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PUNLMP is an acronym for Papillary Urothelial Neoplasm of Low Malignant Potential. This is a non-cancerous growth in the bladder that, however, may become cancerous. The ideal next step to take is to follow your surgeon's recommendation for a cystoscopy in September. This procedure will aid in observing the bladder for any changes. This check-up is the first step in catching any problems that may arise early. Be mindful, that early discovery plays a significant role in the success of such situations. 

Frequent testicular pain could be epididymitis. Pain after micturition could be UTI. Early diagnosis and treatment are necessary. Don't ignore.

Your veins have still not changed from the way they were before the varicocele surgery 4 months ago. Varicocele is a scrotum condition caused by size-wise swollen veins. This can be manifested either in the form of painful swelling or it can lead to infertility. The surgery didn' t probably fix the issue entirely. Go back to your doctor and find out the reason this is happening and what further actions can be taken.

Based on your description of the symptoms, it might be that you had an acute urinary tract infection and antibiotics were used to treat it. Drinking plenty of water is needed and energy drinks should be avoided because dehydration can make UTI symptoms worse. If you are still shaking or experience other similar symptoms after the treatment, you should go to the doctor who prescribed the antibiotics to you or see a urologist.