Should I Consider Surgery for My Urological Concerns?

Q: Should I Consider Surgery for My Urological Concerns?

Hello： In males, the blood from the pampiniform plexus within the scrotum collects from the testes and drains into the right and left spermatic veins. <br>The right spermatic vein drains directly into the inferior vena cava, while the left spermatic vein enters the renal vein at

I'm not sure whether to undergo surgery?

Hello, Director Chen.
I am 28 years old.
A few years ago, during my military service, I accidentally discovered a lump about the size of a mung bean on the right side of my testicle (it moves around with the testicle).
I went to a military hospital for an ultrasound (I believe that's what it's called; they apply a slippery gel on the testicle), and the doctor told me it was nothing serious, so I didn't pay much attention to it.
About two weeks ago, I noticed that the veins on my penis have become somewhat prominent, and they are more noticeable during an erection.
If I press hard, it causes pain.
I went to Tiancheng Hospital in Yangmei for an examination and asked the doctor to check the lump on my right testicle as well.
The doctor said that the issue on my penis is a vascular malformation, while the lump on the right testicle is not problematic; however, the left testicle showed signs of varicocele and suggested that surgery would be better.
I'm unsure whether to proceed with surgery.
I am more concerned about the issue on my penis because it hurts when pressed, and I wouldn't have known about the lump on my testicle if I hadn't had the ultrasound (since it doesn't hurt).
Of course, early detection and treatment are important, but I would like to ask you, Director Chen, if it would be better to address both issues (the vascular malformation on my penis and the problem with my testicles) at once.
If I undergo surgery, what are the risks involved? Will I need to be hospitalized? Will the costs be high (is it covered by health insurance)? I apologize for the lengthy message, but if it's convenient, could you please provide some answers for me? I am quite worried.
Thank you.

Xiao Nan, 20~29 year old female. Ask Date: 2005/07/03

Dr. Chen Xiuyi reply Urology

Hello: In males, the blood from the pampiniform plexus within the scrotum collects from the testes and drains into the right and left spermatic veins.
The right spermatic vein drains directly into the inferior vena cava, while the left spermatic vein enters the renal vein at a right angle, making it more prone to blood stasis compared to the right side.
If the venous valves are incompetent, this can lead to retrograde blood flow, causing abnormal dilation of the vessels in the pampiniform plexus, resulting in a condition known as varicocele.
Varicocele is a common condition in males and a significant cause of male infertility.
Among patients with male infertility, approximately 20-40% have varicocele, and 65% of those with varicocele have poorer semen quality compared to normal individuals.
In terms of treatment, if there is only mild discomfort, medication or supportive measures such as scrotal elevation can help alleviate pressure.
However, if there is severe pain or infertility, surgical intervention is recommended.
For testicular masses and prominent penile vessels, a consultation and physical examination (with ultrasound if necessary) are required for diagnosis.
Sincerely, Dr.
Chen Hsiu-Yi, Urology.

Reply Date: 2005/07/03

More Info

When considering surgery for urological concerns, particularly in your case involving a varicocele (enlarged veins in the scrotum) and a vascular issue on the penis, it is essential to weigh the potential benefits against the risks involved.
Firstly, let's address the varicocele. Varicoceles are relatively common and can sometimes lead to discomfort or pain, particularly when standing for long periods or during physical activity. They can also affect fertility in some cases. Surgical intervention, typically through a procedure called varicocelectomy, is often recommended when the varicocele causes significant pain or if there are concerns about fertility. The surgery involves tying off the affected veins to redirect blood flow to healthier veins.
Regarding the vascular issue on your penis, which has been identified as a vascular malformation or possibly a hemangioma, it is crucial to understand that while these can be benign, they may cause discomfort or pain, especially if they are pressing against surrounding tissues. If the pain is significant or if the condition is affecting your quality of life, surgical removal may be warranted.
Now, regarding your concerns about surgery:
1. Risks of Surgery: As with any surgical procedure, there are inherent risks, including infection, bleeding, and complications related to anesthesia. Specific to varicocelectomy, there is a risk of hydrocele formation (fluid accumulation around the testicle) and potential damage to surrounding structures, including the testicular artery. For the vascular issue, risks may include scarring or changes in sensation.

2. Hospitalization: Varicocelectomy is often performed on an outpatient basis, meaning you may not need to stay overnight in the hospital. However, this can depend on the specific technique used and your overall health. The vascular issue may also be treated on an outpatient basis, but this will depend on the complexity of the case.

3. Costs and Insurance: In Taiwan, many surgical procedures, including those for varicocele and vascular malformations, are covered by the National Health Insurance (NHI), but the extent of coverage can vary. It is advisable to consult with your healthcare provider or the hospital's billing department to understand what costs you might incur.

4. Timing of Surgery: If both issues are causing you discomfort, it may be reasonable to address them simultaneously, provided your healthcare provider agrees that it is safe to do so. This can minimize the need for multiple recoveries and may be more efficient overall.

5. Consultation: It is crucial to have a thorough discussion with your urologist about your symptoms, the potential need for surgery, and any concerns you may have. They can provide you with tailored advice based on your specific situation, including the urgency of the surgery and the best approach to take.

In conclusion, while surgery can be a beneficial option for addressing your urological concerns, it is essential to have a comprehensive evaluation and discussion with your healthcare provider. They can help you understand the risks and benefits, the necessity of the procedure, and the best course of action for your health and well-being. Always prioritize open communication with your medical team to ensure you feel comfortable and informed about your treatment options.

Similar Q&A

Understanding Bladder Dysfunction: When to Consider Surgery for Prostate Issues

Due to prostate issues, the bladder has become distended and there is no sensation of fullness from the abdomen where a catheter is inserted. The doctor at Taipei Medical University Hospital mentioned that the bladder has lost its elasticity due to distension and that it needs ti...

Dr. Li Minghui reply Urology
Hello: Generally, surgery is not performed at this time because the outcomes can vary significantly. If the condition is severe, it may take several months for recovery; if it is not severe, a few weeks may suffice. Overall physical condition should also be taken into considerati...

Overcoming Fear: Seeking Urology Advice for Health Concerns

In response to your question, my current physical condition is fine; I just haven't had the courage to ask, which is why I used this platform to have a urologist check everything, and everything is okay. I just haven't been able to speak up.

Dr. Chen Jiansheng reply Urology
Please seek medical attention.

Managing Small Urological Concerns: When to Seek Further Evaluation

Thank you, doctor. How long should I wait to see if it doesn't grow or protrude before I can stop worrying about it? Should I come back for a check-up every month just to be safe? Also, is it not advisable to undergo any special surgery since it is really small and almost in...

Dr. Du Shixi reply Urology
Hello: If there is a growth, seeking medical attention is sufficient. Electrocautery is not necessary at this time; we are currently in the observation period. Wishing you good health.

Should I See a Urologist for Concerns About My Health?

If my girlfriend is concerned that I might be ill, should I directly see a urologist or consult another specialty first?

Dr. Li Xinyi reply Urology
You can see a urologist for an examination and discuss with the physician.