Testicular Size Discrepancies After Varicocele Surgery

The left testis is larger than the right?

Hello Doctor: 1.
Since I had surgery for varicocele, my left testicle has become larger and my right testicle has become smaller.
I read a report stating that improper varicocele surgery can lead to testicular edema or atrophy.
Is this true? 2.
Can testicular edema lead to testicular cancer? 3.
Does frequent sexual activity cause my left testicle to become larger and my right testicle to become smaller, as I have noticed some changes? Thank you!

A-Wen, 20~29 year old female. Ask Date: 2002/03/13

Dr. Pan Zhenqin reply Urology

One of the main complications after varicose vein surgery is scrotal edema (not testicular edema, but fluid accumulation between the testicles and surrounding tissues), primarily caused by impaired local lymphatic drainage post-surgery.
Regular self-massage of the swollen area may provide some improvement.
If the swelling is significant, a urologist can perform aspiration or further management.
Over time, as lymphatic collateral circulation is reestablished, the condition will gradually improve.
This is unrelated to testicular cancer.
As for any correlation with the frequency of sexual activity, there are no reported data.

Reply Date: 2002/03/13

More Info

After undergoing varicocele surgery, it is not uncommon for patients to notice discrepancies in testicular size. This can be concerning, and it’s important to understand the potential causes and implications of these changes.

1. Post-Surgery Changes: Varicocele surgery, which is performed to correct enlarged veins in the scrotum, can lead to various outcomes. It is indeed possible for the left testicle to appear larger and the right testicle to appear smaller after surgery. This could be due to several factors, including fluid accumulation (hydrocele) or changes in blood flow. Hydrocele is a condition where fluid collects around the testicle, leading to swelling. In some cases, if the surgery does not go as planned, it can result in complications such as testicular atrophy (shrinkage) or persistent swelling. If you are experiencing significant changes in size, it is crucial to follow up with your urologist for a thorough evaluation.

2. Hydrocele and Cancer Risk: Hydrocele itself is generally a benign condition and does not directly cause testicular cancer. However, any persistent swelling or changes in the testicle should be evaluated by a healthcare professional to rule out other conditions, including tumors. Regular self-examinations and awareness of any new lumps, changes in size, or discomfort are essential. If you notice any concerning symptoms, such as pain, a hard lump, or significant changes in size, it is important to seek medical advice promptly.

3. Impact of Sexual Activity: Frequent sexual activity does not typically cause changes in testicular size. However, if you are experiencing discomfort or a sensation of increasing size in one testicle, it could be related to other factors such as inflammation or vascular changes resulting from the surgery. It is essential to communicate any unusual sensations or discomfort to your healthcare provider, as they can provide guidance and determine if further investigation is necessary.

In summary, while changes in testicular size after varicocele surgery can occur, they should be monitored closely. It is essential to maintain open communication with your healthcare provider regarding any changes you experience. Regular follow-ups and self-examinations can help ensure that any potential issues are addressed early. If you have any further questions or concerns, do not hesitate to reach out to your urologist for personalized advice and management.

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