Varicocele: Causes, Symptoms, and Treatment Concerns

Varicocele

Hello Doctor, a year ago I had unprotected oral sex and protected intercourse with my ex-girlfriend.
Two weeks later, I suddenly developed hives, followed by testicular pain and a diagnosis of varicocele.
The doctor prescribed Doxycycline antibiotics for me, instructing me to complete a week-long course without interruption.
However, during this period, I felt increased testicular pain and noticed that my testicles seemed to shrink and become softer.
When I returned for a follow-up, the doctor performed an ultrasound and said everything was fine and not to worry, but I genuinely feel that there has been shrinkage and softness.
I then went to a testing center for a sexually transmitted infection screening, which showed positive results for Group B Streptococcus, Gardnerella vaginalis, and Candida albicans.
However, after consulting 2-3 urologists, they strongly determined that the varicocele is unrelated to these bacteria, stating that these bacteria can be present in healthy individuals and that no treatment is necessary.
I would like to ask the doctor if the varicocele and hives are truly unrelated to these bacteria.
I've seen two or three doctors who all said no special treatment is needed, but I am worried that my testicles are shrinking more each day.
Thank you.

Ken, 40~49 year old female. Ask Date: 2020/05/03

Dr. Xu Wencang reply Urology

It should be unrelated; varicocele does not cause immediate atrophy.
It is advisable to observe first and return for a follow-up if any issues arise.

Reply Date: 2020/05/03

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 can lead to various symptoms and complications, including testicular pain, discomfort, and potential fertility issues. Understanding the causes, symptoms, and treatment options for varicocele is essential for managing the condition effectively.

Causes of Varicocele:
Varicocele occurs when the valves within the veins of the spermatic cord fail to function properly, leading to blood pooling and vein enlargement. The exact cause of this valve malfunction is not always clear, but several factors may contribute, including anatomical differences, increased pressure in the abdomen, and genetic predisposition. Varicocele is more common on the left side of the scrotum due to the anatomical arrangement of the veins.

Symptoms of Varicocele:
Many men with varicocele may not experience noticeable symptoms. However, when symptoms do occur, they can include:
- Dull, aching pain in the scrotum, especially after prolonged standing or physical activity.

- A feeling of heaviness in the affected testicle.

- Visible or palpable enlarged veins in the scrotum, often described as a "bag of worms."
- Changes in testicular size, including atrophy or shrinkage of the affected testicle.

In your case, you mentioned experiencing testicular pain and concerns about testicular atrophy. It is important to note that while varicocele can cause discomfort and changes in testicular size, it is not typically associated with infections or sexually transmitted infections (STIs). The presence of bacteria such as Group B Streptococcus (GBS) or Candida species in your tests does not directly correlate with varicocele.

Treatment Concerns:
Treatment for varicocele is not always necessary, especially if the condition is asymptomatic. However, if pain or fertility issues arise, treatment options may include:
1. Observation: Regular monitoring of the condition, especially if symptoms are mild.

2. Medications: Pain relief can be managed with over-the-counter analgesics.

3. Surgical Intervention: In cases of significant pain or fertility concerns, surgical options such as varicocelectomy (removal of the affected veins) may be recommended. This procedure can alleviate symptoms and improve fertility outcomes.

Regarding your concerns about the relationship between varicocele, urticaria (hives), and the identified bacteria, it is crucial to understand that varicocele is primarily a vascular issue and is not caused by bacterial infections. The hives you experienced could be related to an allergic reaction or another dermatological condition, which is separate from the varicocele diagnosis.
It is understandable to feel anxious about changes in your testicular size and pain. If multiple healthcare providers have assessed your condition and determined that the varicocele is not causing significant issues, it may be beneficial to seek a second opinion from a urologist specializing in male reproductive health. They can provide further insights and reassurance regarding your concerns about testicular atrophy and pain.

In conclusion, while varicocele can lead to discomfort and potential fertility issues, it is not directly linked to bacterial infections. If you continue to experience pain or changes in your testicles, further evaluation and possibly a referral to a specialist may be warranted. Always communicate openly with your healthcare providers about your symptoms and concerns to ensure you receive the best possible care.

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