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Urology (Expert Forum)
Varicocele
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
by osiag, Dec 08, 2005 12:00AM
I had a fertility work up in 2000 including a sonogram with doppler; everything was normal. Recently, I noticed mild scrotal swelling on the left side one the evening. The swelling tends to be more pronounced in the evening and less in the morning. My urologist examined me and dx me with epiditimitis. However, after ten days of doxycycline there really was no difference, so the urologist order a sonogram, which revealed a minor varicocele.
If the sonogram with doppler in 2000 and the current sonogram are both correct, then I developed the varicocele sometime between 2000 and the present. Currently, I am 37. This concerns me since I understand that varicoceles almost always develope early in life; and those that develope later in life may be a result of an adominal mass. My urologist doesn't seem very concerned since the varicocele is small.
I'm repeating the sonogram this time with a doppler and also doing a sonogram of the abdominal.
The big question is if the abdominal sonogram shows no masses, have we done enough to rule out abdominal masses? I know that a CT is better than a songram, but there is a significant amount of radition. Also, consider that I recently (Sept 30th) had a full blood work up and micro-urine analysis both were totally normal other than uric acid being 0.2 above the upper limit. There was no protein in my urine. I have no symptoms. What would you have a loved one do?
Thanks
If the sonogram with doppler in 2000 and the current sonogram are both correct, then I developed the varicocele sometime between 2000 and the present. Currently, I am 37. This concerns me since I understand that varicoceles almost always develope early in life; and those that develope later in life may be a result of an adominal mass. My urologist doesn't seem very concerned since the varicocele is small.
I'm repeating the sonogram this time with a doppler and also doing a sonogram of the abdominal.
The big question is if the abdominal sonogram shows no masses, have we done enough to rule out abdominal masses? I know that a CT is better than a songram, but there is a significant amount of radition. Also, consider that I recently (Sept 30th) had a full blood work up and micro-urine analysis both were totally normal other than uric acid being 0.2 above the upper limit. There was no protein in my urine. I have no symptoms. What would you have a loved one do?
Thanks
Doctor's Answer
by Kevin Pho, MD, Dec 09, 2005 12:00AM
, Dec 09, 2005 12:00AM
Difficult to say without evaluation. It is true that a scrotal ultrasound does not rule out abdominal masses.
A more comprehensive test would be a pelvic CT scan. If the varicocele is small, this can be observed. Sudden, large increase in varicocele size can be due to an abdominal mass that necessitates a CT scan.
This option can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_b
A more comprehensive test would be a pelvic CT scan. If the varicocele is small, this can be observed. Sudden, large increase in varicocele size can be due to an abdominal mass that necessitates a CT scan.
This option can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_b
Member Comments (1)
by masterp, Dec 09, 2005 12:00AM
To: Urology - General
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