What is the cause for acute testicular pain?

Q: I am a 32 year old male, married and have a child. I have been suffering from acute testicular pain for over two years. I consulted two urologists and got ultrasound and other tests done which are all normal. I was given strong antibiotics a long time back but it did not help. My urologist then advised me to take Advil and said that if the pain still persists, I will have to bear with it. This pain is making my life miserable. Sometimes I do not wear any briefs and then the pain is less severe.

A:Firstly, get urine routine test done especially at the time of pain to look for RBCs. Repeat it a few times. If your ultrasound has been done for kidneys as well, it is ok, if not, get it done. Pain can occur due to a tiny stone in lower ureter which does not show up on X-ray. The second cause is recurrent torsion which actually is very rare at your age. It is important to check if you ever had swelling of testes at the time of pain; whether your pain comes on only one side or both; is there any problem in passing urine, specially if your stream has gone down. Tablet Hytrin or capsule Flomax at night might be useful in management.