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What Causes Pain In Groin Area With History Of Varicocele?

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Posted on Tue, 18 Aug 2015
Question: I will try to be as detailed as possible with this question in hope that it helps.I have experienced pain in left groin for several years and have not addressed it recently.I had my urologist check it several years ago and he did a ultrasound on testicles which showed varicocele of the left and he also did a round of anti biotics and checked for hernia -negative.Pain is a quite severe but dull and extends from bottom of pelvis to a point in upper groin.Experience pain when 1) crossing legs 2)after ejaculation and intercourse 3) after nocturnal erection in morning.Have looked at anatomy profiles and believe it is the inguinal ligament that is involved after some sort of straining.Will see my Doctor eventually but wanted another view before visit.Would Mri help identify the issue as it has gone on too long. Thank You XXXXXXX
doctor
Answered by Dr. Vivek Chail (23 minutes later)
Brief Answer:
Investigation of choice for varicocele and groin pain is ultrasound scan.

Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. When you have been diagnosed with a varicocele several years back, it is possible that the pain might be due to a manifestation of the varicocele, which might have progressed over the years.

2. When we try to evaluate a dull pain to the groin in a patient who has a history of varicocele, it is important to go in for another ultrasound scan with Doppler evaluation. This is the imaging of choice in the above situation.

3. Research has shown that MRI evaluation of a varicocele and associated groin symptoms is limited and does not score over ultrasound scan of the area. Even conditions like a small hernia might be seen on an ultrasound scan. Doing a MRI might not be able to provide as much details as given by ultrasound scan. It will be important to do an ultrasound scan of the abdomen and pelvis also, to rule out any intra abdominal cause of your symptoms.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Vivek Chail (6 hours later)
Thank You very much. I had an older ultrasound of the varicocele and my urologist seemed satisfied with that and it was not the cause. Is the inguinal and varicocele connected in some way as the pain extends high into groin. I should have a ultrasound with the groin area included and not just the testes if I understand you correctly. Confused by soreness after a nocturnal erection. Thanks Again XXXXXXX XXXX
doctor
Answered by Dr. Vivek Chail (3 hours later)
Brief Answer:
Possibilities might be regional or neurological in origin

Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.

1. It is clear that the discomfort is particularly associated with events including crossing legs, nocturnal erection and sexual intercourse.

2. Though an initial assessment of the groin region might help to evaluate any regional causes of the pain and discomfort, it is important to rule out any nerve pinching as the primary cause of your pain.

3. I have come across patients who have a nerve related problem which is causing pain during nocturnal emissions. Therefore I suggest a regional evaluation of the groin area and if nothing is found then a neurological assessment of the nerves from lumbosacral spine might have to be done.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Causes Pain In Groin Area With History Of Varicocele?

Brief Answer: Investigation of choice for varicocele and groin pain is ultrasound scan. Detailed Answer: Hi XXXXX, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. When you have been diagnosed with a varicocele several years back, it is possible that the pain might be due to a manifestation of the varicocele, which might have progressed over the years. 2. When we try to evaluate a dull pain to the groin in a patient who has a history of varicocele, it is important to go in for another ultrasound scan with Doppler evaluation. This is the imaging of choice in the above situation. 3. Research has shown that MRI evaluation of a varicocele and associated groin symptoms is limited and does not score over ultrasound scan of the area. Even conditions like a small hernia might be seen on an ultrasound scan. Doing a MRI might not be able to provide as much details as given by ultrasound scan. It will be important to do an ultrasound scan of the abdomen and pelvis also, to rule out any intra abdominal cause of your symptoms. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek