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Right Inguinal hernia and left varicocele to be done. Semen analysis done. Looking for your advice

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Answered by

Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Dear Sir ,
I have undergone following Laproscopic surgeries on 24-Feb-2012
1.Right Inguinal Hernia
2.Left Varicocele

Now Quality of the sperm is a worrying issue for me.
I have attached my Seman Analysis reports ,done before and after surgery .

Yesterday ,I have undergone Seman Analysis again .The result is same as last seman analysis report .

We are trying for Kids .I would like to know proper advise from you .
Posted Wed, 25 Jul 2012 in Men's Health
Answered by Dr. Ketan Vagholkar 2 hours later
Thanks for writing in.
From your history and lab report of the semen analysis there are two issues which merit mention.
1. Preexisting varicocele happens to be a impediment to healthy sperm production by way of raised scrotal temperature.
2. Altered morphological features of the sperms.
I will address both these issues sequentially
1. Surgery for both hernia as well as varicocele may at times exert a temporary negative impact on spermatogenesis. The question now is whether the left varicocele has reduced , disappeared or increased. At times there is violent recurrence of the varicocele. So that needs to be ascertained by a scrotal doppler and comparing it with preoperative studies especially the velocity studies of testicular blood flow.
2. The semen analysis report reveals 3 findings
a) decrease in the sperm count
b) altered morphology with increased percentage
c) pus cells.

For healthy spematogenesis there are a few requirements
1.good blood supply to the testis
2.cooler scrotal temperatures
3.adequate intake of certain vitamins to improve sperm morphology.

I would therefore suggest the following measures now
1. Weight reduction in case if you are over weight. That has an inpact on the hormonal stimulus for sperm production
2. Keep the scrotal temperature on the cooler side by using cotton undergarments and washing the genitalia with cold water twice or thrice a day. Use loose pyjamas at night.
3. Avoid alcohol and tobacco at any cost.
4. Avoid cycling in case you visit the gym.
5. Cardio exercises in the form of walking for 45 minutes is the best way to improve the blood supply to the testicles.
6. Increase the consumption of sprouts in your diet.
7. Plenty of water to prevent ant urinary concentration or infection.
8. Vitamin supplements
a) Vitamin b complex for improving sperm morphology as well as sperm motiliy.
b) vitamin E to improve the gonadal epithelium thus helping to enhance spermatogenesis.
c) essential fatty acids (omega)to improve the vascular lining of the vessels supplying the region.
9. A short course of antibiotic to get rid of those pus cells suggestive of infection.
You do not require any hormonal supplements as the testes are producing sperms.
Follow this regimen strictly for 12 weeks and then repeat a semen analysis thereafter.
I hope this provides you with a road map .
With regards
Above answer was peer-reviewed by
Follow-up: Right Inguinal hernia and left varicocele to be done. Semen analysis done. Looking for your advice 11 minutes later
Sir ,

I have not observed any change in size of the left testis .
But I still feel there is some swelling (little) of both testicles.

this swelling is not constant ..some times no swelling ,some times little .
I also feel little uncomfortness of scotrum .Some times pain on the right testis if I walk too much and ride my bike long distance .

Answered by Dr. Ketan Vagholkar 1 hour later
Thanks for the feedback.
Stop riding the bike. Trauma to the testcles can be caused by 2 wheeler riding on bumpy roads.
Get a scrotal doppler done.That will help in the diagnosis.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
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