Varicocele: Symptoms, Concerns, and Treatment Options

Q: Varicocele: Symptoms, Concerns, and Treatment Options

Hello： The information provided here is for reference only and cannot replace a physician's examination, inspection, or testing. <br><br>(1) At that time, I also noticed that after taking a shower, a small amount of blood vessels appeared on the surface of my scrotum on the right

Varicocele

Hello, doctor.
In August of this year, I visited a urologist who mentioned that I have mild varicocele on both sides of my testicles, but he believed that a semen analysis was not necessary at that time.
Therefore, I left without any tests or medications.
(1) At that time, I also noticed that after showering, a few blood vessels would appear on the surface of my scrotum on the right side (from my perspective).
Is this a symptom of varicocele? (2) Last weekend, I walked for a considerable amount of time due to some matters, and after returning, I occasionally felt discomfort in my testicles, which only alleviated by Wednesday.
Up to now, I haven't experienced any further discomfort, but I noticed that if I lift my testicles, a noticeable bulge appears on the left side (from my perspective).
If I observe after showering without lifting my testicles, only a slight bulge is visible.
I'm unsure if this is a mass or a blood vessel.
Is this due to varicocele or could it be epididymitis? (3) If both sides have varicocele but I don't feel any symptoms in daily life and there are no fertility issues, is surgery necessary? (4) I apologize for asking, but if varicocele is severe, does it necessarily lead to infertility, or is it just a higher probability?

Lin, 10~19 year old female. Ask Date: 2021/11/06

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a physician's examination, inspection, or testing.

(1) At that time, I also noticed that after taking a shower, a small amount of blood vessels appeared on the surface of my scrotum on the right side (from my perspective).
Is this a symptom of varicocele? --> No.
(2) Last weekend, due to some matters, I walked for a considerable amount of time outside.
After returning, I occasionally felt discomfort in my testicles, which only relieved by Wednesday.
Up to now, I have not experienced any further discomfort, but I noticed that if I lift my testicles, a noticeable bulge appears on the left side (from my perspective).
If I observe after taking a shower without lifting my testicles, only a slight bulge appears.
I am unsure if this is a mass or a blood vessel.
Is this due to varicocele or epididymitis? --> You should seek medical attention; it is not certain.
(3) If both sides have varicocele but I do not feel any discomfort in daily life and there are no infertility issues, is surgery necessary? --> Not recommended.
(4) I apologize for asking, but if varicocele is severe, will it definitely lead to infertility, or is it just a higher probability? --> It does not necessarily lead to infertility.

Wishing you good health.

Reply Date: 2021/11/06

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 a common condition, particularly among young men, and can have various implications for reproductive health. Let's address your questions one by one.

1. Symptoms of Varicocele: The presence of visible veins on the surface of the scrotum, especially after activities like bathing, can indeed be a symptom of varicocele. This condition often presents with a "bag of worms" appearance due to the dilated veins. Other symptoms may include discomfort or a dull ache in the scrotum, particularly after prolonged standing or physical activity. However, some individuals may not experience any noticeable symptoms.

2. Discomfort and Swelling: The discomfort you experienced after walking for an extended period could be related to the varicocele, especially if you noticed a lump or swelling in the scrotum. The presence of a lump when elevating the testicle could indicate a few possibilities, including varicocele or possibly an issue with the epididymis (the structure that stores and matures sperm). If the swelling is persistent or accompanied by pain, it would be advisable to consult a urologist for further evaluation, which may include an ultrasound to assess the blood flow and structure of the veins and surrounding tissues.

3. Surgical Intervention: If both sides of the scrotum show signs of varicocele but you are not experiencing any symptoms and have no issues with fertility, surgery may not be necessary. Many men with varicocele live without complications, and surgery is typically recommended only if there are significant symptoms, pain, or fertility concerns. The decision to proceed with surgery should be made in consultation with a urologist, who can assess the severity of the condition and its potential impact on your health.

4. Fertility Concerns: While varicocele is associated with infertility, it does not guarantee that a man will be infertile. Studies suggest that varicocele can affect sperm production and quality, leading to a higher risk of infertility, but many men with varicocele can still father children. The relationship between varicocele and infertility is complex, and factors such as the severity of the varicocele, the presence of other fertility issues, and individual health can all play a role. If you have concerns about fertility, it may be beneficial to undergo a semen analysis to evaluate sperm health.

In summary, while varicocele can present with certain symptoms and has implications for fertility, not all cases require surgical intervention, especially if there are no significant symptoms or fertility issues. It is essential to maintain open communication with your healthcare provider, who can guide you through monitoring your condition and deciding on the best course of action based on your specific situation. If you notice any changes or new symptoms, do not hesitate to seek medical advice.

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