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Urology/Varicocele, epididymitis, and erection quality


Dear Dr. Stephen Leslie, over the years, I have had a reoccurring issue with my testicles.

When I was twenty years old, my family care doctor thought I had an inflamed cyst or infection along my epididymis. The doctor questioned if I was sexually active and I wasn't. He said sometimes this can occur when the epididymis is pinched riding a bike or in another sporting activity. I took antibiotics to address the inflammation and over time it healed.

When I was in my mid-twenties, this came up again. I wasn't sexually active, so I questioned if this happened due to masturbation. I would get frustrated that doctors would continue to provide me with antibiotics, the symptoms would gradually decline and eventually the epididymis would feel like normal after a couple months.

I'm now 32 and sexually active. My girlfriend says I'm not "conditioned" like most guys my age. The inflammation has returned and my urologist just had me take a sonogram to test for varicocele. He says neither epididymitis or a varicocele should effect erection quality, although I have read differing opinions online. I have read both can lower testosterone and affect erection quality. It would make sense an erection would be affected considering the blow flow would behave differently.

I just came off of four weeks of ciprofloxacin to address an infection, although my condition remains the same. I'm frustrated and discouraged my erections are no longer as strong as they once were and my urologist isn't recognizing this as a symptom or issue. I inquired to be tested for low testosterone, although my urologist doesn't believe this would be my issue.

I recognize you are not able to diagnose me, although as opinions differ online I would like to know your thoughts and if I were your friend what would you advise I do to get to the bottom of this?



Your urologist is correct; neither epididymitis nor a varicocele would reasonably be expected to affect erection ability or blood flow.  And neither will affect testosterone.  Remember that there are two testicles and even if one is "abnormal" in some way, the other will continue to function normally.  Since you are concerned, a simple blood test should be enough to know for sure one way or the other.

If you are having inadequate erections, then you ask your urologist for help such as sildenafil (Viagra) or similar; or you can ask your primary care physician.


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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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