Varicocele diagnosis?

[Tom__0__0]

Posted by Tom on June 23, 1999 at 11:27:58
I have been experiencing major pain and swelling of the tube connected to my left testicle for 3 months. Exam by two doctors and an ultrasound revealed NOTHING out of the oridinary besides pain and swelling. My doctor ruled out the usual: varicocele, cysts, cancer, etc.
I saw a urologist last who, in literally ten seconds, (and a 3 second exam) pronounced it a varicocele and said nothing can be done about it. Take advil or ibuprophen for three weeks to bring swelling down! He wouldn't listen to others symptoms:
-increased pain with sexual arousal, blockage of semen( very little ejaculation and when I do I feel it moving through the epidymus(Sp?) and suddenly stop, gather and swell near testicle causing EXTREME pain which last for days).
-the testicle (or rather the tube) is severely swolen and the testicle hands much lower than it used to.
What is this? And what treatment is available? I live out of the country so a visit to the Henry Ford or other US facility is impossible. This has ruined my life over that last 3 months and I am desperate to end this agony.

Posted by David on June 28, 1999 at 14:39:58
I seem to be experiencing a similar problem.  I am 24 years old, and have been experiencing a similar pain in the left side of my scrotum, right by the left testicle for a few months now.  It feels like pain in the vein/tube on the side of the testicle, but I am not certain.
I went to the doctor for a physical about 3 months ago, and there was no diagnosis of a hernia or anything suggested besides taking Advil for a few days until the pain subsided.  I did that for a time, I THINK the pain and discomfort went away at the time, but it has since come back.  It seems to come and go, there are times when I do feel it, other times I don't.  
I have also noted that the left testicle seems to have gotten larger, and more oval-shaped than the right.  In addition, in the last week or so, I have noted an extreme diminishment in semen produced while masterbating (masturbating).  Prior to the last time I had masterbated, it had been about a week.  Normally, that length of time causes a tremendous build-up and release when I finally do it.  This time around, the feeling was there, but very little fluid was produced... much less than normal.
I have a very sedentary life-style.  I have a sit down job, and I travel 3-4 hours a day.  I also do not exercise when I am home.  Could these be contributing to the problem?  What should I do?  Please advise!!!  Thank you.

Posted by Tom on July 03, 1999 at 03:33:08
David, I think I found the answer. Saw my regular physician. He had a letter from the urologist: take Advil (2 in morning, maybe 2 in aft and 2 in eve) everyday for up to 2 to 3 months! Not weeks. Should show a gradual improvement over this time.
Also read in Naturapathic medicine book: exercise for blood circulation, take vitamins B6, B-complex(I did this but not B6; Complex should have B6), Vit C (1000 MG up to five times daily) Calcium & Magnesium, and Vit E (promotes tissue and skin healing.)
I've done all of these (incl Advil) for past wk and half. Remarked improvement. Seems to be healing. Swelling down, pain really down.
Also: DON'T masturbate or have sexual contact AT ALL. Even avoid thoughts or images causing arousal. I was getting better then tried to have sex and whole thing started again. The semen blockage during ejaculation really aggravates problem and makes it start again.
Treat it as injury in knee or something: Avoid activity that increases pain, etc. Keep away from sexual activity for two to three wks. Seems to be helping thank god.

Posted by HFHS M.D.-AK on July 05, 1999 at 09:12:18
Dear Tom,
A Varicocele is a swelling of the veins around the testicle, an up into the abdomen.  The testicular vein which attaches to the renal vein is involved.  Varicoceles can occur bilaterally, but are more common on the left. The prevelence of varicoceles in the general population is between 13-15%, so you are not alone.
The management of this condition is controversial, particularly in the pediatric and adolecent (adolescent) population.  The current trend however is to surgically repair them.  The common problems that occur if they are not repaired are, testicular atrophy(shrinking). infertility, pain and swelling.  The main reason to repair this condition is infertility.  About 35-40% of patients seen in american infertility clinics have a varicocele.
Varicocele is diagnosed by palpation of the spermatocord with the patient in a standing upright position.  The patient performs a Valsalva maneuver and a filling of the veins occurs immediately(so it is possible to make the diagnosis in three seconds).  Ultrasound and other imaging studies have been considered, but often can miss the proble.  A good physical exam is the final determining factor.
Complications of varicocele are rare an usually minor.  About 3% of patients have post-op hydroceles (fluid around the testis), 1% have infections(epididimitis), and less than one percent have immediate recurrence.  However, there is persistent dilation of the ligated veins in a small group of patients.  This can still cause pain and swelling and usually take several months to disappear.
Talk to your doctor, he can follow your physical exam and help you decide if surgery is necessary.
This information is provided for general medical educational 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.-AK
*keyword: Varicocele