some symptoms do NOT match (constipation, pain during sex, urinary incontinence).

I do think it is likely I have have a tight pelvic floor (and maybe a weak one? erections can be weak at times). I clench pretty hard when masturbating and especially when my mind is f'ed and I'm watching more porn and I'm clenching to get it up again. I know I don't masturbate that in a healthy way or with good technique that reinforces good neural patterns, so I'm trying to stop that and porn. Also in general, have a lot of tightness in my body and am stressed (and I used to play a lot of video games when younger and didn't have the best erections when I started having sex).

I saw this user say this in another thread and I can definitely relate:
"I have noticed recently that I need to flex the pelvic muscles and tighten them a lot to reach orgasm or keep an erection, maybe that's an issue?"

What should I do... work on stretching and Kegels/reverse kegels? I'm a bit unsure if I'm even identifying my pelvic floor correctly / I can only seem to activate it if I also clench my glutes or lower ab muscles
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by webslave »

Euphoric-Lake586 wrote: Wed Aug 18, 2021 2:26 pm Are a tight pelvic floor and a hypertonic one the same thing?
Yes
What should I do ... work on stretching and Kegels/reverse kegels?
Kegels NO, reverse kegels yes. And see a therapist to assess pelvic floor.
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by Euphoric-Lake586 »

Ok thanks. I'm not really in a place where there are therapists for this, is there anything I can do instead? Also do you think there might be other issues I should get checked?
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by webslave »

Then get a wand or Theracane to probe yourself, gently, to find problem areas. Your symptoms do sound like a hernia though. Were you assessed by an expert ultrasound person who asked you to bear down as if passing a bowel motion with your lungs full while she scanned the area? Small (but painful) hernias can be missed without using that technique.
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

Post by Euphoric-Lake586 »

Thank you, I'll do that. No unfortunately I wasn't asked to do that during the ultrasound.

My MRI images came in and I'm having a call with the Dr Tuesday. Could I share the MRI images here for your opinion?

Thanks so much.
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Re: Help diagnose me? left upper groin area / testicle dull aches since Jan

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We can't interpret MRIs, but the MRI can help to find a small, nonpalpable occult hernia.

Role of Imaging in the Diagnosis of Occult Hernias
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