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Urology (Expert Forum)
scarring and 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.
scarring and varicocele
by guitarmarkus, Dec 16, 2005 12:00AM
Hi,
I'm 28. Here's my history:
- at age 13, kicked in the sack, vein explodes in the left scrotum, my left pocket fills up with blood to be the size of a grapefruit, emergency surgery, blood drained, supposedly successful without any collateral dammage.
- at age 18, I had an embolization as the affected vein turned into a varicocele. the vein shrunk.
Over the years it gradually came back.
This September I go to a party and someone accidently kicks me in the sack. I hurt. Go home. The next day everything seems fine.
a couple weeks later I have another party where I smoke more pot than usual and drink and all of a sudden I have an excruciating pain in that area. next day fine.
Over the past 2 months I have correlated the fact that when I smoke marijuana, my varicocele swells up and it hurts like crazy. I noticed that redbull also created a little pain. One day, when I had smoked, the pain lasted for 3,4 days and I decided to stop smoking weed and go to a urologist. He says something about my left being higher than the right (muscles more tense) and suggests hot baths to relax. They sort of help but not really. He also mentions some scarring (which seems to be at the back of the testicule). He said the obliteration had been successful as my vein didn't swell up from going to sitting position to standing up. However I feel it does but just very slowly.
A few weeks go by where I'm feeling better, do a lot of cycling classes and running as I'm unemployed. Then I start hurting again (apparently for no reason appart maybe from over exertion) and it's been hurting for the past 10 days. I noticed that when I lift my left leg up it releases some tension as the vein swells down slowly. I take some painkillers (ibuprofen) and the pain seems to slowly go away. I just went to another urologist who was pretty brutal and hasteful in osculting my scrotum. He says he can't really feel the varicocele, says everything is normal but notices the scarring and seems to hint at that being the problem.
I'm going to do some US with doppler and he said that I could do an embolization if I wanted to (but I was the one suggesting it... He was more old school in promoting surgery or some anesthetic injection to help the scarring).
After my visit my balls were killing me all evening and night.
Today they feel a bit better.
So my take is there is some scarring (from that orginal shock and repetive strains) and the varicocele is just an external factor affecting the irritation. Does it seem to make sense? what is the relationship with varicoceles to their surrounding environment?
What should I do? rest, take ibuprofen to help the healing. Can a scar that is 3 or 4 months old still be hurting? Is there anything else I can do to help it heal. If it heals what should I expect for the future? even more fragility?
Should I do the embolization? Could my vein be currently partially blocked and in this case is a second embolization still possible?
Thanks
I'm 28. Here's my history:
- at age 13, kicked in the sack, vein explodes in the left scrotum, my left pocket fills up with blood to be the size of a grapefruit, emergency surgery, blood drained, supposedly successful without any collateral dammage.
- at age 18, I had an embolization as the affected vein turned into a varicocele. the vein shrunk.
Over the years it gradually came back.
This September I go to a party and someone accidently kicks me in the sack. I hurt. Go home. The next day everything seems fine.
a couple weeks later I have another party where I smoke more pot than usual and drink and all of a sudden I have an excruciating pain in that area. next day fine.
Over the past 2 months I have correlated the fact that when I smoke marijuana, my varicocele swells up and it hurts like crazy. I noticed that redbull also created a little pain. One day, when I had smoked, the pain lasted for 3,4 days and I decided to stop smoking weed and go to a urologist. He says something about my left being higher than the right (muscles more tense) and suggests hot baths to relax. They sort of help but not really. He also mentions some scarring (which seems to be at the back of the testicule). He said the obliteration had been successful as my vein didn't swell up from going to sitting position to standing up. However I feel it does but just very slowly.
A few weeks go by where I'm feeling better, do a lot of cycling classes and running as I'm unemployed. Then I start hurting again (apparently for no reason appart maybe from over exertion) and it's been hurting for the past 10 days. I noticed that when I lift my left leg up it releases some tension as the vein swells down slowly. I take some painkillers (ibuprofen) and the pain seems to slowly go away. I just went to another urologist who was pretty brutal and hasteful in osculting my scrotum. He says he can't really feel the varicocele, says everything is normal but notices the scarring and seems to hint at that being the problem.
I'm going to do some US with doppler and he said that I could do an embolization if I wanted to (but I was the one suggesting it... He was more old school in promoting surgery or some anesthetic injection to help the scarring).
After my visit my balls were killing me all evening and night.
Today they feel a bit better.
So my take is there is some scarring (from that orginal shock and repetive strains) and the varicocele is just an external factor affecting the irritation. Does it seem to make sense? what is the relationship with varicoceles to their surrounding environment?
What should I do? rest, take ibuprofen to help the healing. Can a scar that is 3 or 4 months old still be hurting? Is there anything else I can do to help it heal. If it heals what should I expect for the future? even more fragility?
Should I do the embolization? Could my vein be currently partially blocked and in this case is a second embolization still possible?
Thanks
Doctor's Answer
by Kevin Pho, MD, Dec 19, 2005 12:00AM
, Dec 19, 2005 12:00AM
It is possible that the prior procedure with the varicocele is related to the current discomfort. It is difficult to tell without examination.
I would certainly go through with the ultrasound to ensure there isn't anything else going on. If the symptoms are due to a new or existing varicocele, you may want to consider surgery to treat this. It is possible that the prior embolization has failed - leading to a recurrance.
Surgical ligation is generally the first-line treatment for varicoceles rather than embolization.
These options 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
I would certainly go through with the ultrasound to ensure there isn't anything else going on. If the symptoms are due to a new or existing varicocele, you may want to consider surgery to treat this. It is possible that the prior embolization has failed - leading to a recurrance.
Surgical ligation is generally the first-line treatment for varicoceles rather than embolization.
These options 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
by aislebdamn, Feb 09, 2006 12:00AM
To: Urology - General
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