[36M] With scrotal bruising and urinary symptoms

Patient Description

A 36-year-old male presents with a bruise on the scrotum, described as circular, purple, and black, with no history of blunt trauma. The bruise appeared a few days ago. The patient reports experiencing difficult and painful urination for a couple of months, with pain severity rated as 8 out of 10, and very dark urine. There is also blood in the urine. The patient has a history of kidney stones but has not had any recent imaging tests. Additional symptoms include unexplained weight loss, fatigue, and difficulty sleeping. The patient is currently taking Adderall (20 mg twice daily) and testosterone (1 mg biweekly). No recent travel or family history of kidney disease or urinary tract issues. No known allergies to medications except for morphine.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential concerns that should be addressed promptly:

  1. Kidney or Urinary Tract Issue: Given your history of kidney stones, the painful urination, dark urine, and presence of blood could indicate a kidney stone or another urinary tract issue. Kidney stones can cause severe pain and may lead to complications if not treated.

  2. Bruising on the Scrotum: The sudden appearance of a bruise without trauma could be related to a vascular issue or another underlying condition that needs evaluation. It’s important to rule out any serious conditions that might cause such symptoms.

  3. Infection or Inflammation: The combination of symptoms, including painful ejaculation and fatigue, could suggest an infection or inflammation in the urinary or reproductive system, such as prostatitis or a urinary tract infection.

  4. Potential for Serious Conditions: The unexplained weight loss and fatigue are concerning and warrant further investigation to rule out more serious conditions.

What you can do

  1. Seek Immediate Medical Attention: It is crucial to see a healthcare provider as soon as possible. Given the severity of your symptoms, visiting an urgent care center or emergency room would be advisable. They can perform necessary tests, such as imaging or blood tests, to determine the cause of your symptoms.

  2. Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, changes in urine color, or new symptoms. This information will be helpful for your healthcare provider.

  3. Stay Hydrated: Drink plenty of water unless advised otherwise by a healthcare professional. Staying hydrated can help with kidney function and may alleviate some symptoms.

  4. Avoid Strenuous Activity: Until you have been evaluated by a healthcare professional, avoid activities that could exacerbate your symptoms.

  5. Prepare for Your Appointment: Make a list of all your symptoms, any medications you are taking, and your medical history to share with your healthcare provider.

Please remember, while this information can help guide you, it is not a substitute for professional medical advice. It is important to seek care from a healthcare provider to receive a formal diagnosis and appropriate treatment. If your symptoms worsen or you feel that you are in a medical emergency, please call 911 or have someone take you to the nearest emergency room immediately.

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1 mo ago


People Also Ask


What could cause a bruise on the scrotum without any trauma?

A bruise on the scrotum without trauma could be due to a vascular issue, a bleeding disorder, or an underlying medical condition that requires evaluation by a healthcare professional.


Why might someone experience painful urination and blood in the urine?

Painful urination and blood in the urine can be caused by urinary tract infections, kidney stones, or other urinary tract issues. It is important to seek medical evaluation to determine the exact cause.


What are the potential causes of unexplained weight loss and fatigue?

Unexplained weight loss and fatigue can be symptoms of various conditions, including infections, metabolic disorders, or more serious illnesses such as cancer. A thorough medical evaluation is necessary to identify the underlying cause.


How can kidney stones affect urination and overall health?

Kidney stones can cause severe pain, especially during urination, and may lead to complications such as urinary tract infections or kidney damage if not treated. They can also cause blood in the urine and require medical attention.


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