Varicocele: Symptoms, Causes, and Treatment Options

Q: Varicocele: Symptoms, Causes, and Treatment Options

Hello： 2) Heavy work, prolonged sitting, or standing can all be potential causes; many men experience this. <br>3) If you frequently notice pain, it is not recommended to engage in jogging, push-ups, or sit-ups. <br>4) If the pain is mild, it should be optional whether to perform

Varicocele

Hello, doctor.
I have some questions regarding varicocele issues:
1.
About four years ago, after lifting heavy objects or wearing tight pants, I felt some pain and discomfort in the lower abdomen (which I believe is not the testicles).
I thought it was a hernia, but a physician's examination found no issues.
On March 11 of this year, while driving, I suddenly experienced sharp pain in the lower left abdomen (not sure if it was the testicle) 2-3 times (it was quite painful).
I thought it was due to holding my urine or tight pants.
After urinating and loosening my belt, the pain disappeared.
However, from March 11 to March 19, I occasionally felt some dull pain or discomfort in the left lower abdomen or testicle, but it was not as sharp as on March 11.
On March 19, I visited a urologist, and after X-rays ruled out stones, hematuria, and inflammation, the physician found that the left testicle had a varicocele, but it was not severe.
He mentioned that my pain was not very typical, advised against surgery for now, and suggested monitoring.
2.
What types of individuals or lifestyles (height, weight, stress, etc.) are more likely to develop varicocele?
3.
Can I jog, do push-ups, or perform sit-ups now?
4.
Should I proceed with an ultrasound or semen analysis to confirm whether it is a varicocele?
5.
Is my pain caused by the varicocele, or should I undergo other examinations?
6.
Should I wear briefs or boxers now?
7.
How can I prevent the varicocele from worsening?
8.
I cannot see the varicocele when standing; it only appears when I sit and palpate.
9.
Do I need surgery for this pain?
10.
If it is a varicocele, why do I sometimes feel discomfort in the lower abdomen (similar to a mild sensation of touching the testicle) and not necessarily in the testicle itself?
11.
My left testicle hangs about 1 cm lower than the right; is this normal? Is there anything I should be concerned about?
12.
When I look at the back and side of the right testicle, it seems to have a worm-like shape, but I do not feel any discomfort on the right side.

Nìmíng, 30~39 year old female. Ask Date: 2018/03/20

Dr. Du Shixi reply Urology

Hello: 2) Heavy work, prolonged sitting, or standing can all be potential causes; many men experience this.
3) If you frequently notice pain, it is not recommended to engage in jogging, push-ups, or sit-ups.
4) If the pain is mild, it should be optional whether to perform these activities.
5) Varicocele -- pain or discomfort occurs due to poor blood flow and blood pooling in the veins.
6) Loose-fitting pants and underwear are advisable.
7) Avoid prolonged standing and heavy lifting; also, avoid chronic, severe coughing and strenuous physical labor.
8) Mild.
9) If you experience pain several times a week, I personally recommend surgery, but there is a possibility of recurrence.
10) Varicocele is generally not associated with testicular discomfort.
11) Normal.
12) If symptoms are present, consult a urologist to determine whether it is a varicocele or a skin-related vascular issue.
Wishing you good health.

Reply Date: 2018/03/20

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 among young men, and can lead to discomfort and potential fertility issues. Let's address your questions regarding varicocele, its symptoms, causes, and treatment options.

1. Symptoms and Causes: Varicocele often presents with a dull ache or discomfort in the scrotum, particularly after prolonged standing or physical activity. The pain may vary in intensity and can sometimes be mistaken for other conditions, such as hernias or testicular issues. Factors that may contribute to the development of varicocele include anatomical differences, such as the position of the left renal vein, and lifestyle factors like prolonged standing, heavy lifting, or obesity. Men who are taller or have a higher body mass index (BMI) may be at increased risk.

2. Physical Activity: Engaging in moderate exercise, such as jogging, push-ups, and sit-ups, is generally safe for individuals with varicocele. However, it is advisable to avoid heavy lifting or strenuous activities that may exacerbate symptoms. Listening to your body and stopping any activity that causes significant discomfort is essential.

3. Further Testing: If your doctor suspects varicocele, they may recommend a Doppler ultrasound to assess blood flow in the veins of the scrotum. Semen analysis may also be suggested if fertility concerns arise. These tests can help confirm the diagnosis and rule out other conditions.

4. Pain Assessment: The discomfort you are experiencing could be related to varicocele, but it is essential to consider other potential causes. If the pain persists or worsens, further evaluation may be necessary to rule out other conditions, such as infections or hernias.

5. Underwear Choice: Wearing supportive underwear, such as briefs or athletic supporters, can help alleviate discomfort associated with varicocele. Boxers may not provide the same level of support, so it is advisable to opt for styles that offer more support to the scrotum.

6. Prevention of Progression: To prevent varicocele from worsening, maintain a healthy weight, avoid prolonged standing, and engage in regular physical activity. If you have a sedentary job, take breaks to move around and avoid heavy lifting whenever possible.

7. Surgical Consideration: Surgery for varicocele is typically recommended if the condition causes significant pain, testicular atrophy, or fertility issues. Since your doctor has advised observation, it suggests that your varicocele is not severe enough to warrant immediate surgical intervention. However, if symptoms worsen or if you have concerns about fertility, discussing surgical options with your urologist may be beneficial.

8. Testicular Position: It is normal for one testicle to hang lower than the other. The left testicle often hangs lower due to anatomical differences in the spermatic cord. However, if you notice significant changes in size or position, it is worth discussing with your healthcare provider.

9. Conclusion: Your symptoms may be related to varicocele, but it is essential to have a thorough evaluation to rule out other conditions. Regular follow-ups with your urologist and monitoring your symptoms will help manage your condition effectively. If you experience any new or worsening symptoms, do not hesitate to seek medical advice.

In summary, varicocele is a manageable condition, and with appropriate lifestyle modifications and monitoring, many individuals lead normal, active lives. If you have further questions or concerns, please consult your healthcare provider for personalized advice and treatment options.

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