Testicular Pain/ Scrotal Pain

[erichpen]

In the last two years of my life I had some major health problems and I would like to have someone to answer my questions, so I can make good decisions for my future.
I am 57 years old; I was born with undescended testicles and I was not circumcised. The undescended testicles were surgically corrected in my childhood. I am married and have 3 healthy daughters, (20, 17, and 12); my sexual life was good until about 12 years ago when I had vasectomy and removal of hydrocele The reason for the vasectomy was birth control and the large hydrocele was discovered by the urologist during exam before the scheduled vasectomy
I started to have chronic pain in my testicles after the surgery. The chronic orchalgia never went away but I learned live with it because the pain was not too intense. About 6 years ago I went to my general practitioner to check my ED and the chronic testicular pain. The doctor checked my testosterone level, it was low, 147. I was diagnosed with hypogonadism The doctor started me on testosterone replacement treatment (AndroGel 1%, 2x daily) after PSA test (3.3), the testosterone level raised to 342 in 2 months but the ED was not getting much better, so I was prescribed Viagra, Cialis and Lavitra, to address the ED. The side effects from taking the medication were too severe to continue with the treatment (bad headaches and blurred vision). For the testicular pain I was given pain medication. Then two years ago I made a appointment with a urologist to do something with the ED. My PSA was checked and it was 7. Prostate biopsy showed prostate cancer Gleason score 7 (3+4). In July 2007 I had radical retropubic prostatectomy, no nerve sparing, 3 large tumors, both lobes, no penetration of the outer layer, seminal vesicles and lymph nodes biopsies were negative. In October 2007 the doctor found mass in my right testicle. Tests were done, Ultrasound, MRI CT and other tests. The results were inconclusive with the possibility of neoplasm. The radical prostatectomy left me with severe incontinence and no lack of penile erections. In January 2008 I had surgery for inflatable penile implant, artificial urinary sphincter and inguinal orchiectomy of the right testicle. The pathology report on the testicle showed no cancer. In April I had to have revision surgery for the implant pumps and tubing. The AUS pump migrated to the inguinal area. I believe that this could have done damage to the testicular cord nerves in the inguinal area. Also circumcision of the redundant foreskin, result of the penile shrinkage after the prostatectomy, was done. My last PSA check was not detectable (July 2008). Now my chronic testicular pain in my left testicle is back and it is worse then before the surgeries. Also my penile glans is now very small, shriveled and cold, and hypersensitive, I still have small incontinence and have to ware one pad a day. It is very uncomfortable to have sexual intercourse and even the touch of clothes is irritating. There is also a small remnant of frenulum left from the circumcision and that little remnant of skin causes sharp pain.
Can the remnant of the frenulum be removed and is that going to stop the sharp pain?
Can selective neurectomy of the penile dorsal nerve or Hyaluronic Acid Gel injections in the glans, reduce the hypersensitivity?
With my history of prostate cancer would it be good to have orchiectomy on my left testicle to stop the chronic testicular pain and also have this procedure used for adjuvant hormonal therapy to delay or prevent the recurrence of PC? Or is a better option microsurgical denervation of spermatic cord and testicle, or epididymectomy?
Thank you for taking the time to read and answer my questions.
PS: My wife was diagnosed last summer with stage 3c Breast Cancer She is going through second round of chemotherapy In March she is going to have surgery to remove right breast. Radiation will follow and than she would like to have the left breast removed and reconstructive surgery on both breasts done.

Erich

[paininthenuts]

I can't help, but it puts my problems into perspective. Good luck and I hope your wife is OK

simon