Varicocele and Prepuce Issues: A Urology Perspective

Q: Varicocele and Prepuce Issues: A Urology Perspective

Concerns： Hello, regarding your question, my answers are as follows： 1. <br>Varicocele generally requires surgery for two main reasons： first, it can be painful; second, it can affect semen quality. <br>In other words, if you experience these symptoms, it is best to seek medical

Regarding varicocele and the foreskin issues?

Hello, doctor.
I have two questions to ask:
1.
Recently, I visited the clinic due to a feeling of heaviness in my left testicle.
After a physical examination and ultrasound, I was diagnosed with mild varicocele.
The doctor mentioned that it is not serious and advised me to continue monitoring without surgery.
However, I still occasionally experience discomfort in the left scrotum.
Additionally, I have heard that varicocele can lead to decreased semen quality and testicular atrophy, potentially affecting fertility.
Should I really just monitor the situation, or would it be better to undergo a semen analysis for confirmation? Also, does abstinence increase the likelihood of experiencing discomfort in the testicles?
2.
I am currently serving in the military, and due to poor hygiene conditions during base training and hot weather, I have developed some peeling on the glans and redness, swelling, and itching in the coronal sulcus, resembling balanitis.
I have been more diligent about hygiene, and the condition has improved, but I have noticed that during erection, there is a ring of redness at the junction of the foreskin and penis, accompanied by some pain.
When the penis is fully erect and engorged, the foreskin feels very tight, and sometimes when I lightly pull on the foreskin, the junction can break and bleed (I have not been circumcised, but previously, the foreskin could retract completely without discomfort during erection).
I would like to ask if this is because the balanitis has not fully healed? What should I do about it? (For your reference, my sexual life is quite simple.)

Youlu, 20~29 year old female. Ask Date: 2005/12/26

Dr. Xu Weikai reply Urology

Concerns: Hello, regarding your question, my answers are as follows: 1.
Varicocele generally requires surgery for two main reasons: first, it can be painful; second, it can affect semen quality.
In other words, if you experience these symptoms, it is best to seek medical attention.
2.
It is likely due to localized fibrosis following a previous case of balanitis, which has caused the foreskin to become somewhat narrowed.
Generally, in such cases, it is important to enhance local hygiene and avoid further irritation.
When cleaning, it is recommended to use cold water and to avoid using detergents.
If it is very dirty and cleaning products are necessary, it is best to dilute them or use body wash or products that claim to be moisturizing.
Avoid products that leave a dry and rough feeling after use.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Dr.
Hsu Wei-Kai.

Reply Date: 2005/12/26

More Info

Dear Patient,
Thank you for your questions regarding varicocele and prepuce issues. I appreciate your detailed description of your symptoms and concerns, which will help in providing a comprehensive response.

1. Varicocele and Its Implications
You mentioned that you have been diagnosed with a mild varicocele on the left side, and your doctor advised you to continue monitoring it without surgical intervention. Varicocele is a condition characterized by enlarged veins within the scrotum, similar to varicose veins in the legs. While mild cases often do not require treatment, it is essential to understand the potential implications.

Impact on Fertility: There is evidence suggesting that varicocele can negatively affect sperm quality and overall fertility. The mechanism is thought to involve increased temperature in the testicular area, which can impair spermatogenesis (the production of sperm). If you are concerned about fertility, it may be prudent to undergo a semen analysis to assess sperm count, motility, and morphology. This will provide a clearer picture of your reproductive health.

Symptoms and Management: The discomfort you experience, such as the feeling of heaviness or aching in the scrotum, can sometimes be alleviated through lifestyle modifications. Wearing supportive underwear, avoiding prolonged standing, and managing any underlying conditions can help. If symptoms persist or worsen, a follow-up with your urologist is advisable.

Regarding your question about abstinence and its relation to testicular discomfort, it is possible that prolonged periods of sexual inactivity can lead to increased pressure and discomfort in the testicles. Regular ejaculation may help alleviate some of this discomfort, but it is essential to listen to your body and consult your doctor if you have concerns.

2. Prepuce Issues: Balanitis and Related Symptoms
Your second concern involves symptoms resembling balanitis, characterized by peeling skin on the glans and redness and pain at the corona. Balanitis is an inflammation of the glans (the head of the penis) and can be caused by various factors, including poor hygiene, infections, or irritants.

Current Symptoms: The tightness and pain you experience during erections, along with the redness at the connection between the foreskin and the penis, may indicate that the inflammation has not fully resolved. It is crucial to maintain proper hygiene, especially in hot and humid conditions, to prevent further irritation. Gently cleaning the area with mild soap and water, and ensuring it is thoroughly dried, can help.

Treatment Options: Over-the-counter antifungal or hydrocortisone creams may provide relief, but it is essential to consult a healthcare provider before starting any treatment. If the symptoms persist or worsen, a visit to a urologist or dermatologist is warranted for a thorough examination and appropriate management.

Conclusion
In summary, while your mild varicocele may not require immediate intervention, monitoring your symptoms and considering a semen analysis could be beneficial for your peace of mind regarding fertility. For your prepuce issues, maintaining hygiene and seeking medical advice for persistent symptoms is crucial.
If you have any further questions or concerns, please do not hesitate to reach out to your healthcare provider. Your health and well-being are of utmost importance, and addressing these issues proactively can lead to better outcomes.

Best regards,
Doctor Q&A Teams

[Your Contact Information]

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