Varicocele: Risks and Treatment Options for Teens

Varicocele

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 during the summer.
However, I have already noticed a significant venous plexus on the left testicle (which can be felt and seen), and I can feel some discomfort in my daily life.
What are the potential consequences of not addressing the varicocele immediately? Will surgery be necessary?

J, 10~19 year old female. Ask Date: 2010/06/09

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 worms may be visible or palpable in the scrotum.
The impact of varicocele on young males extends beyond pain, significantly affecting semen quality.
Research indicates that 40% of male infertility cases are attributed to varicocele.
However, it is also found in about 10% of normal males.
Surgical treatment has the potential to improve semen quality, with better outcomes observed in younger patients.
Regarding pain, the vast majority of patients experience improvement, although approximately 5% may still have occasional discomfort postoperatively.
While varicocele is not life-threatening, young males should be mindful of their future fertility.
Therefore, it is recommended to schedule a semen analysis with a physician.
If the quality is poor, surgical intervention should be considered when possible.
If the quality is normal and pain is minimal, regular follow-up every six months to a year to monitor semen quality is advised.

Reply Date: 2010/06/09

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 among adolescent males and can often be asymptomatic. However, in some cases, it can lead to discomfort and may have implications for fertility and testicular health.

In your situation, it is important to understand the potential risks associated with varicocele, especially since you are experiencing noticeable symptoms and discomfort. The presence of a varicocele can affect testicular function, potentially leading to issues such as reduced testosterone levels, impaired sperm production, and even testicular atrophy (shrinkage of the testicle). These effects are particularly concerning for adolescents and young adults, as they can impact future fertility.

The discomfort you are feeling may be due to the increased blood flow and pressure in the affected veins. While many individuals with varicocele do not require treatment, those who experience pain or other complications may benefit from intervention. The standard treatment for symptomatic varicocele is surgical intervention, which can be performed through various techniques, including open surgery, laparoscopic surgery, or percutaneous embolization. These procedures aim to redirect blood flow away from the affected veins, alleviating symptoms and potentially improving testicular health.

It is crucial to follow up with a healthcare provider, especially since you have already been advised to monitor the condition. While waiting until the summer to see a doctor is understandable due to your academic commitments, it is essential to keep an eye on any changes in your symptoms. If the discomfort worsens or if you notice any significant changes, it may be worth seeking medical attention sooner.

In terms of whether surgery is absolutely necessary, it depends on the severity of your symptoms and the findings upon examination. If the varicocele is causing significant discomfort or if there are concerns about testicular function, surgical intervention may be recommended. However, if the varicocele is asymptomatic and not affecting your overall health, your doctor may suggest a watchful waiting approach, with regular follow-ups to monitor the condition.

In summary, while varicocele is a common condition among adolescents, it is essential to address any symptoms you are experiencing. The potential risks associated with untreated varicocele include discomfort, hormonal imbalances, and fertility issues. Surgical treatment may be necessary depending on the severity of your symptoms and the impact on your testicular health. It is advisable to maintain open communication with your healthcare provider and to seek timely evaluation and treatment as needed.

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