Urology/testes

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Question
Hi there I had a embolization done on my varracocele veins in left testicle also had a seaman analysis done which came back as 20 mill but only 20 percent mobility does that mean I won't father a child? Also I have one again as I didn't have it after varicose treatment, so may be improvement. Only thing is my left testicle is so small and hurts too I also ejaculate tiny amounts could this be a varicose veins again? It hurts on the top where my epydidimous is?

Answer
Ben:

A semen analysis needs to be evaluated carefully.  For example, you indicated a 20 million count but did not indicate if this is the total count or 20 million per cc.  Mobility is not usually rated as a single percentage.  Does the mobility mean 20 percent have 100% mobility or that all of the sperm are at 20% of normal?  Without all the details and numbers, a semen analysis cannot be interpreted and we virtually never make any conclusions unless we have at least 2 separate semen analyses because of significant variations between samples.  You'll need to ask your physician about the interpretation of the semen analysis, but most likely you are not totally infertile.

If you have a new varicocele that you didn't have before, it usually means that remaining veins have become dilated and a repeat surgery or embolization may be necessary.

A small, painful testicle may require treatment, surgery and possibly even removal.  

Varicoceles do not usually cause any change in ejaculate volume or atrophy of the testicle.  Neither does it cause pain in the head of the epididymis which is usually due to either cysts, scarring or infection.  An ultrasound of the testicle may help clarify this.  Talk to your urologist.

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Stephen W. Leslie, MD

Expertise

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

Experience

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.

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

Publications
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.

Education/Credentials
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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