Question:
I'm not certain this is the best forum for my questions. If not, please accept apologies, point me in the right direction. I have had a varicocele (left testicle) for decades. It didn't bother me when I was younger (I'm now 54). About 8 years ago it started to become painful. About 4 years ago I had a simple hernia operation on my left side. It was generally successful and there were no complications. Pain from what has become a Class 4 varicocele has increased. Ultrasound indicates my left testicle is atrophied (has become smaller then the right). I've been limping a little from the pain. The urologist/surgeon recommends retroperitoneal varicocele ligation which involves traditional surgery in the area of the hernia operation. As I understand it, many (but not all) testicular veins would be "tied off". Has anyone been thru something similar? If so, could you describe costs/benefits of the surgery (my private Email address is below if you prefer). Actually, any knowledgable comments would be welcomed. I have the feeling I could get into "a world of trouble" going into this thing with the tiny bit of knowledge I now possess.

Answer: -A varicocele is a mass of varicose veins in the scrotum. The main vein that leads from the scrotum back to the heart is a large vein that just goes up inside your body. It is so long and so large that it needs valves to keep the blood from falling back down into the scrotum. The valves frequently (about 10% of men) do not function with 100% efficiency and allow the blood to "back up" in the scrotum and cause varicose veins. The standard treatment is to ignore the varicosities unless there is pain or infertility. There are two different surgeries to correct it, but the one you describe is to simply clip off the vein that leads from the scrotum (up in the abdomen) and tie the ends off. This isn't a problem because there are actually other veins that lead from the scrotum, which are smaller and have more horizontal parts and everything works better. Sort of makes it sound like a bad design job to start with. Of course, all surgeries carry some risk, but this is low-risk surgery with a high success rate. -15 years ago I had a vericocele years ago that became very painful. The onset of pain coincided with consumption of digestive enzymes I was taken, but I didn't realize that at the time, and got the surgery (tied off). 4 months after the surgery, the pain went away, but I don't know if I can attribute it to the surgery. More recently I had an apparent hernia or rupture of the blood vessel in the area of the surgery (see my letter about the abdominal protrusion). Now I have severe prostatitis. I am not qualified to advise on this, and am not a doctor. But I know that varicoceles are faulty veins lile in varicose veins. I also know that in Germany they use something called horesechestnut extract to treat varicose veins. If I were yшu, I'd be tempted to try it before resorting to the surgery. Just keep in mind however, that there are reasons besides pain to get the varicocele fixed (sterility). So please check with your doctor.