Pain from Varicocele: Causes, Treatments, and Recovery

Q: Pain from Varicocele: Causes, Treatments, and Recovery

Xiao Lin： Hello. 1. It is possible. 2. It is uncertain. 3. There is no need for abstinence; whether it is varicocele or chronic prostatitis, sexual activity does not need to be restricted. 4. Yes, it is permissible. 5. There is no relevant

Pain from varicocele?

Hello Dr.
Hsu, I have the following questions I would like to ask you: My symptoms occur about five to six minutes after ejaculation during masturbation, when I begin to feel a soreness in my scrotum.
This aching sensation sometimes alleviates when lying down (this has been ongoing for two years).
An ultrasound examination at the hospital revealed that I have varicocele on both sides.
However, I do not experience discomfort in daily life or after weight training (bodybuilding), and there is no pain during a rectal examination.
Semen and urine tests show sterile results, and the doctor suspects chronic prostatitis.

1.
Could the soreness be caused by chronic prostatitis or the varicocele?
2.
If I undergo surgery for the varicocele, will the chronic prostatitis make my condition worse than it was before the surgery?
3.
Should I practice abstinence? I have previously abstained for almost three weeks but still experienced pain.
4.
If I have varicocele surgery, will I be able to continue heavy weight training after recovery?
5.
If I apply ice after weight training, can it help mitigate the damage to the varicocele?

Xiao Lin, 20~29 year old female. Ask Date: 2014/12/02

Dr. Xu Weikai reply Urology

Xiao Lin: Hello.
1.
It is possible.
2.
It is uncertain.
3.
There is no need for abstinence; whether it is varicocele or chronic prostatitis, sexual activity does not need to be restricted.
4.
Yes, it is permissible.
5.
There is no relevant information.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Answers from the internet should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Ministry of Health and Welfare, who cares about you.

Reply Date: 2014/12/02

More Info

Understanding pain associated with varicocele can be complex, as it often involves multiple factors, including anatomical, physiological, and psychological components. Based on your description, it seems you are experiencing discomfort in the scrotal area following ejaculation, which has persisted for two years. The ultrasound findings of bilateral varicocele and the absence of pain during rectal examination and sterile urine and semen tests suggest that your symptoms may be multifactorial.

1. Causes of Pain: Chronic Prostatitis vs. Varicocele
The pain you are experiencing could be attributed to either chronic prostatitis or varicocele. Chronic prostatitis is characterized by pelvic pain and discomfort, often exacerbated by sexual activity, while varicocele is associated with a feeling of heaviness or aching in the scrotum, particularly after physical exertion or sexual activity. Given that your pain occurs after ejaculation, it could be related to either condition. However, the absence of urinary symptoms and the normal findings on your tests make chronic prostatitis less likely. It is plausible that the varicocele is the primary source of your discomfort.

2. Surgical Considerations
If you are considering surgery for varicocele, it is essential to discuss the potential impact of chronic prostatitis with your urologist. While varicocele surgery is generally safe and effective, the presence of chronic prostatitis could complicate recovery or lead to persistent symptoms. However, many patients report improvement in pain and discomfort after varicocele repair, even if they have underlying prostatitis. It is crucial to have a thorough evaluation and possibly a consultation with a specialist in chronic pelvic pain to address all aspects of your condition.

3. Sexual Activity and Abstinence
Regarding abstinence, it is not uncommon for individuals with varicocele to experience discomfort regardless of sexual activity. While some patients find that abstaining from ejaculation helps alleviate symptoms, others may not notice a significant difference. Since you mentioned that you experienced pain even after a three-week period of abstinence, it may not be necessary to impose strict limits on sexual activity. Instead, focus on managing symptoms and discussing any changes with your healthcare provider.

4. Post-Surgery Activity
After varicocele surgery, most patients can return to their normal activities, including weight training, within a few weeks. However, it is essential to follow your surgeon's recommendations regarding activity restrictions during the recovery period. Gradually resuming weight training and listening to your body will be crucial. If you experience pain during or after workouts, it may be wise to consult your physician or a physical therapist specializing in sports medicine.

5. Ice Therapy and Recovery
Using ice after weight training may help reduce inflammation and discomfort associated with varicocele. While ice therapy can provide temporary relief, it is not a substitute for addressing the underlying condition. If you find that ice helps alleviate symptoms, it can be a useful adjunct to your recovery strategy. However, it is essential to combine this with other treatments and lifestyle modifications as recommended by your healthcare provider.

Conclusion
In summary, your symptoms could stem from either chronic prostatitis or varicocele, with the latter being more likely given your ultrasound findings. Surgical intervention for varicocele may improve your symptoms, but it is essential to consider the potential impact of chronic prostatitis. Abstinence may not be necessary, and you should be able to resume weight training after surgery with proper guidance. Ice therapy can provide symptomatic relief but should be part of a broader treatment plan. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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