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Urology/Scrotal pain


QUESTION: Hello Sir,

Brief history, 30 y/o male, 5'7 200 lbs. Doppler ultrasound of the Testicles showed varicole on left side, very small hydrocele. I felt a small bump behind my Right testicle, right where the epidydimis meets the testicle in the middle part of the testicle, but they didnt not mention anything about that in my report. Not sure if its relevant as I had it for 2 years and no change of size is noted. I had a left Varicocelectomy back in 2010 where they tied off 3 veins.  Diagnosed with Hydrogonatric(?) Hypogonadism a year later. Put on testosterone but developed gynecomastia. HCG blood test was at 2.4

My issue today is that I have been having this dull ache in my scrotum area. I do not notice any lumps on testicle. I notice a little bit of fluid build up on my left side again, in which I used a flash light to check for transillumination, in which it lit up red, meaning more than likley a hydrocele came back, plus it feels soft and fluidy. I also notice when when I felt my spermatic cord, that I noticed the vein pop out on the left side. I feel that the Varicocele came back. What are the reoccurance rate fo these? I just notice that my scrotum is more loser and that my testicles sag a little more than usual(When penis is flacid, you can see the testicles well).

I do not have any burning upon urination, no discharge. I checked for a Hernia, and I cant feel any types of swelling in the Inguinal area.

With that being said, what would be the next course of action? (I do work in the medical field as a Hospital Corpsman in the US Navy)


I can't give you an official number as far as recurrence of varicoceles, but I can tell you it is not uncommon.  Even when you fix a varicocele, the remaining small veins can dilate later and cause another varicocele so technically it doesn't come back; you just develop a new one.

I cannot determine the cause of your scrotal discomfort.  You've had surgery so thre is always possible scarring.  There is also the issue of a possible lump. You'll need to check with a urologist.  Another ultrasound might be recommended as well as a rectal exam to look for possible prostatitis.

---------- FOLLOW-UP ----------


Received another ultrasound last night at urgent care. The stated i have bilateral hydroceles, enlarged epidiymis on the left, and a epi cyst on the right. my urine yest came back fine with a few white and red cells but the doc said yhat it was normal. No tumors or masses noted. He did not conduct a rectal exam. No hernia was found as well. What else can cause a hydrocele? They mentioned a possible varicocele on the left, but they used a ultrasound sonagram, not doppler. I have a consult with a urologist in 3 day. Was put on Cipro 500 mgfor 10 days yo kill any bacterial im scared that a kidney tumor could have caused this


A kidney tumor would be extremely unlikely if the only indication is a repeat varicocele on the left.  If it were on the right, then a renal tumor would be a reasonable but remote possibility.

Hydroceles are normal to some degree.  THis is just the fluid around the testicle inside the sac.  If this fluid is increased, we call it a hydrocele.  Typically, small hydroceles are not clinically significant and we usually ignore them.  The antibiotic treatment is reasonable given the urinalysis report and your symptoms.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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