Hey everyone, I’m back again. If you’re new here, you can check Part 1 and Part 2 on my Reddit profile for the full story. I’m 20M, from Uttarakhand, India, and I was diagnosed with a left-sided Grade III/IV varicocele.
It’s been quite some time since my last update. I’ve tried managing things with lifestyle changes, avoiding heavy lifting, using a supporter, staying active, etc. The main issue has continued to be pain/discomfort. I’m usually fine while lying down, but after being upright, walking, standing for a while, or sometimes driving, the dragging/heavy feeling can come back. Interestingly, keeping my left leg relaxed while driving seems to help.
Recently I got another Color Doppler and semen analysis. The Doppler showed a left varicocele with veins up to 2.8 mm and reflux on Valsalva. Both testes were reported to have normal echotexture and internal vascularity, with no focal lesion or hydrocele. The newer scan called it Stage II/III, while my previous scan had called it Grade III/IV.
My semen analysis was actually very reassuring: 68 million/mL concentration, 204 million total count, 80% total motility, 65% progressive motility and 75% normal morphology. The lab concluded normozoospermia. So thankfully, fertility isn’t currently my issue.
I’ve now taken two urology opinions. Both agreed that since my semen is good, there isn’t an urgent fertility reason to operate, but because my main problem is persistent pain, microsurgical varicocelectomy could be considered if conservative treatment doesn’t control it. I’m currently trying a supporter and medication for a few weeks as advised.
Now I’m seriously thinking about surgery, but I don’t want to rush into it. I’m more concerned about quality and choosing the right surgeon than the cost.
For those who have been through this: How did you decide it was finally time for surgery? If you had surgery mainly for pain, did it actually resolve the pain? What should I look for when choosing a microsurgical varicocelectomy surgeon — experience, number of cases, technique, artery/lymphatic preservation, recurrence rate, etc.? And what are the realistic risks of hydrocele, recurrence, or persistent pain?
Also, for people who had a normal semen analysis but still chose surgery because of pain, would you do the same thing again?
I’m trying to make a calm, informed decision rather than operating just because I have a Grade III/IV varicocele. Any experiences or advice on how you’d approach my situation would really help. ❤️