Managing Left Varicocele: Symptoms, Concerns, and Treatment Options

Varicocele

1.
The doctor said I have a varicocele on my left testicle (like several worms).
2.
Then he asked me if I have children.
Answer: Yes.
3.
He then said: That's not a problem! Just drink plenty of water, quit smoking, and avoid prolonged standing or sitting.
4.
I asked: Do I need surgery? The doctor said: No need! 5.
Here’s the main point! I experience occasional "dull pain," "heaviness," and an exaggerated "sagging of the left testicle" almost every day! (Sometimes even light contact with the testicle can be painful.) 6.
What should I do!? (It hurts like this every day, and it's very distressing; I've even stopped sexual activity.) Thank you.

Zhao Sir, 40~49 year old female. Ask Date: 2016/08/27

Dr. Sun Hongshun reply Urology

Hello, I'm not sure if you have discussed your feelings of sadness with your physician.
If you have, and the physician still says there is no issue, I recommend that you promptly seek a consultation with another urologist.

Reply Date: 2016/08/27

More Info

Managing a left varicocele can be a complex issue, especially when symptoms such as discomfort, heaviness, and pain are present. A varicocele is essentially an enlargement of the veins within the scrotum, similar to varicose veins that can occur in the legs. While many individuals with a varicocele may not experience significant symptoms, others can have discomfort that affects their quality of life, including sexual function.

Symptoms and Concerns
From your description, it seems that you are experiencing significant discomfort and pain in the left testicle and groin area. Symptoms of varicocele can include:
1. Dull ache or pain: This is often described as a feeling of heaviness or a dragging sensation in the scrotum, especially after prolonged standing or physical activity.

2. Visible veins: The veins may appear enlarged and can resemble a "bag of worms."
3. Changes in testicle size: The affected testicle may be smaller than the other one, particularly if the varicocele has been present for a long time.

4. Sexual dysfunction: Pain during sexual activity can occur, as you've mentioned.

Treatment Options
1. Conservative Management: Since your doctor has advised against surgery, conservative management is often the first line of treatment. This includes:
- Hydration: Drinking plenty of water can help improve circulation.

- Avoiding prolonged standing or sitting: Changing positions frequently can alleviate pressure on the veins.

- Wearing supportive underwear: Supportive garments can help reduce discomfort.

- Pain management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain.

2. Surgical Options: If conservative measures do not alleviate your symptoms, or if the varicocele is affecting your quality of life or fertility, surgical intervention may be considered. Surgical options include:
- Varicocelectomy: This is a surgical procedure to remove the affected veins. It can be done through an open surgery or laparoscopically.

- Embolization: A less invasive procedure where a catheter is used to block the blood flow to the enlarged veins.

3. Follow-Up: Regular follow-up with your healthcare provider is essential. If your symptoms persist or worsen, further evaluation may be necessary. This could include imaging studies to assess the varicocele and rule out other potential issues.

When to Seek Immediate Care
If you experience severe pain, swelling, or any signs of infection (such as fever or redness), it is crucial to seek immediate medical attention. These could be signs of complications that require urgent intervention.

Conclusion
While your doctor has indicated that surgery is not necessary at this time, your ongoing symptoms warrant further discussion. It may be beneficial to seek a second opinion or consult a urologist who specializes in male reproductive health. They can provide a more tailored approach to your situation, considering both your symptoms and your desire for a resolution. Managing a varicocele can be challenging, but with the right support and treatment plan, you can find relief and improve your quality of life.

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