Varicocele: Symptoms, Concerns, and When to Seek Treatment

Q: Varicocele: Symptoms, Concerns, and When to Seek Treatment

Hello： I have currently examined myself and noticed that there are indeed worm-like veins on my left testicle. <br>When I hold my breath and exert pressure, the veins become more prominent. <br>This should be a symptom of varicocele. <br>However, I would like to ask the doctor if

Varicocele

Hello Doctor, I have detected that there are indeed worm-like veins on my left testicle when I palpate it.
The veins become more prominent when I hold my breath and exert pressure.
This should be a symptom of varicocele.
However, I would like to ask if this condition, being in my second year of high school, might affect my fertility.
It doesn’t cause me much trouble, as I experience almost no pain, but I do have varicocele.
Should I seek medical attention, take medication, or consider surgery? Or is it sufficient to just monitor the situation? If I start experiencing pain in the future, should I then seek medical help? For now, is it okay to just observe? It looks somewhat prominent, but since there is no pain and I am unsure about any fertility issues, what do you recommend? Thank you.

k, 10~19 year old female. Ask Date: 2021/08/23

Dr. Du Shixi reply Urology

Hello: I have currently examined myself and noticed that there are indeed worm-like veins on my left testicle.
When I hold my breath and exert pressure, the veins become more prominent.
This should be a symptom of varicocele.
However, I would like to ask the doctor if being in the second year of high school means it might affect my fertility.
It usually doesn't cause me much trouble, and I hardly feel any pain; it's just that I have varicocele.
Should I seek medical attention, take medication, or consider surgery? Or is it sufficient to just monitor the situation? --> Medication is ineffective, and if there are no fertility issues, monitoring is the main approach, unless there is persistent pain.
If pain develops later, should I seek medical attention? --> If there is pain, you should seek medical attention.
Is it okay for me to just monitor my current situation? --> It may be best to see a doctor once to rule out any other issues.
Wishing you good health.

Reply Date: 2021/08/23

More Info

Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that can occur in the legs. It is relatively common, particularly among adolescent males and young adults. The symptoms you describe, such as the presence of a "worm-like" appearance of veins in the left testicle, especially when straining or holding your breath, are indeed indicative of a varicocele.

Symptoms and Concerns
While many individuals with varicocele may not experience significant discomfort, some common symptoms can include:
1. Visible Enlarged Veins: As you've noted, the veins may appear swollen and can be more pronounced when standing or during physical exertion.

2. Dull Pain or Discomfort: Some individuals may experience a dull ache or discomfort in the scrotum, especially after prolonged standing or physical activity.

3. Testicular Atrophy: In some cases, varicocele can lead to a decrease in testicular size, particularly on the affected side.

4. Fertility Issues: Varicocele has been associated with male infertility, as it can affect sperm production and quality.

When to Seek Treatment
Given that you are currently in high school and have not experienced significant pain or discomfort, it is understandable to be cautious about seeking immediate treatment. Here are some considerations regarding when to seek medical advice or treatment:
1. Pain Development: If you begin to experience persistent pain or discomfort, it would be advisable to consult a healthcare professional. Pain can indicate complications or worsening of the condition.

2. Fertility Concerns: If you have concerns about future fertility, it may be worth discussing with a urologist. They can provide guidance on whether your varicocele might impact your reproductive health and whether any intervention is necessary.

3. Physical Examination: Regular self-examinations and monitoring for any changes in the size or appearance of the veins can be beneficial. If you notice any significant changes, it would be prudent to seek medical advice.

4. Impact on Daily Life: If the condition begins to interfere with your daily activities or causes psychological distress, it may be worth discussing treatment options with a healthcare provider.

Treatment Options
If treatment is deemed necessary, options may include:
1. Observation: If the varicocele is asymptomatic and not affecting fertility, a "watchful waiting" approach may be appropriate.

2. Medications: There are no specific medications to treat varicocele, but pain relief can be managed with over-the-counter pain relievers if discomfort arises.

3. Surgical Intervention: If the varicocele causes significant pain or fertility issues, surgical options such as varicocelectomy (removal of the affected veins) or embolization (blocking the blood flow to the enlarged veins) may be recommended.

Conclusion
In summary, while your current symptoms do not seem to warrant immediate medical intervention, it is essential to remain vigilant. Observing any changes in symptoms, especially the onset of pain or concerns about fertility, should prompt a visit to a healthcare professional. Regular check-ups with a urologist can also help monitor the condition and provide peace of mind. Always feel free to discuss your concerns with a trusted healthcare provider, who can offer personalized advice based on your specific situation.

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