1. You haven't mentioned about the effect of this problem on Marital Life (If married??) because it is associated with low sperm count
and poor sperm motility
2. are the tumor markers been carried out??
3. followup with your Physician is essential for further evaluation and management.
4. present with Valsalva
, probably Grade I
5. we have to maintain the arterial inflow and lymphatic drainage
thus internal spermatic vein ligation is treatment of choice.
6. moreover its a mechanical problem so surgery is best
7. In the mean time take diet rich in Vit. C (amla,citrus fruits) and high protein diet and low in fat, sugar and salt.
8. rest,elevation,and scrotal support.
9. avoid anything which impairs venous return:wearing tight clothes, crossing the legs at knees, prolonged sitting and standing.
10. Ayurvedic Drugs: Yashad Bhasam,Brahmi and Onion are the drug of choice