Pea size lump outside of testicular! Kindly prescribe me the best urologist in BBK

[Local foreigner]

Hello medical experts and practitioner, 

I am currently experiencing some unusual things (like a pea size of lump) outside of my left testicular. Suddenly two months ago in the morning,  I found out a big lump with severe back pain near my testicular.  I went to the local hospital and consulted with the doctor. The doctor preliminary assumed it caused due to infection and gave me antibiotics (7 days ) and prescribed an ultrasound. After taking the antibiotics, the Lump was decrease and getting smaller. I did the ultrasound and found two cm size epididymal cyst outside of the left testicular. Doctor assumed that could happen due to infection. Doctor prescribed me again antibiotics for 7 days and another ultrasound. I took the antibiotics and did the 2nd ultrasound agin. This time the ultrasound specialist couldn’t get any lump and it gone . But after two days of the 2nd ultrasound, I felt very tiny mess outside of the left testicular. I went to doctor again and did the 3rd ultrasound yesterday. During the 3rd ultrasound, doctor found one cm epididymal cyst outside the left testicular in the same place. Now doctor prescribe me again antibiotics for another 7 days . I am still experiencing back pain . Besides that, I feel materllic taste on my tongue last two months . 
I am afraid about my health condition as it’s not clear what’s the problem and how to solve it. I would be thankful if you could provide your advice, and suggest me a good hospital and an urologist. Thank you so much for your time and advice. 

[Sheryl]

I do not understand the treatment you report relative to the stated diagnosis.

 

Epididymal cysts are not caused by infection nor treated with antibiotics.

 

In addition, they are harmless and do not usually require treatment.

 

The metallic taste is due to the antibiotics, which unless there is some other problem you did not mention, you probably do not need.

 

As for recommending a urologist, please indicate where in Thailand you are.

[rascalman]

May require a Nutectomy.. Consult surgeon. 

[Local foreigner]

Hello Sheryl, 

Thank you so much for your time and reply. 
As I mentioned my post, at the beginning the lump was bigger like a another ball. I experienced it suddenly. It was supposed that the lump came from an infection or hurt. So doctor prescribed antibiotics. After taking the antibiotics, it was dramatically decreased and became smaller.

In the first ultrasound, the ultrasound specialist found like a mass (2 cm) outside of the testicular ( He said it was epididymal cysts) . 
Then I took 2nd time antibiotics and the lump almost gone. I did again ultrasound and found nothing. 
But now the lump comes again and I did third ultrasound yesterday. The ultrasound specialist said there is a pea size lump outside of the testicular. 
I feel back pain, tiredness and metallic taste.   
As the lump decreased after taking antibiotics, the doctor can’t exactly tell whether it is a lump or comes from infection. The doctor prescribed me again antibiotics for another 7 days . 
I have already took two times  (7 days + 7 days ) antibiotics. So, I am afraid to take antibiotics again. So, I would like to consult with an experienced urologist specialist and find out the problem. 
Currently, I am working and living in Nakhon Nayok, Thailand.
I would be thankful if you could provide valuable advice based on my case and suggest me an urologist. 
Again, Thank you so much for your time . 

[CFCjeff]

I have the same problem, Doc said they could remove it if caused problems,but it doesnt hurt me, and 15 years on still got it, but all ok.  Its quite common.

[Local foreigner]

CFCjeff, 
thank you so much for your information. I don’t feel any pain or discomfort too. Hope doctor will suggest me the best things. 

[Sheryl]

13 hours ago, Local foreigner said:

Hello Sheryl, 

Thank you so much for your time and reply. 
As I mentioned my post, at the beginning the lump was bigger like a another ball. I experienced it suddenly. It was supposed that the lump came from an infection or hurt. So doctor prescribed antibiotics. After taking the antibiotics, it was dramatically decreased and became smaller.

In the first ultrasound, the ultrasound specialist found like a mass (2 cm) outside of the testicular ( He said it was epididymal cysts) . 
Then I took 2nd time antibiotics and the lump almost gone. I did again ultrasound and found nothing. 
But now the lump comes again and I did third ultrasound yesterday. The ultrasound specialist said there is a pea size lump outside of the testicular. 
I feel back pain, tiredness and metallic taste.   
As the lump decreased after taking antibiotics, the doctor can’t exactly tell whether it is a lump or comes from infection. The doctor prescribed me again antibiotics for another 7 days . 
I have already took two times  (7 days + 7 days ) antibiotics. So, I am afraid to take antibiotics again. So, I would like to consult with an experienced urologist specialist and find out the problem. 
Currently, I am working and living in Nakhon Nayok, Thailand.
I would be thankful if you could provide valuable advice based on my case and suggest me an urologist. 
Again, Thank you so much for your time . 

As you are in Nakorn Nayok I suggest you go to either:

 

1. Srinakharinwirot University Hospital  in Ongkharok.  It is right on route 33 maybe a kilometer or 2 west of the Ongkharok junction. Bring a Thai  speaker with you at least the first time, if possible.

 

2.  Bangkok and see this very nice, Uk-trained urologist privately

https://www.bumrungrad.com/en/doctors/Viroj-Chodchoy

The consultation will cost approximately 1,500 baht. Don't buy an medicine at the hospital (probably none needed but if it is, buy at a pharmacy). While it will involve more travel time to go into Bangkok the total time spent may not be much different because at Srinakharinwirot , a government teaching hospital, there are long waits and you have to be seen first by a medical student or intern/resident and then have your case presented to the supervising doctor, unlikely to be done in less than 3-4 hours or more. And communication will be difficult. At Bumrungrad you can make an exact appointment and will probably be in and out within an hour.

 

From what you now describe I think the original large lump was something entirely different from the epididymial cysts being found on ultrsound. Epididymal cysts are extremely common and harmless and often people don't even know they have them until an ultrsound is done for some other reason. They also don't change much in size, certainly not quickly. I think these are just incidental findings and not what the original lump was.  That could have been many things, including a hydrocele or variocele. The good news is that if it were testicular cancer it would not disappear or decrease in size.

 

So your real issue may be that you had a large, painful lump that disappeared aftre a course of antibiotics.  And the  epididymal cysts are just an incidental and unimportant finding. try not to confuse these 2 issues as it may also confuse the urologist you go to see (if they think you have come just because of epididymal cysts they will likely just tell you they are harmless and don't need treatment - after all, they will not have seen the original large lump).

 

Get a detailed report from the doctor you have been seeing to bring with you.

 

I agree that it is unlikely that more antibiotics are needed. Thai doctors do tend to overuse antibiotics and to use them blindly without a clear diagnosis. Asmentioned the antibiotics are probably the cause of the metallic taste.

 

 

 

[ChrisKC]

2 hours ago, Sheryl said:

As you are in Nakorn Nayok I suggest you go to either:

 

1. Srinakharinwirot University Hospital  in Ongkharok.  It is right on route 33 maybe a kilometer or 2 west of the Ongkharok junction. Bring a Thai  speaker with you at least the first time, if possible.

 

2.  Bangkok and see this very nice, Uk-trained urologist privately

https://www.bumrungrad.com/en/doctors/Viroj-Chodchoy

The consultation will cost approximately 1,500 baht. Don't buy an medicine at the hospital (probably none needed but if it is, buy at a pharmacy). While it will involve more travel time to go into Bangkok the total time spent may not be much different because at Srinakharinwirot , a government teaching hospital, there are long waits and you have to be seen first by a medical student or intern/resident and then have your case presented to the supervising doctor, unlikely to be done in less than 3-4 hours or more. And communication will be difficult. At Bumrungrad you can make an exact appointment and will probably be in and out within an hour.

 

From what you now describe I think the original large lump was something entirely different from the epididymial cysts being found on ultrsound. Epididymal cysts are extremely common and harmless and often people don't even know they have them until an ultrsound is done for some other reason. They also don't change much in size, certainly not quickly. I think these are just incidental findings and not what the original lump was.  That could have been many things, including a hydrocele or variocele. The good news is that if it were testicular cancer it would not disappear or decrease in size.

 

So your real issue may be that you had a large, painful lump that disappeared aftre a course of antibiotics.  And the  epididymal cysts are just an incidental and unimportant finding. try not to confuse these 2 issues as it may also confuse the urologist you go to see (if they think you have come just because of epididymal cysts they will likely just tell you they are harmless and don't need treatment - after all, they will not have seen the original large lump).

 

Get a detailed report from the doctor you have been seeing to bring with you.

 

I agree that it is unlikely that more antibiotics are needed. Thai doctors do tend to overuse antibiotics and to use them blindly without a clear diagnosis. Asmentioned the antibiotics are probably the cause of the metallic taste.

 

 

 

Your reply is really useful and helpful for the OP

 

I am unaffected by the condition of the OP - just appreciate the time you have given

[Hummin]

Seems like antibiotics is the answer and first response to everything in Thailand, better to search an specialist as mentioned  when experience something abnormal like this, Thats why I swear to Bangkok Hospital in Bangkok, or would ask Sheryl next time before going anywhere and take her recommendations and advises where to go. 
 

Always deliver

[Local foreigner]

Hello Sheryl, 
Thanks a lot again for your reply. I appreciate your time and effort for suggesting me the medication and hospital.