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QUESTION: Hi Stephen,

My name is Vinay and I am 25 now.

My problem(Since 19 september 2011) - I got a testicle pain. I was not able to tolerate. Every day I used to get pain on both the sides. Sometimes it's right and sometimes it's left.

Finally I contacted Urologist and found out that I had a Mild bilateral varicocele. After some days I started losing my erection as well.

1st sperm test - Sperm count - 38.4 millions/ml
         Motility - Rapid progression - 20
         Slow progression - 15
         Non progression - 10
         Immotile - 50

         Morphological - Total abnormal forms - 25

2nd test (After 6months)  Sperm count -64 millions/ml
         Motility -Rapid progression - 15
         Slow progression - 20
         Non progression - 25
         Immotile - 40
         Morphological - Total abnormal forms - 20

3rd test (After 6months)   Sperm count -58 millions/ml
         Motility -Rapid progression - 30
         Slow progression - 20
         Non progression - 15
         Immotile - 35
         Morphological - Total abnormal forms - 11

Doctor said the report is good. There is no need of surgery. However, sometimes it's very painful for me. I just cant tolerate the pain. And now, I asked the doctor about erections problem. He suggested me  for Doppler test.

The test says - Bilateral cavernosal arteries revealed normal systolic velocities. Diastolic flow reversal was not seen - suggestive of Venous incompetence. There was no erection during the study

Impression - Moderate venous incompetence noted.

I was getting good erection just before getting testicles pain. I used to get Hard rock erections in just seconds. Now it's very soft and it lasts for just seconds. I am disappointed in my life. I am not even getting morning erections. I feel my penis is shrinking. When I urinate, there is no force at all. Please advise whats happening. Do you suggest me for a varicocele surgery? Are there any chances to get erections after the surgery?

Please please please say something!!!!!!!

ANSWER: Vinay:

There is not enough information presented to make a diagnosis.  Venous incompetence is likely given the doppler test.  Treatment for ED would usually involve viagra type meds, penile injections, MUSE urethral suppositories or an external vacuum device.

Pain from a physical problem in the testicle would not go from one to the other.  Each testicle is distinct and separate.  However, prostatitis can sometimes affect testicular pain as you've described.

The penis is not likely to actually shrink unless there is a major trauma, radiation or major pelvic surgery; none of which apply to you.

A weak urinary stream could be accounted for by prostatitis so it may be worth asking your physicians about it.

I would not recommend varicocele surgery at this point.  Once the other problems are solved, I would suggest repeating the semen analysis and see what it shows.  Any varicocel surgery is not likely to help your erection problem although it might help the sperm quality a little.

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

QUESTION: Thank you very much for your reply. It's very simple and I liked it.

However. How can I tolerate the pain? What information you need? I have all the test done. And can you tell me whatz the average sperm count at my age? Is my sperm count good? I can father a child right?


Your sperm count is good but motility is a little low.  Certainly the semen analysis is good enough for normal reproduction.

You'll need to talk to your local physicians about pain control.  Sometimes sitting in a hot tub will help with the pain.

The information on average sperm count is readily available on the Internet, but in general, anything over 20 million per cc is considered acceptable


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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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