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QUESTION: can a large varicocele be left alone even if its quite big as long as you dont mind it being there?

and secondly i have read that testicular temperature is quite important when it comes to the general functioning of the testicle. i have even seen some products which are designed to cool your testicles by applying cold to it.

My question is can the cold temperature of tap water damage your testicles? i used tap water to try to cool them down but it felt a bit too cold and painful. It would not have been painful to my hands, but it did feel too cold on my testicles.


Large varicoceles are sometimes associated with infertility and testicular shrinkage.  If the varicocele doesn't bother you, there is no issue with fertility and the testis and testicle are not damaged, then there is no reason to do any surgery.

Cold temperatures to a limited degree can help with sperm production, but if the temperature is too cold it can do damage.  Various devices to try and regulate the temperature have been tried but none have been successful as the temperature needs to be controlled for lengthy periods of time.  Using tap water to cool the testicles is not going to make any significant difference in sperm production or testicular function.

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QUESTION: What devices are you referring to?  I would like to see evidence with regards to sperm production and functioning and temperature. Do you know any research papers written on this topic? Do you believe that testosterone and sperm are affected by higher temperatures? I have seen some papers suggesting that even a difference of 1 degree celsius can affect it.

What can help with testosterone if not cold temperature therapy? we do start to produce less testosterone as we age so what can stop this?


There was actually a scrotal refrigerator but it was too impractical. You can research temperature and sperm production at

Lower temperatures can help sperm production but not testosterone which is separate. Testosterone will slowly decrease as we age, there is no way to prevent this.


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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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