Varicocele: Symptoms, Diagnosis, and Treatment Options - Urology

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Varicocele


Hello Doctor: Over the past six months, I have noticed that when I play sports and feel more fatigued, my left testicle feels a bit swollen, and I can clearly see something resembling a worm on the left side.
It feels soft to the touch, but when I lie down, it seems to shrink.
The swelling doesn't significantly affect me, but for health reasons, I went to see a urologist.
The doctor diagnosed me with varicocele (after performing an ultrasound), noting that the left testicle measures 2.6 cm in diameter and the right one 3.6 cm.
He recommended surgery.
I would like to ask the doctor: A: Does varicocele (which I suspect I may have had for a long time) affect penile development? If it does, will the penis stop developing after the surgery, considering I am already 19 years old? B: Do you recommend surgery? If so, what are the reasons, and what is the approximate cost?

Pipi, 10~19 year old female. Ask Date: 2016/12/10

Dr. Du Shixi reply Urology


Hello: Without an examination, I cannot recommend whether or not to proceed with surgery.
However, this is not an emergency that requires immediate surgery, and the decision to operate is not related to penile development.
Thank you for your inquiry.

Reply Date: 2016/12/10

More Info


Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that occur in the legs. It is a common condition, particularly in young men and adolescents, and can have implications for fertility and testicular health. Understanding the symptoms, diagnosis, and treatment options for varicocele is essential for managing this condition effectively.


Symptoms of Varicocele
The symptoms of varicocele can vary, and some individuals may not experience any noticeable symptoms. However, common symptoms include:
1. Swelling or Enlargement: Patients often report a feeling of heaviness or swelling in the scrotum, particularly on the affected side. This can be more pronounced after physical activity or prolonged standing.


2. Visible Veins: The affected veins may become enlarged and visible, resembling a "bag of worms," which is a classic description of varicocele.

3. Discomfort or Pain: Some individuals may experience dull, aching pain in the scrotum, which can worsen with physical activity or prolonged standing.

4. Testicular Atrophy: In some cases, the affected testicle may be smaller than the other due to impaired blood flow.

5. Fertility Issues: Varicocele is associated with male infertility, as it can affect sperm production and quality.


Diagnosis of Varicocele
Diagnosis typically involves a physical examination by a healthcare provider, where they may palpate the scrotum while the patient is standing and lying down. An ultrasound may be performed to confirm the diagnosis and assess the severity of the varicocele. The ultrasound can help visualize the enlarged veins and any potential impact on the testicular tissue.


Treatment Options for Varicocele
Treatment for varicocele is not always necessary, especially if there are no symptoms or fertility concerns. However, if the varicocele is causing discomfort, pain, or fertility issues, surgical intervention may be recommended. The primary treatment options include:
1. Surgical Repair (Varicocelectomy): This is the most common treatment for symptomatic varicocele. The procedure involves ligating the affected veins to redirect blood flow and reduce the size of the varicocele. It can be performed through open surgery or laparoscopically.

2. Embolization: This is a minimally invasive procedure where a catheter is used to block the affected veins, reducing blood flow to the varicocele. This option may be preferred for patients who wish to avoid surgery.


Addressing Your Concerns
Regarding your specific questions:
A. Impact on Penis Development: Varicocele itself does not directly affect penile development. However, if there are underlying hormonal imbalances or testicular dysfunction due to the varicocele, it could potentially influence overall sexual health. At 19 years old, you are likely nearing the end of your physical development, and surgical intervention should not hinder any further growth.

B. Surgical Recommendation and Costs: If your urologist has recommended surgery, it is likely due to the presence of symptoms or concerns about fertility. The primary reasons for surgery include alleviating discomfort, preventing potential complications, and improving fertility outcomes. The cost of varicocele surgery can vary widely based on location, healthcare provider, and whether you have insurance coverage. It is advisable to discuss the specifics with your healthcare provider, including potential costs and what your insurance may cover.

In conclusion, while varicocele can be a benign condition, it is essential to address any symptoms or concerns with your healthcare provider. Surgical intervention can provide relief and improve quality of life, particularly if fertility is a concern. Always consult with a qualified urologist to discuss your specific situation and the best course of action.

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