Varicocele: Symptoms, Fertility Impact, and Treatment Urgency

Q: Varicocele: Symptoms, Fertility Impact, and Treatment Urgency

Hello： The diagnosis of varicocele should be determined by a physician. <br>Currently, your situation may still be assessed based on the severity of symptoms to decide whether to seek medical attention. <br>Varicocele is related to sperm quality, but not everyone will experience

Inquiry about varicocele?

Hello Dr.
Du, I apologize for the inconvenience.
I am currently working abroad and will not return to Taiwan for another two months.
In the past few weeks, I have started to experience a mild aching and heaviness in my scrotum and testicles.
The size and firmness of my testicles seem to be the same as before, but I have felt a soft tube-like structure (soft tissue) inside the scrotum.
After researching online, I believe this resembles the symptoms of varicocele.
I often walk long distances and stand for extended periods in my daily life.
I am 31 years old and have been married for a year and a half.
We plan to try for a baby after the pandemic, around mid-next year.
I am concerned about how this condition might affect fertility.
Given that I have to wait two more months for treatment, is it safe to wait? Is there a high urgency for treatment?

CHIU, 30~39 year old female. Ask Date: 2022/07/18

Dr. Du Shixi reply Urology

Hello: The diagnosis of varicocele should be determined by a physician.
Currently, your situation may still be assessed based on the severity of symptoms to decide whether to seek medical attention.
Varicocele is related to sperm quality, but not everyone will experience infertility.
Upon returning to Taiwan, a sperm analysis can be conducted.
In the meantime, you should take care to avoid prolonged sitting or standing, wear loose-fitting underwear, refrain from smoking, and engage in moderate exercise to improve the symptoms of varicocele and maintain sperm quality.
Wishing you good health.

Reply Date: 2022/07/18

More Info

Hello! Thank you for reaching out with your concerns regarding varicocele and its potential impact on fertility. Let's break down the symptoms, implications for fertility, and treatment urgency.

Understanding Varicocele
A varicocele is an enlargement of the veins within the scrotum, similar to varicose veins that can occur in the legs. It is quite common, affecting about 15% of the male population, and is often found in men aged 15 to 25. The symptoms you described—mild swelling, a feeling of heaviness or discomfort in the scrotum, and the presence of a soft mass (which could be the dilated veins)—are indeed characteristic of varicocele.

Symptoms
Common symptoms of varicocele include:
- A dull ache or pain in the scrotum, which may worsen with prolonged standing or physical activity.

- A feeling of heaviness in the affected side of the scrotum.

- Visible or palpable enlarged veins (often described as a "bag of worms").

- Changes in testicular size or firmness, although you mentioned that your testicles feel normal.

Fertility Impact
Varicoceles are known to potentially affect male fertility. They can lead to:
- Decreased sperm production.

- Abnormal sperm morphology (shape) and motility (movement).

- Increased temperature in the testicles, which can negatively impact sperm development.

Research indicates that varicoceles are associated with infertility in about 40% of men who have them. However, not all men with varicoceles will experience fertility issues. Since you are planning to conceive in the near future, it is essential to consider the potential impact of this condition on your fertility.

Treatment Urgency
In terms of treatment urgency, it is generally advisable to seek evaluation and treatment for a varicocele, especially if you are planning to start a family. While many men with varicoceles do not experience significant fertility issues, if you are experiencing symptoms and have concerns about your fertility, it would be prudent to consult a healthcare provider.

Treatment options include:
- Observation: If the varicocele is not causing significant symptoms or fertility issues, a "watchful waiting" approach may be taken.

- Surgical intervention: Varicocelectomy is a surgical procedure to remove the varicocele. This is often recommended if there are significant symptoms or if fertility is a concern. The procedure can improve sperm parameters and, in some cases, lead to improved fertility outcomes.

Conclusion
Given your symptoms and your plans to conceive, it would be wise to consult with a urologist or a fertility specialist as soon as you return to Taiwan. They can perform a physical examination and possibly recommend a semen analysis to assess your fertility status. While it may not be an emergency, addressing the varicocele sooner rather than later could be beneficial for your reproductive health.

In the meantime, try to avoid activities that exacerbate your symptoms, such as prolonged standing or heavy lifting. If the discomfort increases or you experience any significant changes, consider seeking medical advice sooner, even while abroad.

Best wishes for your health and future family planning!

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