What causes intermittent testicular pain, dysuria (painful urination), and frequent urination after ejaculation?

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Differential Diagnosis

  • Single most likely diagnosis
    • Prostatitis: This condition, which is an inflammation of the prostate gland, can cause testicular pain, burning sensation while urinating, and frequent urination. The symptoms can be exacerbated by ejaculation, which may explain the intermittent nature of the symptoms.
  • Other Likely diagnoses
    • Epididymitis: Inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm, can cause testicular pain and burning sensation while urinating. It can be caused by bacterial or viral infections.
    • Urethritis: Inflammation of the urethra, often caused by sexually transmitted infections, can cause burning sensation while urinating and frequent urination.
    • Seminal vesiculitis: Inflammation of the seminal vesicles, which are glands that produce a significant portion of the fluid in semen, can cause testicular pain and burning sensation while urinating after ejaculation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular torsion: Although this condition is more commonly associated with sudden and severe testicular pain, it is a medical emergency that requires prompt attention. Delayed treatment can result in loss of the testicle.
    • Testicular cancer: While testicular cancer is not typically associated with burning sensation while urinating, it can cause testicular pain and should be ruled out, especially if there is a palpable mass or significant testicular enlargement.
  • Rare diagnoses
    • Interstitial cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain, which can be exacerbated by ejaculation.
    • Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, which can cause testicular pain and swelling.
    • Spermatocele: A cyst that forms in the epididymis and can cause testicular pain and discomfort, especially after ejaculation.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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