This person had a palpable (I could feel it) varicocele on exam that was confirmed by in-office doppler scrotal ultrasound.
Varicoceles are essentially varicose veins of the scrotum. Varicoceles contribute to infertility by making the testicle too hot, among other things. Varicoceles can cause abnormal sperm counts, motility, and morphology. In addition, some me have vague testicular or scrotal discomfort from the varicoceles. Most varicoceles occur on the left side only. Isolated right sided varicoceles are very rare and may be caused by the presence of a large kidney tumor. If a man has a varicocle only on the right side, the urologist needs to obtain kidney imaging. Bilateral varicoceles are common and when present do not indicate that a kidney mass may be present.
Varicoceles can be fixed easily and with little risk or discomfort. The procedure to fix the varicocele is outpatient and can even be done under local anesthetic. When the urologist uses a high power operative microscope during the varicocelectomy, success rates improve and very few men will experience any side-effects after the surgery.
When abnormalities exist on the semen analysis, 65% or so of men will experience improvement in the abnormality. 50% of couples will get pregnant naturally within a year after the man's varicocele is fixed. Success rates for IUI (artificial insemination) improve dramtically in couples after the man has had his varicocele corrected.
Varicoceles are abnormal findings in men, though they are quite common in the general population. Since they are abnormal, most insurance plans, including Medicare, cover the varicocelectomy surgery.
Varicoceles are diagnoses intially on a physical examination. I confirm the physical exam finding with a scrotal doppler ultrasound that I perform right in my office. Other urologists with similar training and expertise can do this as well.
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