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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Bilateral mild varicocele and Mild right hydrocele with semen count zero are curable?

I am 32 years old , married 1 year before.
2 semen analysis did, both with zero sperm count as result
FHS =10.3 , reference range 1 ~ 14
Prolactin = 7.2 , reference range 1.2 ~ 19.2
TSH = 1.9, reference range 0.3 ~ 5.5

Scrotal usg & Doppler:-
Right testis measures 3.2*2.1*2.3 cm
Left testis measures 3.1*2*2.4
both test shows e/o microcalcification, vascularity is normal
No e/o focal lesion
Both epidermal heads are normal in size and echotexture
Mild right hydrocele

Pampiniform plexus of veins :-
Right at rest = 2.1mm , Valsalva = 3mm
Left at rest = 2.3mm, valsalva = 3mm

Impression:-
Both testes are slightly reduced in size with microcalcifications
- Bilateral mild varicocele
- Mild right hydrocele


Query: is this condition curable with treatment or surgery?
Do I need donor sperm?


Thu, 28 May 2015
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General & Family Physician 's  Response
Hello there,
Since both your testis are affected with varicocoele and hydrocoele respectively they have to be treated first . They require surgery. Depending on your doctor he may do them simultaneously or one by one. After the surgery we give some time for your testis to recover and again check if they are able to make sperm.
If not we take a biopsy of your testis(Which does not damage them in anyway) and check if they are capable of making sperm.
A short course of hormonal therapy may follow this.
If still your sperm count does not restore then we will have to consider donor sperm.
This is the protocol that doctors/surgeons follow. We go step by step and explore all options with you and ensure that you make the most of what you have.

Hope this helps,
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