Varicocele: Symptoms, Concerns, and Treatment Options

Q: Varicocele: Symptoms, Concerns, and Treatment Options

Hello： 1) Intense exercise can inevitably exacerbate symptoms, but varicocele is caused by impaired blood flow. <br>You might try exercising at different times and avoid prolonged sitting or standing to prevent poor venous return. <br>2) Many people have varicoceles, and it is pe

Varicocele

Hello Doctor, I am starting my freshman year this year, but I have noticed since my first year of high school that sometimes when I go out with my family and walk for a long time, I feel a kind of swelling sensation in my left testicle, which is a bit uncomfortable.
It's not exactly painful, but I've been enduring it.
Recently, it has been happening more frequently, and after researching, I suspect it might be varicocele.
However, there are no visible signs of a "worm-like" appearance on my testicle, and it's hard to bring it up, so I've kept it to myself.

1.
Additionally, I love playing basketball, but I’ve learned that intense exercise might worsen the symptoms, which worries me.
What should I do?
2.
Should I seek medical attention during the last week of summer vacation, or wait for the freshman health check?
3.
Is this related to masturbation? It seems like the symptoms are more pronounced the day after I masturbate.
Please, Doctor, help me understand and guide me.

Chen Tongxue, 10~19 year old female. Ask Date: 2019/08/24

Dr. Du Shixi reply Urology

Hello: 1) Intense exercise can inevitably exacerbate symptoms, but varicocele is caused by impaired blood flow.
You might try exercising at different times and avoid prolonged sitting or standing to prevent poor venous return.
2) Many people have varicoceles, and it is perfectly fine to seek medical attention if needed.
3) It may be related to abdominal exertion, but it is not always the case.
Wishing you good health.

Reply Date: 2019/08/24

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding varicocele. It's understandable to feel apprehensive about symptoms that can be uncomfortable or concerning, especially as you transition into a new phase of your life in college. Let’s address your questions and provide some clarity on varicocele, its symptoms, and treatment options.

Understanding Varicocele
Varicocele is a condition characterized by the enlargement of the veins within the scrotum, similar to varicose veins that can occur in the legs. This condition is quite common and affects about 15% of men. The symptoms can vary, but many individuals report a feeling of heaviness or discomfort in the affected testicle, particularly after prolonged standing or physical activity. In your case, the sensation of heaviness and discomfort in your left testicle after walking for extended periods aligns with typical symptoms of varicocele.

Symptoms and Concerns
1. Symptoms: The primary symptoms of varicocele include:
- A dull ache or discomfort in the scrotum, often described as a feeling of heaviness.

- Symptoms may worsen after physical activity or prolonged standing.

- In some cases, there may be visible swelling or a "bag of worms" appearance in the scrotum, although this is not always present.

2. Concerns: While varicocele is often benign, it can lead to complications such as:
- Infertility: Varicocele is associated with decreased sperm production and quality.

- Testicular atrophy: Over time, the affected testicle may shrink due to impaired blood flow.

Treatment Options
1. Observation: If your symptoms are mild and not affecting your daily life or activities, a "watchful waiting" approach may be appropriate. Many men live with varicocele without requiring treatment.

2. Lifestyle Modifications: If you enjoy basketball and other physical activities, you might consider adjusting your routine. While vigorous exercise can exacerbate symptoms, engaging in low-impact activities or wearing supportive undergarments may help alleviate discomfort.

3. Medical Intervention: If symptoms worsen or you experience significant discomfort, it may be worth consulting a urologist. Treatment options include:
- Surgical Repair: This is often recommended if the varicocele is causing significant pain or fertility issues. The procedure involves tying off the affected veins to redirect blood flow.

- Embolization: A minimally invasive procedure where a catheter is used to block the affected veins.

Timing for Consultation
Regarding your question about when to seek medical advice, it would be prudent to schedule an appointment with a urologist sooner rather than later, especially since your symptoms have been increasing in frequency. While the new student health check may provide some insights, a dedicated visit to a specialist can offer a more thorough evaluation and tailored advice.

Relationship with Masturbation
As for your concern about masturbation, while it is a normal activity, some individuals report that it can temporarily exacerbate discomfort in the context of varicocele. This may be due to increased blood flow and pressure in the area. However, it is not a direct cause of varicocele. If you notice a pattern where symptoms worsen after masturbation, you might consider moderating the frequency and observing if that alleviates your discomfort.

Conclusion
In summary, while varicocele can be concerning, it is manageable, and many individuals lead normal lives with this condition. I encourage you to seek medical advice to discuss your symptoms and explore your options. Remember, addressing health concerns early can lead to better outcomes and peace of mind.

Wishing you good health and a successful transition into college life!
Best regards.

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