Varicocele: Symptoms, Concerns, and When to Seek Treatment

Varicocele

Hello Doctor, I have detected that there are indeed worm-like veins on my left testicle when I palpated 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, 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? If I experience pain in the future, should I seek medical help then? For now, is it okay to just observe? It appears somewhat prominent, but since there is no pain and I am unsure about any fertility issues, what do you recommend, Doctor? Thank you.

k, 10~19 year old female. Ask Date: 2021/08/24

Dr. Du Shixi reply Urology

Hello, Doctor.
Do I need to seek medical attention or take medication or undergo surgery? Or is it sufficient to just observe? --> If there is no pain, observation is recommended.
It is advisable to seek medical attention for a diagnosis if pain develops later.
Should I just observe for now? --> It appears somewhat noticeable but there is no pain, and I am unsure if there are any fertility issues.
What do you recommend, Doctor? Thank you.
(No pain, focus on observation; if pain occurs, seek medical attention; persistent pain or fertility issues may require surgery.) Wishing you good health.

Reply Date: 2021/08/24

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 quite common, particularly in adolescent males and young adults. The symptoms you describe, such as the appearance of "worm-like" veins when straining or holding your breath, are indeed indicative of varicocele.

Symptoms and Concerns
Most individuals with varicocele do not experience significant discomfort or pain, which seems to be your case. However, some may report a dull ache or a feeling of heaviness in the scrotum, especially after prolonged standing or physical activity. The concern with varicocele primarily revolves around its potential impact on fertility. Studies have shown that varicocele can affect sperm production and quality, which may lead to fertility issues later in life.

When to Seek Treatment
In terms of treatment, it is essential to consider a few factors:
1. Symptoms: Since you mentioned that you do not experience pain or discomfort, and the varicocele is not causing you significant issues, it may be reasonable to adopt a watchful waiting approach. Regular self-examinations and monitoring for any changes in symptoms are advisable.

2. Fertility Concerns: If you are planning to have children in the future, it might be prudent to discuss your varicocele with a healthcare provider, especially if you have concerns about fertility. A semen analysis can help assess whether the varicocele is affecting your sperm quality.

3. Progression of Symptoms: If you begin to experience pain, discomfort, or any other concerning symptoms, it would be wise to seek medical advice. Surgical intervention, such as varicocelectomy, is typically recommended if the varicocele is symptomatic or if there is evidence of impaired fertility.

4. Age and Development: Since you are currently in high school, your body is still developing. In some cases, varicoceles can stabilize or even resolve as you grow older. Regular check-ups with a healthcare provider can help monitor any changes.

Conclusion
In summary, given your current situation—no significant pain and uncertainty about fertility—it seems reasonable to continue observing your condition for now. However, it is crucial to remain vigilant for any changes in symptoms. If you experience pain or have concerns about future fertility, do not hesitate to consult a healthcare professional. They can provide a thorough evaluation and discuss potential treatment options if necessary.
Remember, while varicocele is often benign and manageable, staying informed and proactive about your health is always a good strategy. Regular check-ups can help ensure that any potential issues are addressed early on.

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