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Suggest Treatment For Dull Pain In The Scrotum
Question: Hi, I have a question about male reproductive system.
It is about my spermatic cord. When I stand up, it feels like a tube (with a diameter of 3-4mm, estimated). When I lie down, it is very thin and hard to feel by fingers. Is this normal or I should worry about varicocele? Does the spermatic cord should feel exactly the same when one stand up and lie down?
I am asking this because my scrotum feel pain a few weeks ago. I went to see a doctor, and did general ultrasound, but my doctor told me nothing is wrong. However, I think general ultrasound can only rule out cancer or epididymitis, it can not diagnose varicocele, right?
Should I go to see a doctor again?
It is about my spermatic cord. When I stand up, it feels like a tube (with a diameter of 3-4mm, estimated). When I lie down, it is very thin and hard to feel by fingers. Is this normal or I should worry about varicocele? Does the spermatic cord should feel exactly the same when one stand up and lie down?
I am asking this because my scrotum feel pain a few weeks ago. I went to see a doctor, and did general ultrasound, but my doctor told me nothing is wrong. However, I think general ultrasound can only rule out cancer or epididymitis, it can not diagnose varicocele, right?
Should I go to see a doctor again?
Brief Answer:
Thats not varicocele. Kindly read ahead
Detailed Answer:
Hello,
Thanks for posting in HCM.
Dull pain in scrotum can also occur after sexual activity or intense cough or other physical activity.
Ultrasound can surely pickup varicocele and also they must have done doppler to rule out varicocele.
Varicocele is generally described as ' bag of worms' appearance. Thats how it feels when scrotum is palpated in patients who actually have varicocele.
If your ultrasound has come as normal then I don't see any need to be worried of it.
On the other hand 3 to 4 mm thickness of spermatic cord is normal and not thickened. It could be subjective that you feel its getting thicker after you lie down.
You can get it confirmed from a doctor once for your mental satisfaction.
But I do not see it as any problem to be worried about.
All in all I feel its definitely not varicocele and if you are worried about the thickening after lying down, get it examined from your family doctor or general surgeon.
I hope I have answered your question well.
if you have any questions kindly ask me back.
Thank you
Thats not varicocele. Kindly read ahead
Detailed Answer:
Hello,
Thanks for posting in HCM.
Dull pain in scrotum can also occur after sexual activity or intense cough or other physical activity.
Ultrasound can surely pickup varicocele and also they must have done doppler to rule out varicocele.
Varicocele is generally described as ' bag of worms' appearance. Thats how it feels when scrotum is palpated in patients who actually have varicocele.
If your ultrasound has come as normal then I don't see any need to be worried of it.
On the other hand 3 to 4 mm thickness of spermatic cord is normal and not thickened. It could be subjective that you feel its getting thicker after you lie down.
You can get it confirmed from a doctor once for your mental satisfaction.
But I do not see it as any problem to be worried about.
All in all I feel its definitely not varicocele and if you are worried about the thickening after lying down, get it examined from your family doctor or general surgeon.
I hope I have answered your question well.
if you have any questions kindly ask me back.
Thank you
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thanks for your kind reply. I have some follow up questions:
1, I feel thickening of spermatic cord after standing up, not lying down. Except for the thickness, the shape seemed different. When I stand up, it is in cylinder shape roughly, but after I lie down, it is flat. The differences are defined and I do not think it is subjective. Is this normal?
2, I was lying down when I did the ultrasound, breathing as normal. Is this possible to diagnose varicocele? To my knowledge, the varicocele is more apparent when standing up or holding breath. I did it in Canada, not sure weather they did doppler as in other countries. ...
Thanks again
1, I feel thickening of spermatic cord after standing up, not lying down. Except for the thickness, the shape seemed different. When I stand up, it is in cylinder shape roughly, but after I lie down, it is flat. The differences are defined and I do not think it is subjective. Is this normal?
2, I was lying down when I did the ultrasound, breathing as normal. Is this possible to diagnose varicocele? To my knowledge, the varicocele is more apparent when standing up or holding breath. I did it in Canada, not sure weather they did doppler as in other countries. ...
Thanks again
Brief Answer:
Kindly read ahead
Detailed Answer:
Hello and thanks for following up with me.
Yes I also replied regarding increased in thickness on standing only.
You are right that its possible that the swelling might have reduced during scanning as you need to lie down for the same.
All in all from what you have mentioned I feel then it could be varicocele as you suspect and it might be in earlier phase.
Other possibility can be vasitis which also can cause fluid accumulation in vas due to inflammation and can result in similar complaints as of yours. But there will be also fever alongwith which you haven't mentioned so I assume thats not the condition.
I also feel it could be varicocele and you should get a scan in standing position after the swelling is maximum. Usually in earlier stages, its more of a clinical diagnosis than scanning. Hence I would advice you to consult an urologist where clinical exam will be more helpful.
I hope this might help. If you have any questions feel free to ask.
Thank you
Kindly read ahead
Detailed Answer:
Hello and thanks for following up with me.
Yes I also replied regarding increased in thickness on standing only.
You are right that its possible that the swelling might have reduced during scanning as you need to lie down for the same.
All in all from what you have mentioned I feel then it could be varicocele as you suspect and it might be in earlier phase.
Other possibility can be vasitis which also can cause fluid accumulation in vas due to inflammation and can result in similar complaints as of yours. But there will be also fever alongwith which you haven't mentioned so I assume thats not the condition.
I also feel it could be varicocele and you should get a scan in standing position after the swelling is maximum. Usually in earlier stages, its more of a clinical diagnosis than scanning. Hence I would advice you to consult an urologist where clinical exam will be more helpful.
I hope this might help. If you have any questions feel free to ask.
Thank you
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thanks for your help, doctor. I will go to see a doctor for clinical exam this week.
I also would like to ask, if it is varicocele, what should I do? Is there any possible cure except fore surgery?
How serious it could be? Will it affect fertility? to what extent?
I also noticed that my left testicle hangs about 1 cm lower than the right one, is it because of varicocele (I know the left one always hangs lower than the right one, but is it normal to be so low)?
thanks again...
I also would like to ask, if it is varicocele, what should I do? Is there any possible cure except fore surgery?
How serious it could be? Will it affect fertility? to what extent?
I also noticed that my left testicle hangs about 1 cm lower than the right one, is it because of varicocele (I know the left one always hangs lower than the right one, but is it normal to be so low)?
thanks again...
Brief Answer:
Surgery is the treatment.
Detailed Answer:
Hello.
Yes surgery will be required as the pampiniform plexus which gets engorged causing the varicocele.
As the temperature increases around testis, infertility is seen in patients with higher stages of varicocele. Usually that is the presenting complaints in patients with varicocele that they have oligospermia and they are found to have varicocele.
Left testis is usually lower than right by 1 cm. So that is not the concern here much.
Good that you are consulting a doctor soon. I hope you find a solution for it soon.
So all in all surgery is the option for varicocele. Left testis is usually lower than right and its normal.
Infertility and scrotal pain are the complications of varicocele jn near future.
I hope that answers your questions.
Thank you
Surgery is the treatment.
Detailed Answer:
Hello.
Yes surgery will be required as the pampiniform plexus which gets engorged causing the varicocele.
As the temperature increases around testis, infertility is seen in patients with higher stages of varicocele. Usually that is the presenting complaints in patients with varicocele that they have oligospermia and they are found to have varicocele.
Left testis is usually lower than right by 1 cm. So that is not the concern here much.
Good that you are consulting a doctor soon. I hope you find a solution for it soon.
So all in all surgery is the option for varicocele. Left testis is usually lower than right and its normal.
Infertility and scrotal pain are the complications of varicocele jn near future.
I hope that answers your questions.
Thank you
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for your answers , doctor. I am really grateful for your help.
One more question is what should be the normal spermatic cord feel like when touch by fingers? Should it be exactly the same when standing up and lying down?
Is surgery suggested for all stages of varicocele, or it is depended on each case?
The third question is what is the reason that cause varicocele? Is frequent masturbation the possible reason? should I stop all sexual behavior before recovery?
Thanks again for your patience, I have really a lot of question. Thanks very much for your answers and helps.
One more question is what should be the normal spermatic cord feel like when touch by fingers? Should it be exactly the same when standing up and lying down?
Is surgery suggested for all stages of varicocele, or it is depended on each case?
The third question is what is the reason that cause varicocele? Is frequent masturbation the possible reason? should I stop all sexual behavior before recovery?
Thanks again for your patience, I have really a lot of question. Thanks very much for your answers and helps.
Brief Answer:
Surgery will be required.
Detailed Answer:
Hello again. Its totally OK to have questions. That is the purpose of this website.
So coming to your questions-
1. Spermatic cord will feel like cord like structure which is same to feel on lying down as well as standing position. Usually it will not swell on standing up.
2. Yes, surgery will be required for all stages of varicocele. Its basically dilated veins in scrotum. There is no other way to reduce the vein dilatation other than surgery. So yes, surgery is the only option we have.
3. No sex and masturbation do not cause varicocele or even worsen it. The exact reason which causes varicocele is not clear but same as varicose veins which are seen in legs it may be due to human erect posture and antigravity flow of blood might be a reason.
I hope these answers help to clear your doubts.
Any more questions are welcome.
Thank you
Surgery will be required.
Detailed Answer:
Hello again. Its totally OK to have questions. That is the purpose of this website.
So coming to your questions-
1. Spermatic cord will feel like cord like structure which is same to feel on lying down as well as standing position. Usually it will not swell on standing up.
2. Yes, surgery will be required for all stages of varicocele. Its basically dilated veins in scrotum. There is no other way to reduce the vein dilatation other than surgery. So yes, surgery is the only option we have.
3. No sex and masturbation do not cause varicocele or even worsen it. The exact reason which causes varicocele is not clear but same as varicose veins which are seen in legs it may be due to human erect posture and antigravity flow of blood might be a reason.
I hope these answers help to clear your doubts.
Any more questions are welcome.
Thank you
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thanks very much for your answers, doctor.
Today I went to see a GP, and he told me that my condition is not varicocele. When I told him I have a little swelling of spermatic cord when standing compared to lying down, he told me it is the normal condition... Does it sound too strange? Not sure I should believe him or not.
It seemed that they really relay on the ultrasound result, and think it could rule out varicocele, but in my condition, I am not sure whether the ultrasound was done correctly or not...
My doctor think it is not necessary to see a urologist at present, and told me the pain is probably because of inflammation of prostate, and told me excesses could be helpful.
I am totally feel confused, not sure what is the correct thing to do next... Should I see another doctor?
Today I went to see a GP, and he told me that my condition is not varicocele. When I told him I have a little swelling of spermatic cord when standing compared to lying down, he told me it is the normal condition... Does it sound too strange? Not sure I should believe him or not.
It seemed that they really relay on the ultrasound result, and think it could rule out varicocele, but in my condition, I am not sure whether the ultrasound was done correctly or not...
My doctor think it is not necessary to see a urologist at present, and told me the pain is probably because of inflammation of prostate, and told me excesses could be helpful.
I am totally feel confused, not sure what is the correct thing to do next... Should I see another doctor?
Brief Answer:
Consult a urologist for the best opinion
Detailed Answer:
Hello again.
I think as you are getting mixed opinions and ultrasound done previously has not helped much, I feel you should consult an urologist directly for best opinion.
As I cannot do a physical examination and totally relying on the description you gave I feel still it could be varicocele.
This condition is best diagnosed by clinical examination in early phases and ultrasound study as it progresses.
Yours sounds like early phase so ultrasound may or may not pick it up. Best way will be proper physical examination.
An urologist deals specifically with this speciality hence I would suggest you to consult directly an urologist first and if asked then go for ultrasound exam.
Prostate inflammation would not cause any pain in scrotumas you mentioned previously and it will be more of urinary tract inflammation kind of picture. So I personally do not feel prostate might be involved. Hence suggesting to consult urologist directly.
Hope this helps.
Thank you
Consult a urologist for the best opinion
Detailed Answer:
Hello again.
I think as you are getting mixed opinions and ultrasound done previously has not helped much, I feel you should consult an urologist directly for best opinion.
As I cannot do a physical examination and totally relying on the description you gave I feel still it could be varicocele.
This condition is best diagnosed by clinical examination in early phases and ultrasound study as it progresses.
Yours sounds like early phase so ultrasound may or may not pick it up. Best way will be proper physical examination.
An urologist deals specifically with this speciality hence I would suggest you to consult directly an urologist first and if asked then go for ultrasound exam.
Prostate inflammation would not cause any pain in scrotumas you mentioned previously and it will be more of urinary tract inflammation kind of picture. So I personally do not feel prostate might be involved. Hence suggesting to consult urologist directly.
Hope this helps.
Thank you
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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