Varicocele: Symptoms, Complications, and Treatment Options

Varicocele

Hello Doctor, I was diagnosed with left-sided varicocele during middle school.
At that time, the doctor said that if there were no discomfort, surgery was not necessary.
Recently, after standing for a long time, I suddenly experienced a sharp pain in my left testicle, followed by a feeling of bloating in my lower abdomen.
In the following days, I had difficulty urinating; the initial stream was just dribbling, and only later did I manage to urinate properly.
I often felt like I couldn't fully empty my bladder and had a constant urge to go to the bathroom.
Additionally, I experienced soreness in both sides of my lower back.
I later visited a family medicine clinic where an ultrasound was performed, and no kidney stones or urethral issues were found.
There was also no pain during urination, and after a few days, the symptoms naturally improved.
I have occasionally experienced similar symptoms of difficulty urinating and discomfort in the lower abdomen in the past, but they usually resolved on their own after a few days, and tests for urinary infections showed no issues.

1.
I would like to ask if difficulty urinating could be related to varicocele? Additionally, I sometimes notice prolonged intermittent erections (lasting over an hour), which cause significant discomfort in my lower abdomen and testicles.
After ejaculation, lying down for a while provides some relief.

2.
Is this condition related to varicocele?
3.
Lastly, if the symptoms mentioned above are related to varicocele, would you recommend surgery? Thank you.

Niming, 20~29 year old female. Ask Date: 2024/07/28

Dr. Chen Jiansheng reply Urology

Please seek medical attention.

Reply Date: 2024/07/28

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 relatively common and often occurs on the left side due to anatomical differences in venous drainage. Understanding the symptoms, complications, and treatment options for varicocele is crucial for managing the condition effectively.

Symptoms of Varicocele
Many individuals with varicocele may not experience any symptoms, but when symptoms do occur, they can include:
1. Pain or Discomfort: This is often described as a dull ache or a feeling of heaviness in the scrotum, particularly after prolonged standing or physical activity. The pain may improve when lying down.

2. Swelling: The affected side of the scrotum may appear enlarged or swollen, resembling a "bag of worms."
3. Changes in Testicular Size: There may be a noticeable difference in size between the affected testicle and the other one.

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

Complications
While many individuals with varicocele do not experience significant issues, potential complications can arise, including:
1. Infertility: Varicocele is linked to decreased sperm production and quality, which can lead to difficulties in conceiving.

2. Testicular Atrophy: The affected testicle may shrink in size due to impaired blood flow and oxygen supply.

3. Chronic Pain: Some individuals may develop chronic pain that can affect quality of life.

Treatment Options
Treatment for varicocele is not always necessary, especially if there are no symptoms. However, if symptoms are present or if infertility is a concern, treatment options include:
1. Observation: If the varicocele is asymptomatic and not affecting fertility, a "watchful waiting" approach may be taken.

2. Surgery: Surgical options include varicocelectomy, where the affected veins are tied off to redirect blood flow. This can alleviate symptoms and improve fertility in some cases.

3. Embolization: A minimally invasive procedure where a catheter is used to block the affected veins, reducing blood flow and alleviating symptoms.

Addressing Your Concerns
1. Urination Issues and Varicocele: Your experience of urinary difficulties, such as a sensation of incomplete bladder emptying and discomfort, may not be directly related to varicocele. However, the discomfort in the lower abdomen and groin area could be influenced by the varicocele, especially if there is associated pelvic congestion. It’s essential to rule out other potential causes, such as urinary tract issues or prostate problems.

2. Intermittent Erections and Discomfort: The discomfort you experience during prolonged erections could be related to increased blood flow and pressure in the pelvic region, which may be exacerbated by the presence of varicocele. While this discomfort can occur independently, it is advisable to monitor these symptoms and discuss them with your healthcare provider.

3. Surgical Consideration: Whether to proceed with surgery for varicocele depends on several factors, including the severity of your symptoms, the impact on your quality of life, and any concerns regarding fertility. If your symptoms are recurrent and significantly affect your daily activities or if you are considering starting a family, discussing surgical options with a urologist would be prudent.

Conclusion
In summary, while varicocele can lead to various symptoms and complications, not all individuals will require surgical intervention. It is essential to have a thorough discussion with your healthcare provider, who can evaluate your specific situation, consider your symptoms, and recommend the most appropriate course of action. Regular follow-ups and monitoring can help manage the condition effectively.

Similar Q&A

Understanding Varicocele: Symptoms, Risks, and Treatment Options

During my enlistment medical examination, the examining doctor told me that I have a varicocele. I didn't have time to ask him, so could you please tell me what I should do, what potential complications or symptoms I might experience, and how it can be treated? Thank you!

Dr. Zhang Zhenxiang reply Surgery
Varicocele occurs in about 1 in 5 young males, often discovered during school or military entrance examinations, so there is no need for immediate concern. This condition primarily results from poor venous return in the internal spermatic vein, leading to blood pooling on the pos...

Managing Varicocele: Symptoms, Treatment Options, and Relief Strategies

Hello Doctor, I have been experiencing varicocele for about two years. Recently, I had an examination, and the doctor stated that "surgery is not necessary," but on that day, the varicocele was less pronounced due to the cold weather. Normally, the left side shows a sig...

Dr. Du Shixi reply Urology
Hello: Please take care of your lifestyle and avoid excessive abdominal strain for prolonged periods, as neglecting this after surgery can increase the risk of recurrence. It is advisable to have regular follow-ups at a major hospital. Wishing you good health.

Understanding Varicocele: Symptoms, Diagnosis, and Treatment Options

Hello doctor, I have been experiencing frequent testicular pain recently. After undergoing an ultrasound at the hospital, I was diagnosed with varicocele. The doctor prescribed medication for me, but I still occasionally experience sharp pain, and sometimes I also feel pain in my...

Dr. Du Shixi reply Urology
Hello: 1) Varicose veins often cause scrotal pain or discomfort near the groin area. 2) Ultrasound is sufficient for diagnosis. 3) Regarding surgery, it depends on the individual, but recurrence is common. It's important to discuss with your physician first to minimize the r...

Understanding Varicocele: Risks and Treatment Options for Teens

I previously had an examination during the summer to check for left-sided varicocele, and many high school students seem to have been advised by doctors to be monitored every six months. It has been nearly a year now, and due to academic commitments, I can only see a doctor durin...

Dr. Liu Jiaju reply Urology
Varicocele is a common condition among young males, typically occurring on the left side. The clinical symptoms primarily include discomfort or aching during prolonged standing or sitting due to poor blood circulation. In more severe cases, a network of blood vessels resembling w...