Kidney Cyst and Hematuria

Posted by Steffen on April 14, 1999 at 16:16:35
I am a 33 year old male in generally good health.  My wife and I are trying to get pregnant, and I went in for a semen analysis.  First the doc said I had vericocele (bundle of vessels)in the testicle.  How serious is that?  As routine, doc also did a urine test and told me I had blood in the urine, microscopic.  We did and IVP and it was unremarkable.  He also did a ultrasound which identified a 2.5 centimeter cyst on my right kidney (why did it not show on the IVP?).  They want to do a CT Scan.  How can a CT Scan tell anything more, as in benign or not?  Also, could this be causing the hematuria?  Should I be concerned about this?  Can it affect my semen count?  Can the cyst, if found to be benign, is left alone, can it grow to mailignancy?  I am worried - I am justified?  Please respond.  I am still awaitng the semen analysis, but wanted to at least ask you these questions now!  Thank you very much!

Posted by HFHS M.D.-JL on April 19, 1999 at 08:02:42

Dear Steffen,
A varicocele is dilation of the veins that drain the testes.  You can think of them as being analogous to varicose veins of the leg.  A varicocele is found in about 15% of the general population and 35% of men who have never been fertile--and 75-81% of men with new onset infertility.  Varicoceles are associated with a progressive and duration-dependent decline in testicular function.  Decreased motility of sperm is found in 90% of patients along with decreased sperm count and abnormal sperm shape.  Surgical ligation of these veins varicolectomy, results in significant improvement in semen analysis in 60 to 80 % of men and an increased postoperative pregnancy rate of 44% at one year versus 10% in the non-operated group.  The risks of the operation include, but are not limited to recurrence of the varicocele, testicular artery injury and atrophy of the testicle, and hydrocele (fluid around the testicle).
With regards to the hematuria evaluation goes, you still need to have a cystoscopy (look into the bladder with a lighted scope) and urine sent for cytology.  You are at risk for bladder cancer if you are a smoker.  Regarding he renal cyst, if it is a