Varicocele

[sher11]

My 18 year old was diagnosed with a grade 1 vacicocele a few months ago after experiencing testicular pain. This diagnosis was by exam and ultrasound. He said leave it alone unless it causes more or persistant pain. I was not pleased with the urologist's quick and dismissive demeanor and made an appointment with a highly regarded Dr. in a large teaching hospital in a big city for a 2nd opinion.

Dr. #2 said that it is a grade #3 varicocele (determined by exam by standing up and bearing down) he claims he can visibly see the veins and feel them. He also claimed that the left testicle is about 1 cm smaller than the right. He recommended surgery.

I'm confused about the 2 very different opinions. I suppose I should get another opinion, but if potential Dr# 3 agrees with Dr. #1 I'll still question if I should be doing something, if he says grade #2 I'm not sure what I"ll do and if he agrees with Dr. #3 I guess I'd defer to surgery. How do I determine what the proper course should be and how do I decifer whose opinion I trust? Just because Dr. #1 has a bad bedside manner doesn't mean he's wrong and just because Dr. #2 is in a more prestigious position doesn't mean he's right. I'm confused

[mk379941]

I am not a doctor, but I have read on the web several sites mentioning that varicocele repair done on adolecents is somewhat controversial. Some studies are finding that if its done young enough if the varicocele is going to cause infertility it can be a 100% reversal so by the time they want to have kids its not causing a low count etc.. Varicocele can eventually cause testicular athrophy as well. This again they find can give a total reversal if dealt with early enough. If you and your son decide in the end for him to go for the surgery there are several types. The one I read with the best results is the micro-surgical type, but since I am not in the medical field you have to go over that with your doctor and research as well. Also I would see a Male Infertility Urologist specialist they are usually the best at determining the affects of the varicocele.

[dober-man]

I kind of had the same thing happen to me. I saw a urologist close to my house (for convenience) and he diagnosed me with a grade 1 varicocele and said that I could get surgery done if I really wanted to. I went to him because of infertility issues. He then recommended me to a well known urologist who deals mainly with infertility and he diagnosed me with a grade 3 varicocele. The difference was that the first doctor examined me as I laid down and the second doctor examined me standing up. I always knew that I had a varicocele because it was extremely visable and you could feel it.

I ended up going getting the surgery done around 2 months ago and so far I am glad that I got it done. The pain is gone and the "sack of worms" has really gone down. I am getting my follow up semen analysis next month so we'll see if there was any improvement.

[sher11]

I'm glad you're feeling better and hopefully, your anaysis will provide good results. We are not aware of any fertility issues at this point as he is only 18 years old--my concern was that we head off any potential problems in the future in the event that this progresses and things become irrevesible.

How long were you out of commission after your procedure?

[dober-man]

I was in a good deal of pain for approximately two weeks. I ended up with a hematoma (blood clot) because my vein was so big and there was some leakage during the surgery. That added to a lot of the pain, but the clot has now subsided. I actually had a bi-lateral varicocelectomy done because I had a very large one on my left side and a small one on my right side.