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Urology/lymphangiosclerosis?

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QUESTION: Dear Dr:

I have had what could be lymphangiosclerosis or a sclerotic vein for about six years. I have tried up to three weeks abstinence at times with no major difference. I have seen a urologist who said not to worry about it, but a couple months ago it flared up and is a bit painful for a couple days after sex or masturbation.  So, I guess my question is can a more clear diagnosis be given with ultrasound to discover if it is a vein or lymph channel and after dealing with it for this many years, is surgery something to consider? thank you! max

ANSWER: Max:

We rarely, if ever, do ultrasounds on obvious penile venous anomalies but you can ask your physician to do this or order one for you.  

Surgery is possible, but rarely necessary.  Most of the time, the problem resolves by itself.  In your case, there may be an infection or some other problem causing it to intermittently flare up.  Check with your local urologist.

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

QUESTION: Thank you very much! If I may ask one more follow up, at what point does one assume that it will no longer resolve itself? Since I have tried a handful of times to lay off all activity (and this helps reduce pain, but hard vein/cord remains) for up to a month with no long term resolution thus far?

Are there any pointed questions that I should be asking my urologist when I visit him? Is this something that could be treated like varicose veins are treated?(scheduled a follow up today)

Thank you,
max

Answer
Max:

This is not like a varicose vein.  The vein itself is much larger and there are potential complications.  There is also no hard and fast rule about how long to wait.  My personal opinion is to wait 90 days.  Clearly, it should show improvement by that time if it's going to get better at all.

Ask your urologist about what complications are likely if a surgery is necessary.  Good luck.

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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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