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Urology (Expert Forum)
Varicocele questions
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Varicocele questions
by jstr, May 06, 2003 12:00AM
I have a left site varicocele and a cyst (containing water according to the doctor) on the left testicle. The varicocele is 'moderate' says the doctor (not an urologist, just an ordinary doc) and that I shouldn't worry, especially when I don’t feel pain in the testicle. But I doubt that. And I have also done an ultrasound test. He examined me after I sat in a chair waiting for one hour so the varicocele was not that intense the moment. Shouldn’t you examine it when it's at it worse?
When I was 18 years old I started training in a gym and stopped after I was 20, then everything was fine. When I started again at 22-23 years I stated to get severe head aces after straining me in the gym, it feels like all the blood is going to my head. Sometimes the head ace gets real bad. It's much worse if I train my abdominal muscles. Later I found out that I have varicocele. When I lie I bed and is resting the varicocele veins is small. And when I tense the abdominal muscles the veins gets really hard really fast and I can feel the blood pulsating through the veins, sometimes without touching them, but I can’t feel anything on the right side. The blood flow is much smaller if I if i tense my chest or leg muscles rather then the stomach. I almost never train anymore cause of this. Should i stop?
Now that can't be good? Can this be related to the varicocele?
I have a strong feeling that it does, is it medically possible that these two problems can be related?
When should I start to get worried? Only when I’m in testicular pain?
If I strain myself ex in a gym, can that harm my testicle since all the blood it flowing from them, and possibly drain them?
How do I know that I don't have "backflow" of blood to the testicle?
And can this affect the production of testosterone?
At what time should you have surgery?
I hope that someone can answer some of my questions. And yes, I know that it's hard to diagnose me over internet without a physical examination. But what do you think it can be. It would be great if I got some answers of the above questions. And what should I ask my urologist when I see him, any recomendations of what to ask him? Personally I want that surgery now!
When I was 18 years old I started training in a gym and stopped after I was 20, then everything was fine. When I started again at 22-23 years I stated to get severe head aces after straining me in the gym, it feels like all the blood is going to my head. Sometimes the head ace gets real bad. It's much worse if I train my abdominal muscles. Later I found out that I have varicocele. When I lie I bed and is resting the varicocele veins is small. And when I tense the abdominal muscles the veins gets really hard really fast and I can feel the blood pulsating through the veins, sometimes without touching them, but I can’t feel anything on the right side. The blood flow is much smaller if I if i tense my chest or leg muscles rather then the stomach. I almost never train anymore cause of this. Should i stop?
Now that can't be good? Can this be related to the varicocele?
I have a strong feeling that it does, is it medically possible that these two problems can be related?
When should I start to get worried? Only when I’m in testicular pain?
If I strain myself ex in a gym, can that harm my testicle since all the blood it flowing from them, and possibly drain them?
How do I know that I don't have "backflow" of blood to the testicle?
And can this affect the production of testosterone?
At what time should you have surgery?
I hope that someone can answer some of my questions. And yes, I know that it's hard to diagnose me over internet without a physical examination. But what do you think it can be. It would be great if I got some answers of the above questions. And what should I ask my urologist when I see him, any recomendations of what to ask him? Personally I want that surgery now!
Doctor's Answer
by Kevin Pho, MD, May 07, 2003 12:00AM
, May 07, 2003 12:00AM
Hello - thanks for asking your question.
As you have mentioned, I cannot diagnose you over the internet. However, here are some answers about varicocele.
It is certainly possible that tensing your stomach will exacerbate the varicocele. If your training requires this, then it makes sense to limit these activities.
A varicocele may cause the following symptoms:
- Dull, aching left scrotal pain, typically noticeable when standing and relieved by recumbency
- Testicular atrophy, believed to be secondary to loss of germ cell mass by induction of apoptosis (programmed cell death) initiated by the associated slightly increased scrotal temperature
- Possibly compromised fertility.
It is certainly possible that a varicocele may decrease testosterone levels.
Treatment of varicoceles are variable. Surgery is recommended in younger men while conservative treatment is recommended in older men who have completed their families.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
As you have mentioned, I cannot diagnose you over the internet. However, here are some answers about varicocele.
It is certainly possible that tensing your stomach will exacerbate the varicocele. If your training requires this, then it makes sense to limit these activities.
A varicocele may cause the following symptoms:
- Dull, aching left scrotal pain, typically noticeable when standing and relieved by recumbency
- Testicular atrophy, believed to be secondary to loss of germ cell mass by induction of apoptosis (programmed cell death) initiated by the associated slightly increased scrotal temperature
- Possibly compromised fertility.
It is certainly possible that a varicocele may decrease testosterone levels.
Treatment of varicoceles are variable. Surgery is recommended in younger men while conservative treatment is recommended in older men who have completed their families.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
