Varicocele???

I'm a 58 year old male who had a vasectomy in 1986. Because of various other medical conditions like Thyroid issues, arthritic pain, and panic/anxiety attacks, I take a variety of drugs that make me, for all practical purposes, impotent. Therefore, I am not sexually active. I don't know if that is relevant. I just offer that as background information.
Several years back I started experiencing a pain in my left testicle whenever I lifted too much weight or if I sat down too hard and hit my left testicle. Once aggravated, the pain lasted for several days. If I touch the bottom of the testicle, it generates a sharp shooting pain upward into my left lower abdomen. Also, the back side of the testicle feels like worms inside. I know this is a typical symptom of a Varicocele, but I don't feel this anomaly anywhere else on the surface of the testicle. The left testicle hangs lower than the right and also appears to be slightly larger.
About 3 years ago, I went to a Urologist who did a sonogram, and diagnosed a Varicocele. He said if and when the pain became unbearable, he come perform surgery. My concern is this: I don't seem to have all of the normal symptoms of a Varicocele. And I do seem to have some symptoms of a hernia. What is your opinion?

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. While it is normal to have slight discrepancy in the position and the size of the two testicles, possible causes of the symptoms that may need to be considered include GU infections, inflammations, growths/ masses, neuro-muscular causes etc. I would suggest getting this evaluated by a primary care physician or a urologist for a detailed evaluation and suggestion of an appropriate management plan.
Hope this is helpful.

Take care!