Varicocele: Symptoms, Concerns, and Treatment Options

Q: Varicocele: Symptoms, Concerns, and Treatment Options

A continuous tradition： You have varicocele, and the main complications are： 1. <br>Testicular atrophy, which affects fertility; 2. <br>Local swelling and pain. <br>Testicular atrophy does not necessarily require ultrasound for assessment; typically, a comparison of size and firm

Regarding varicocele?

Hello Doctor: More than six months ago, I visited due to discomfort in my left testicle.
The doctor performed a scrotal ultrasound, and since there was an initial shadow detected, the scan was done twice (which was quite alarming...).
After reviewing the images and reports, the doctor stated that the size and condition of my testicles were normal, and there was almost no indication of varicocele.
However, I still occasionally feel a dull ache in my left groin.
I have a few questions: 1.
The doctor mentioned that I am still young, so I shouldn't worry too much.
Is there a correlation between these symptoms and age? 2.
I have heard that varicocele can lead to testicular atrophy.
If I am experiencing occasional discomfort without severe pain or worsening symptoms, does that mean I don't need to worry about atrophy? 3.
The doctor suggested that I could have an ultrasound once a year.
How much does that cost? Is it covered by health insurance? (I have military status from the initial examination.) 4.
In the images, one of my testicles (I forgot which side...) has a black spot, which the doctor referred to as a "calcification." What exactly is this? How does it form? Does it affect testicular health? Your title makes me feel that this is a serious matter and a significant responsibility.
I kindly ask for your clarification.
Thank you!

Yi Mai Dan Chuan, 20~29 year old female. Ask Date: 2006/08/17

Dr. Xu Weikai reply Urology

A continuous tradition: You have varicocele, and the main complications are: 1.
Testicular atrophy, which affects fertility; 2.
Local swelling and pain.
Testicular atrophy does not necessarily require ultrasound for assessment; typically, a comparison of size and firmness between the left and right testicles should suffice.
"Necessary examinations will definitely be covered by the National Health Insurance," is the principle stated by the National Health Insurance Administration.
The so-called calcification points in the testicles are usually due to previous infections or injuries that have caused scarring, which appear as high-density spots on ultrasound.
Generally, regular follow-ups are sufficient, and as long as there are no changes, it should not impact daily life.
In other words, most cases are benign.
This is a response from Dr.
Hsu Wei-kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2006/08/17

More Info

Dear Patient,
Thank you for your detailed inquiry regarding varicocele and your concerns about your testicular health. I understand that you have been experiencing discomfort in the left groin area and have undergone an ultrasound examination that indicated minimal varicocele. Let’s address your questions one by one.

1. Age and Symptoms: You mentioned that your doctor indicated your age is a factor in your condition. Generally, varicocele is more common in younger males, particularly those between the ages of 15 and 25. As males age, the incidence of varicocele tends to decrease. However, discomfort in the groin area can be caused by various factors, including muscle strain, nerve irritation, or even referred pain from other areas. While age can influence the likelihood of developing certain conditions, it does not directly correlate with the presence of symptoms. If your discomfort persists or worsens, it is advisable to follow up with your healthcare provider.

2. Concerns about Testicular Atrophy: You are correct that varicocele can potentially lead to testicular atrophy, which is a reduction in the size of the testicles. However, the risk of atrophy is typically associated with significant varicocele and prolonged exposure to elevated temperatures and venous pressure. Since your ultrasound indicated minimal varicocele and you are not experiencing severe pain or worsening symptoms, it is likely that the risk of atrophy is low. Nonetheless, it is essential to monitor any changes in your symptoms and report them to your doctor.

3. Ultrasound Follow-Up: Your doctor’s recommendation for annual ultrasound examinations is a prudent approach to monitor any changes in your condition. The cost of an ultrasound can vary widely depending on your location and the facility you choose. In many cases, if you have military insurance or are covered under a national health plan, these examinations may be partially or fully covered. It is best to check with your insurance provider or the facility where you plan to have the ultrasound for specific cost details and coverage options.

4. Calcification in the Testicle: The "black dot" you mentioned in your ultrasound report, referred to as a "calcification," is typically a benign finding. Calcifications in the testicle can occur for various reasons, including previous infections, trauma, or even normal developmental changes. They are often asymptomatic and do not usually affect testicular function or health. However, it is essential to have regular follow-ups to ensure that there are no changes in size or characteristics of the calcification.

In summary, while your symptoms may be concerning, the findings from your ultrasound suggest that there is no immediate cause for alarm. Regular monitoring and communication with your healthcare provider are key to managing your health. If you experience any new symptoms, such as increased pain, swelling, or changes in testicular size, please seek medical attention promptly.

Wishing you good health and peace of mind. If you have any further questions or concerns, please do not hesitate to reach out.

Best regards.

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