Varicocele: Causes, Symptoms, and Impact on Fertility

Masturbation and Varicocele

Hello doctor, is it true that varicocele only involves a cluster of blood vessels above? I feel something unusual, like a strange cord, on my testicle...
what could that be? Also, I used to masturbate by lying on my stomach, rubbing against my penis, and that would lead to ejaculation.
However, when I try to masturbate normally with my hand, I can't seem to ejaculate...
why is that? Could this cause infertility?

A Jun, 10~19 year old female. Ask Date: 2015/08/10

Dr. Fu Shizhang reply Urology

It is recommended to have a consultation at the outpatient clinic for the presence of a foreign object on the testicle; additionally, this will not cause infertility.

Reply Date: 2015/08/10

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. This condition is relatively common and can have significant implications for male fertility. Understanding the causes, symptoms, and impact of varicocele on fertility is crucial for men who may be experiencing fertility issues.

Causes of Varicocele
Varicocele occurs when the valves within the veins of the spermatic cord fail to function properly, leading to the pooling of blood and subsequent enlargement of the veins. The exact cause of this valve failure is not always clear, but several factors may contribute, including:
1. Anatomical Differences: The left testicular vein drains into the left renal vein at a right angle, which can create a higher pressure environment compared to the right testicular vein, which drains directly into the inferior vena cava. This anatomical difference can predispose men to develop varicocele on the left side.

2. Hormonal Factors: Hormonal imbalances may also play a role in the development of varicocele, as testosterone levels can influence the function of the veins.

3. Genetic Predisposition: Some individuals may have a genetic tendency to develop varicose veins, which can extend to the veins in the scrotum.

Symptoms of Varicocele
Many men with varicocele may not experience noticeable symptoms. However, some common symptoms include:
- A "bag of worms" feeling in the scrotum due to enlarged veins.

- Discomfort or pain in the scrotum, especially after prolonged standing or physical activity.

- Testicular atrophy (shrinkage of the testicles) on the affected side.

- Fertility issues, as varicocele is associated with decreased sperm production and quality.

Impact on Fertility
Varicocele is known to affect male fertility in several ways:
1. Sperm Production: The increased temperature in the scrotum due to the pooling of blood can negatively impact sperm production. The testes are designed to function optimally at a temperature slightly lower than the body's core temperature, and varicocele can disrupt this balance.

2. Sperm Quality: Studies have shown that men with varicocele often have lower sperm motility (the ability of sperm to swim) and abnormal sperm morphology (shape). These factors can significantly reduce the chances of successful fertilization.

3. Hormonal Changes: Varicocele can lead to hormonal imbalances that may further affect sperm production and overall fertility.

Addressing Concerns
Regarding your specific concerns about the "strange thing" you feel on your testicle, it is essential to consult a healthcare professional for a proper examination. It could be related to varicocele or another condition, such as a spermatocele or epididymal cyst. A physical examination and possibly an ultrasound can help clarify the situation.

As for your experience with ejaculation, it is not uncommon for men to have different experiences with various forms of stimulation. If you find that you can ejaculate through one method but not another, it may be related to psychological factors, physical stimulation differences, or even anxiety. If this is causing concern or affecting your sexual health, discussing it with a healthcare provider or a urologist may provide insights and solutions.

Conclusion
In summary, varicocele is a common condition that can impact male fertility. If you suspect you have varicocele or are experiencing fertility issues, it is advisable to seek medical advice. A urologist can provide a thorough evaluation and discuss potential treatment options, which may include lifestyle changes, medications, or surgical interventions to improve fertility outcomes. Understanding your body and seeking help when needed is vital for addressing any health concerns effectively.

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