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Urology (Expert Forum)
Varicocele surgery complications.
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 surgery complications.
by Jason B., Jan 11, 2000 12:00AM
Hi,
A year and a half ago I went to a urologist because I was having some pain and heaviness in my left testicle from a varicocele. He suggested I have surgery to repair the problem.
After my inguinal surgery my testicle had swollen to the size of a baseball, and I was in a lot of pain. I called the doctor and he said this is normal after surgery and to give it support. After two weeks the swelling subsided and I returned to work. After about a week at work wearing normal briefs I noticed the veins in my left testicle started to become enlarged again, almost as bad as it was before. Since I was moving in less than a month to a new city and in no serious pain, just discomfort I decided against doing anything further with the doctor to remedy the problem. Fast forward eight months I started a new job joined a health club and began working out more heavily at the gym.. mainly Cardio exercises. I was making diner with my wife and felt a sharp pain in the area right above my right testicle. I lowered my pants to feel the area where I had pain. There was a small nickel sized lump in the area above my right inginal ring. I went to a general physician who believed it was a hernia and refered me to a surgeon, and he examined the raised area and said it wasn't a hernia and appeared to be a swollen lymph node. He prescribed antibiotics and light activity to see if it goes away. It took several weeks on anti biotics for the small lump to dissappear. During this time I noticed that the eppididimus on my right testicle appeared to be swollen and was causing me pain. My pain and swelling seemed to be greatest when I wore undergarments that constricted the testes or sat in a chair up right for long peroids of time. I switched to wearing large side boxer briefs and larger sized pants and laying flat on a bed to subdue the discomfort. I had convinced myself that my left testicle was causing the discomfort so I went to another urologist who examined the swelling in my left testicle and he suggested another varicocelectomy to decrease the size of the left testes. After having my second inguinal surgery, my left varicocele was smaller but there was still a discomfort in the right. After my surgery I went back to the urologist and he had no idea what could be causeing the pain in the right and suggested I take hot baths and ibuprofin for a couple weeks.
This treatment did not work and the pain in the right and left testicle would always return if I tried to wear any constricting
clothing. After several weeks of pain and discomfort I went back to my uroligist and he refered me to another physician for a second opinion. The urlogist he recommended examined me and said their could still be a varicocele and recommended another ultrasound. During the the ultrasound they discovered that I still had some enlarged veins in the left testes. During this period I was having increased swelling and burning sensation right above the left inguinal ring area (skin was red and tender to the touch). I went back to the doctor and he performed a cord block on the left testicle. After having cord block I noticed a definnate change in the size and position of the left testicle. Also the swelling and pain in my right testicle has been reduced. I'm just guessing but could it have released some trapped fluid from a hydrocele? The next step my doctor recommended was to have a venogram in that area to get a better look at whats happening with the veins. Does this sound like the best thing to do? Are there any other less invasive test that could reveal what is happening with blood flow to my left testicle?
Thanks,
Jason B.
A year and a half ago I went to a urologist because I was having some pain and heaviness in my left testicle from a varicocele. He suggested I have surgery to repair the problem.
After my inguinal surgery my testicle had swollen to the size of a baseball, and I was in a lot of pain. I called the doctor and he said this is normal after surgery and to give it support. After two weeks the swelling subsided and I returned to work. After about a week at work wearing normal briefs I noticed the veins in my left testicle started to become enlarged again, almost as bad as it was before. Since I was moving in less than a month to a new city and in no serious pain, just discomfort I decided against doing anything further with the doctor to remedy the problem. Fast forward eight months I started a new job joined a health club and began working out more heavily at the gym.. mainly Cardio exercises. I was making diner with my wife and felt a sharp pain in the area right above my right testicle. I lowered my pants to feel the area where I had pain. There was a small nickel sized lump in the area above my right inginal ring. I went to a general physician who believed it was a hernia and refered me to a surgeon, and he examined the raised area and said it wasn't a hernia and appeared to be a swollen lymph node. He prescribed antibiotics and light activity to see if it goes away. It took several weeks on anti biotics for the small lump to dissappear. During this time I noticed that the eppididimus on my right testicle appeared to be swollen and was causing me pain. My pain and swelling seemed to be greatest when I wore undergarments that constricted the testes or sat in a chair up right for long peroids of time. I switched to wearing large side boxer briefs and larger sized pants and laying flat on a bed to subdue the discomfort. I had convinced myself that my left testicle was causing the discomfort so I went to another urologist who examined the swelling in my left testicle and he suggested another varicocelectomy to decrease the size of the left testes. After having my second inguinal surgery, my left varicocele was smaller but there was still a discomfort in the right. After my surgery I went back to the urologist and he had no idea what could be causeing the pain in the right and suggested I take hot baths and ibuprofin for a couple weeks.
This treatment did not work and the pain in the right and left testicle would always return if I tried to wear any constricting
clothing. After several weeks of pain and discomfort I went back to my uroligist and he refered me to another physician for a second opinion. The urlogist he recommended examined me and said their could still be a varicocele and recommended another ultrasound. During the the ultrasound they discovered that I still had some enlarged veins in the left testes. During this period I was having increased swelling and burning sensation right above the left inguinal ring area (skin was red and tender to the touch). I went back to the doctor and he performed a cord block on the left testicle. After having cord block I noticed a definnate change in the size and position of the left testicle. Also the swelling and pain in my right testicle has been reduced. I'm just guessing but could it have released some trapped fluid from a hydrocele? The next step my doctor recommended was to have a venogram in that area to get a better look at whats happening with the veins. Does this sound like the best thing to do? Are there any other less invasive test that could reveal what is happening with blood flow to my left testicle?
Thanks,
Jason B.
Doctor's Answer
by HFHS M.D.-TP, Jan 14, 2000 12:00AM
There are many medical conditions that can present as a mass in the scrotum. These include but are not limited to hernia, hydrocoele (an acummulation of fluid in the tissue layers that encircle the testicle), benign cyst, infection, varicoele, and the most feared testicular cancer. From your description of physical findings, it sounds like this mass may be a varicocoele.
A varicoele is a dilation of the pampiniform plexus, which is made up of the veins that drain the testicle. Approximately 16% of adolescent boys have a varicocoele, with the same figure found in the normal adult population. Varicocoeles often occur on one side, and usually on the left. Straining, lifting, or standing may enlarge a varicocoele and cause pain. Fertility can be afftected by a varicocoele due to the elevated intrascrotal temperature that results from pooling of warmer blood in the dilated veins. Sometimes, a left varicocoele can be a sign of kidney cancer . This is because the kidney tumor may extend into the left renal vein and block venous return from the left pampiniform plexus.
In regards to your childhood hernia, a hernia does not increase your risk of developing testicular cancer.. However, a hernia can be found in association with an undescended testicle. If you have an undescended testicle, i.e., a testicle that does not descend down into the scrotum at birth or shortly after birth and in which case would require hormonal or surgical placement of the testes into the scrotum, there is an increased risk of developing testicular cancer later on in life. However, in the absence of a complete history and physical exam, I cannot provide a definitive diagnose for you.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Sincerely,
HFHS M.D.-TP
*Keyword: varicocele
A varicoele is a dilation of the pampiniform plexus, which is made up of the veins that drain the testicle. Approximately 16% of adolescent boys have a varicocoele, with the same figure found in the normal adult population. Varicocoeles often occur on one side, and usually on the left. Straining, lifting, or standing may enlarge a varicocoele and cause pain. Fertility can be afftected by a varicocoele due to the elevated intrascrotal temperature that results from pooling of warmer blood in the dilated veins. Sometimes, a left varicocoele can be a sign of kidney cancer . This is because the kidney tumor may extend into the left renal vein and block venous return from the left pampiniform plexus.
In regards to your childhood hernia, a hernia does not increase your risk of developing testicular cancer.. However, a hernia can be found in association with an undescended testicle. If you have an undescended testicle, i.e., a testicle that does not descend down into the scrotum at birth or shortly after birth and in which case would require hormonal or surgical placement of the testes into the scrotum, there is an increased risk of developing testicular cancer later on in life. However, in the absence of a complete history and physical exam, I cannot provide a definitive diagnose for you.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Sincerely,
HFHS M.D.-TP
*Keyword: varicocele
Member Comments (12)
by mulhugh@esatclear.ie, Jan 24, 2000 12:00AM
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