Varicocele: Medication, Surgery, and Lifestyle Tips

Q: Varicocele: Medication, Surgery, and Lifestyle Tips

Health is the most important： Hello, Grade 3? It should be classified as Grade 3, which indicates a more severe condition. <br>If that is indeed the case, considering surgery would be advisable. <br>The response to medication is generally not very good; they only provide pain rel

Medication issues?

Thank you, Dr.
Hsu.

1.
I have a grade 3 varicocele.
I often experience swelling and pain.
Is this considered severe?
2.
The doctor prescribed Cataflam for me to take for 5 days.
If it is ineffective, will I need surgery?
3.
Is it true that I should not drink milk while taking this medication?
4.
I usually wear boxers.
Should I switch to briefs to support the scrotum better? I'm really afraid of surgery.
Is varicocele surgery considered a major operation? Thank you for your answers, Dr.
Hsu.

Jiànkāng zuì zhòngyào, 30~39 year old female. Ask Date: 2005/05/17

Dr. Xu Weikai reply Urology

Health is the most important: Hello, Grade 3? It should be classified as Grade 3, which indicates a more severe condition.
If that is indeed the case, considering surgery would be advisable.
The response to medication is generally not very good; they only provide pain relief and anti-inflammatory effects, addressing the symptoms but not the underlying disease.
When using medication, it is best to avoid beverages such as tea, coffee, alcohol, milk, and vegetable soup; plain water is the most suitable option.

Surgery for varicocele generally consists of high ligation and inguinal ligation.
Most cases utilize high ligation due to the smaller incision.
However, high ligation has a higher recurrence rate and requires more technical skill, so for patients with more severe conditions or those who are obese, traditional inguinal ligation is recommended.

Regardless, both types of surgery are considered minor procedures, with the incision for high ligation being approximately 2 to 4 centimeters and for inguinal ligation about 3 to 6 centimeters.
The surgery typically does not exceed 30 minutes.

Urology Department Chief, Dr.
Hsu Wei-Kai, responds on behalf of the Taitung Hospital of the Ministry of Health and Welfare, expressing concern for you.

Reply Date: 2005/05/17

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 and can lead to discomfort, pain, and even fertility issues in some cases. Let's address your questions one by one.

1. Severity of Varicocele: A grade of 3.0 indicates a moderate to severe varicocele. The presence of swelling and pain suggests that it may be affecting your quality of life. While not all varicoceles require treatment, those that cause significant discomfort or are associated with fertility problems often do. It's essential to monitor your symptoms and discuss them with your healthcare provider.

2. Medication and Surgery: Cataflam (diclofenac) is a non-steroidal anti-inflammatory drug (NSAID) that can help alleviate pain and inflammation. If you find that the medication is ineffective after five days, it is reasonable to discuss surgical options with your doctor. Surgery for varicocele, typically called varicocelectomy, is a common procedure and is generally considered safe. It can significantly relieve symptoms and improve fertility outcomes in men with associated issues.

3. Dietary Considerations: Regarding your question about milk consumption while taking Cataflam, there are no specific contraindications against drinking milk while on this medication. However, some individuals may experience gastrointestinal discomfort when combining NSAIDs with dairy products. It is advisable to take the medication with food or milk to minimize potential stomach upset. If you have any concerns, consult your healthcare provider for personalized advice.

4. Underwear Choices: Wearing supportive underwear can help manage discomfort associated with varicocele. While there is no definitive evidence that switching from boxers (four-cornered) to briefs (three-cornered) will improve your condition, many men find that tighter-fitting underwear provides better support and reduces pain. It may be worth trying to see if it alleviates your symptoms.

5. Surgical Considerations: Varicocele surgery is generally considered a minor surgical procedure, but it can be classified as a major surgery depending on the specific technique used and the individual’s health status. The most common methods include open surgery, laparoscopic surgery, and percutaneous embolization. Each has its risks and benefits, and the choice of procedure will depend on your specific case and the surgeon's recommendation.

In summary, while varicocele can be a source of discomfort and potential fertility issues, there are effective treatment options available. It is crucial to maintain open communication with your healthcare provider about your symptoms, treatment efficacy, and any concerns you may have regarding surgery. Lifestyle modifications, such as wearing supportive underwear and managing pain with medications, can also play a role in your overall management of the condition. Always consult with your physician before making any significant changes to your treatment plan.

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