Brief Answer:
Surgical management and c/s guided antibiotic

Detailed Answer:
Hi
Thanks for posting the concern in the HCM.

After going through your history, my understanding is you have two issues-
1. Varicocele
2. Long standing uro-genital / only genital infection.

Both of these are well known impeding factors for spermatogenesis and viability of the sperms.
My experience is correction of varicocoele improves spermatogenesis. Researchers also opine that the correction can increase sperm retrieval rate. Now, let's find out what varicocele is.
It is abnormal ballooning of the venous network that drains blood from your testis. This is associated with abnormality in testicular blood flow. Now, their will be increased temperature alongwith accumulation of gonadotoxic metabolites locally. This alongwith adrenal hormone reflux, antisperm antibody formation etc. mechanisms kill your sperms even before they are fully mature.
Now this an anatomical defect, like presence of a lump on your forehead or presence of an extra finger. Have you ever heard that the latter conditions are cured by medications and not surgery? I haven't. So, The answer of the question whether there is a non-surgical way is NO.

Look, you don't have a chance to have a child from your own sperm now. So, you don't have to risk even 1% of your fertility. Rather, there is chance that after surgery the semen quality improves and you become able to be a proud father.

But, I won't persuade you for surgery. That is the choice which you have to make. Every surgery has its own risks, so has varicocelectomy. It is not a very complex surgery, but should be done by experienced hands.

Now, regarding the infection, I haven't read anywhere that gonorrhoea caused Staph infection. There may be the former, caused by gonococci and there may also be the latter, caused by the staphylococci. Both can be resistant to certain antibiotics. In co-infection they are often difficult to treat. So, what should we do?

The plan, get a confirmatory pin point diagnosis first, i.e infection of such and such site caused by such organism. Several tests are needed, including CBC, CRP, urea, creatinine, electrolytes, Urine RE, C/S, urethral swab C/S and ultrasound examination of lower abdomen. After getting the exact diagnosis and antibiotic sensitivity report, proper antimicrobial medication at proper dosage, interval and duration would be able to cure you.

For that you need to consult a Venereal disease specialist. Also take your partner with you because she may need evaluation.

If you are satisfied with the above answer, please close the thread and rate it.
Regards,
Dr. Kaushik Sarkar

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