Everything Men

I have a varicocele and do not want to undergo surgery. My doctor says I should undergo embolization. Can you explain?

2011-05-15T12:12:00.001-07:00

For those who are afraid of the knife or the surgeon, a technique called embolization can be performed. This is done in a radiology suite by a radiologist and involves passing a small tube from the groin to the varicocele. The entire procedure is visualized under x-rays and then the veins are plugged or closed off. The procedure is tedious and time consuming and is generally recommended when there is recurrence of varicoceles. Best advice-if your varicocele is not bothering you, leave it alone. Some doctors like to perform unnecessary surgery and make money.

I am a 33 year old man and am interested in augmenting my lips. What dermal filler should I choose?

2011-03-02T17:55:00.001-08:00

Today, lip augmentation has become a refined technique with excellent results most of the time. In most cases, lip augmentation is done with dermal fillers. There are many types of dermal fillers on the market and selection of which one can be difficult. In most cases, it is the physician who selects the dermal filler. The dermal fillers already come as a solution or in a pre-filled syringe. Some dermal fillers are like thin plastic and sometimes even fat is used to plump-up lips. For the plastic type lip filler, one needs to make a tiny incision to insert them. The best advice is go for a temporary filler the first time and see if you like the feeling of luscious lips. If you do, next time go for the permanent filler.

I am a 33 year old male and have flat thin lips. Do men ever undergo lip augmentation?

2011-03-02T17:54:00.001-08:00

Sure. The second most common cosmetic procedure after breast augmentation is making lips plump and sexy. While the majority of individuals who seek lip augmentation are women, men are also fast catching up. Having a nice plump set of lips is always sexy and erotic.

Final Advice on Varicoceles

2010-10-26T17:37:00.001-07:00

There is a lot of conflicting advice on Varicoceles and how they may affect sterility. Surgery for Varicocele is strictly elective and no one should be rushed into.

For best advice, talk to a reputable urologist. Ask questions and if in doubt seek a second opinion. Whilst there are some who say Varicocele affect sterility, there are is also data that show that
Varicoceles have no bearing on sterility.

The last thing you want is to undergo an unnecessary surgical procedure that has a real risk of damaging your sexual organ. If you have no symptoms- leave the Varicocele alone. If you have symptoms, wear scrotal support panties. Both are reasonable treatments. One should only undergo Varicocele surgery if there is documentation of abnormal sperm and that one is unable to father a child.

What are results like after surgery?

2010-10-26T17:36:00.000-07:00

Surgery is hyped up to be the best treatment for Varicocele. It is estimated that in about 40-60 percent of men, sterility can be restored. However, real data are lacking and many men have undergone this surgery, needlessly. There are many men who have had their Varicocele fixed and still cannot conceive

Do Varicocele recur after treatment?

Sure, recurrence of Varicocele is quite common. These recurrences may occur a few months or may even occur a few years later. In most cases, recurrence is due to poor technical surgery and leaving some small veins intact at first surgery. To obliterate a Varicocele; one has to ligate all small veins.

Who fixes a varicocele?

Urologists are physicians who specialize in the field of male genitals and most are decent surgeons.

What is embolization?

This is perhaps the best treatment for Varicocele. It is an easy procedure done by an interventional radiologist. One side of your groin is numbed with a local anesthetic and a small tube is passed into the vein. Using x rays, the Varicocele is identified in the scrotum and through the tube, glue like substances are injected into the Varicocele. Confirmation that the Varicocele is blocked is done with another x ray study and you are done. There is no general anesthesia, no incisions and the pain is minimal. You go home in the evening. Data on embolization are decent and recurrences are rare. However, the procedure is very expensive and there is still a question of whether the Varicocele should be treated in the first place.

Which individual with a Varicocele should be treated?

2010-10-26T17:33:00.001-07:00

If one has symptoms, then a scrotal support should be worn. Varicocele is not life threatening nor is it an emergency; one should never be rushed into surgery. Varicocele surgery is purely an elective procedure and should be done after giving it a lot of thought. If the Varicocele is small and one has no symptoms or problems with fertility, just leave it alone.

Repair of a Varicocele is indicated when the couple has documented infertility and abnormal semen has been demonstrated.

Repair should be done when there is a significant discrepancy in size between the two testes.
Just having a Varicocele does not mean that you need surgery. Never go to a surgeon who recommends surgery without documenting that you have problems with semen.

What are surgical options for treatment of a varicocele?

There are three options to treat a varicocele and include:

- Open surgical varicocele repair

- angiographic embolization- highly recommended

- laparoscopic method

What other problems are associated with a varicocele?

2010-10-26T17:32:00.002-07:00

The occasional individual with a Varicocele may have small testes. However, this is not a universal finding and it is meaningless. There is not a single study, which has shown a relationship between Varicoceles and small testes- it is believed to be a coincidental finding.

Why do some individuals develop Varicoceles suddenly?

Sometimes a sudden swelling may appear in the scrotum and this is most common on the left side. Usually sudden appearance of a Varicocele happens in elderly individuals and a cancer or a mass somewhere in the abdomen may be a reason. A CT scan will immediately determine if this is the case

Are Varicocele life threatening?

No, varicoceles have no affect on health; they do not rupture nor cause severe pain.

Who should not undergo Varicocele treatment?

Despite what some physicians suggest, the majority of young males with Varicocele should be left alone if there are no symptoms.

Individuals with mild symptoms should wear a scrotal support (special panties should be worn) and this will ease the discomfort.

Married men have a Varicocele and have no problems with fertility should stay away from surgeons.

What are symptoms of Varicocele?

2010-10-26T17:32:00.000-07:00

In the majority of individuals, Varicoceles are painless. Most men do not even know they have a Varicocele. Sometimes the Varicocele gets to be very large and some men will feel a dragging or a pulling sensation in the groin. Pain is a rare finding with Varicoceles. Some individuals do feel an odd ache that is relieved when lying down. In almost all cases, Varicoceles become more conspicuous at the end of the day or after standing for long periods. Lying down empties the Varicoceles and hence decreases the symptoms.

What medical problems are associated with Varicoceles?

There is a belief among physicians that Varicoceles may be the cause of infertility in some men. This association is not very strong. There are many men who have Varicoceles and have no problems fathering children. There are some men who have tiny Varicoceles and have abnormal sperm. There is a lot of debate on Varicoceles and whether they really cause abnormal sperm. There are a few studies showing that having large Varicoceles can cause infertility, but there are just as many studies that show nothing.

Some surgeons always claim that there is a relation between Varicoceles and abnormal sperm- partly because they want to operate on you and make money. To keep facts straight- even after correcting a Varicocele does not always guarantee return of fertility. So all individuals should beware of surgeons who want to book you right away for surgery- these greedy surgeons only want to make money. For all consumers, remember one fact, there are thousands of men with Varicoceles and have no problems fathering children.

How can Varicocele cause infertility?

Whether Varicoceles actually cause infertility is still in question. Some claim that engorged blood in the veins can lead to high temperatures that damage sperm. Sperms are very fragile and cannot tolerate high temperatures. All this is just speculation. During sexual intercourse, the banging and thrusting of the penis in the vagina leads to even higher temperatures, but sperms do just fine. So all this temperature theory is a load of bull.

At what age are Varicoceles observed?

2010-10-26T17:31:00.000-07:00

Varicoceles are common and some studies indicate that nearly 10%-15% of men will develop Varicoceles. Varicoceles are generally seen in males in-between the ages of 16-30.

Are Varicoceles painful?

In most cases Varicocele are not painful. Many individuals may not even be able to see Varicocele but may be able to feel them. One may feel a sensation like a “bag of worms” when the scrotum is examined with fingers. In some cases, Varicocele do become large and may become prominent. The majority of Varicoceles are no longer then 1-2 cm in length

How is diagnosis of Varicocele made?

Diagnosis of a varicocele is not difficult. An astute physician can usually make the diagnosis of a Varicocele based on a physical exam of the scrotum. It is best for the individual to be standing when examination is done. Sometimes the “bag of worms” will disappear when you lie down.
When the Varicocele is small, one may be asked to bear down by taking a deep breathe and pushing out the stomach, this forces the Varicocele to pop out. Individuals who have long standing Varicoceles may not see any change in size when lying down.

What tests are done to make a diagnosis of a varicocele?

In most cases, an ultrasound is ordered to confirm presence of a Varicocele. Ultrasound is not painful and simply involves placing a small hand held probe on the scrotum. The device can measure location, size, and abnormal blood flow.

What is a varicocele?

2010-10-26T17:30:00.000-07:00

A varicocele is a medical disorder that describes a collection of dilated or enlarged veins in the scrotum. There are many small veins that drain blood away from the scrotum into the blood circulation. Sometimes these veins get blocked and congestion of blood results. Over time, these veins become engorged and are known as Varicoceles. Varicoceles are the same thing as varicose veins on the legs. When Varicoceles become large, one may be able to feel them – this sensation is often described as a “bag of worms”

Which scrotum is most affected with Varicoceles?

Varicoceles can occur in both scrotums. but generally are more common on the left side.

Wonder Topical Spray for premature ejaculation

2010-10-02T16:21:00.000-07:00

Male erectile failure is a common problem not only in North America but worldwide. For decades research has been ongoing to discover a pill or cream that can at least maintain erection and help males who suffer from premature ejaculation. Recent reports from the first US trials on a formulation of a spray anesthetic indicate that drug, Tempe, may have some promise.

The anesthetic is sprayed on the penis and recent studies show that it increases the time to ejaculation by as much as five hundred percent. Researchers claim that this is by far the best drug ever for premature ejaculation.

Premature ejaculation is a common problem in males aged 18-60 and affects as many as one in 3 men. These numbers experts say may even be much higher as many men do not always come forward because of fear of embarrassment.

In men who have erectile dysfunction, premature ejaculation is claimed to be even more common. While many treatments have been devised for this annoying social problem, none has been effective in the long term. Previously available creams took nearly 45-60 minutes to work. More over the individuals had to wear a condom to prevent transmitting the anesthetic to the partner.

Now there is news for individuals suffering from premature ejaculation. Pharmaceutical company Plethora Solutions of London, England and Sciele Pharma Inc. of Atlanta have developed an anesthetic spray, called PSD502 or Tempe, that contains Lidocaine and prilocaine which is released as an aerosol spray. The drug is simply sprayed on the penis prior to sexual intercourse.

The present trial was held in 38 US medical centers and had 256 men across the USA, Canada and Poland. Prior to the study, these patients had an average duration of intercourse of 36 seconds.

Two-thirds of the participants used PSD502 and the rest were given a placebo spray.

Dr. Michael G. Wyllie of Plethora presented his findings at a recent Sexual Medicine Society meeting in San Diego. The results showed that men who received the drug had an increased intercourse time to an average of 156 seconds, compared with an increase of only 48 seconds in the placebo group. These benefits continued for several months during the study. Moreover, both men and women reported superior fulfillment with their sexual experiences. Other than an occasional numbing sensation felt by the female, no other adverse effects were observed. Since the Europeans have also showed similar results there are now plans to undertake more studies and get FDA approval.

Male menopause?

2010-01-15T08:36:00.001-08:00

Males have no equivalent of a female menopause. In women, changes start to occur sometime at the 4th decade of life and there is notable decline in sex hormones which results in a variety of physical and emotional changes. At this stage, women lose their capacity to have babies and they also start to develop bone thinning or osteoporosis. The protective effects of the sex hormones which were present prior to menopause now disappear and by the 6th decade of life women have the same risk of heart problems as men.

Unlike women, men do not have an abrupt decline in sex hormones. However, in men there is a gradual loss of hormones which starts sometime in the ¾ decade of life and continues for the next couple of decades. Men do develop depression, loss of libido, and sexual dysfunction and often these symptoms have been linked to loss of male hormones. The diagnosis of male menopause is also difficult; there is no correlation between between declining levels of testosterone and symptoms. In fact just as many men with low testosterone levels have no symptoms at all.

While there are many male hormones out on the market, their use in males is questionable and also associated with prescribing hassles. However, replenishment of males with testosterone has not always resulted in reversal of these symptoms. Most physicians do not readily prescribe androgens for fear of side effects. Finally, unregulated use of testosterone can worsen prostate cancer. For males who are going through andropause, the best recommendations are to eat a well balance diet, exercise, have an enjoyable sex life and stay healthy.

Men and Nose Jobs: What you must know

2009-06-28T00:45:00.000-07:00

The Plastic Surgeon for your Rhinoplasty

There are just too many plastic surgeons around, and not all are good. So select the best plastic surgeon for your surgery. One may be able to hide a complication near the buttock area, but any problem around the face is difficult to hide and embarrassing- and it becomes a life long feature for the whole world to see. The following are tips to selecting a surgeon:

1. Make sure that your surgeon is board certified in Plastic surgery. The lure of money has led to many surgeons doing procedures for which they are not trained in.

2. Make sure that the surgeon has a current license to practice and he is up-to-date with his plastic surgery skills. Verify the doctor's credentials and training.

3. Check if the surgeon has had any disciplinary actions and malpractice judgments. Many of the state websites have information on disciplinary actions. A few have information on malpractice judgments. A warning sign is if the surgeon has had more than three malpractice judgments over a period of 5-10 years, seek another surgeon.

4. Ask about the number of rhinoplasty the surgeon has done and his/her complication rates. Any surgeon who claims that he/she has had no complications is a damn liar.

5. Ask where the procedure is going to be done, who is going to administer anesthesia. There have been a number of incidences, esp. among cosmetic surgeons who have tried to cut corners and save money on essential nurses and anesthesiologist. Do not get the procedure in a rinky dinky office. Check out the clinic or the hospital first. You are paying for the surgery, so you will get what you pay for.

6. Most cosmetic surgeons have before and after photos of their patients. Ask to look at some of these illustrations

7. Talk to other patients, family and your personal physician. Always if in doubt, seek a second opinion

8. Ask about anesthesia. - Make sure that your anesthesia is being administered by a properly certified registered nurse anesthetist or a physician anesthesiologist.

Men continue to seek cosmetic procedures, and the trend is definitely on the rise. With the continued development of improved and new minimally invasive procedures and wider male acceptance of plastic surgery, there is every indication that more and more men will seek cosmetic enhancement in the coming years.

Rhinoplasty is strictly an elective procedure and one should never be rushed into the procedure. Always seek a second opinion if one is not happy. You do not want to wear a surgical mask like MJ for the rest of your life

Men and nose jobs: part 7

2009-06-28T00:37:00.000-07:00

Cost of Rhinoplasty

After one is realistic and ready for the surgery, one should select a surgeon based on his skills, reputation and his results. Do not select a surgeon based on the cost. The most expensive is not always the best and vice versa.

Rhinoplasty is an expensive undertaking and is considered a cosmetic procedure; most health plans and Medicare do not cover it. Costs range anywhere from $3,000 - $12,000, depending upon the surgeon and the location. In some cases where the nasal septum is deviated, perforated or one has had a traumatic injury or has difficulty breathing through the nose; part of all of the surgery may be covered by medical insurance.

For the rest of the individuals relying on the medical insurance to pay for the surgery, call the insurance company and be certain that you have proper pre-authorization for your procedure. Find out exactly what will be covered and get it in writing. Medicine is a business (just in case you did know that) and every one wants your money. After consulting with the surgeon, get the total costs which includes the surgeon’s fee, cost of anesthesia, cost of medicines, splints, dressing and other hidden costs (doctors are notorious for these-just like car mechanics).

For those who claim that their rhinoplasty was covered by medical insurance, this is a very rare exception to the rule.

Men and Nose Jobs: Part 6

2009-06-28T00:34:00.000-07:00

Complications from rhinoplasty

Like any surgery, rhinoplasty can be associated with some rare complications. These include:

- Some bruising around the nose and face is common.
This is transient and disappears within 7-12 days
- Some individuals may develop skin necrosis or allergy
to tape material
- Difficulty breathing for a few days from swelling in the
nose
- Open rhinoplasty may have a surgical scar but the closed
procedure has no visible scar. With the open technique the
scar is typically just on the underside of the nose.
- Repeat (revision) rhinoplasty maybe required in some cases.

Depending on whom one talks to, this figure ranges from 2-15% of individuals. The revision procedure may be required to correct the remaining deformity. Michael Jackson had numerous revisions and the result was obvious.

It is also possible that the cosmetic results of the surgery will not be what you wanted (there are always some individuals who are not satisfied).

Men and Nose Jobs: part 5

2009-06-28T00:33:00.000-07:00

After Surgery Results

The surgery is an outpatient procedure. After surgery most patients go home. The patient is not allowed to drive home and someone must pick up the patient. Depending on how the surgery was done, a packing may be placed inside the nose which is usually removed in a few days. A nose guard/splint and a dressing is applied on the nose for about a week. The facial and nose area are always bruised and swollen for a couple of days after surgery. It is recommended that the individual sleep with the head up and place ice compresses-this helps to decrease the facial swelling.

The pain is moderate and controlled with over the counter pain medications. Most individuals stay at home for about 7-10 days. It usually takes at least 2-3 weeks before on can resume all normal activities including sports.

Men and Nose Jobs: part 4

2009-06-28T00:31:00.000-07:00

The Surgery

Rhinoplasty is a common procedure and thousands of individuals undergo the procedure. However, the surgery is technically demanding and requires a lot of surgical skill and judgment. Most of the surgery is done by a sense of feeling-which is acquired only by experience. There are two main techniques used: closed and open rhinoplasty.

In closed rhinoplasty, the incision is located in the inside of the nose. There is minimal swelling and the post operative course is generally easier. However, the surgeon must be excellent to perform this type of surgery.

In open rhinoplasty, the incision is located just below the nose and provides greater access for surgery. The swelling is more and the post operative course is a little difficult. The recovery period after surgery is also slightly longer. The surgery is either done in a clinic or the hospital. Once anesthesia is induced –either general or local, the surgery is performed. The incisions are usually made on the inside of the nose and are not visible from the outside. Some bone and cartilage is removed and rarely extra tissue is added to reshape the nose. One the surgery is done, a nose guard/splint is placed to support and protect the nose. Some surgeons also place nasal packing inside the nose to support the nasal surgery.

The procedure takes about 2 hrs to complete. With newer versions of rhinoplasty, the post operative course is less troublesome. The pain is significantly less and the nose may not have any packing (it is the nose packing that most individuals hate about the procedure).

The results of the surgery are obvious immediately after surgery.

Men and Nose Jobs: part 3

2009-06-28T00:30:00.001-07:00

Realistic Expectations

Rhinoplasty is not for everyone. Some individuals are satisfied with their face and some aren’t. Rhinoplasty in most cases brings about a remarkable physical change in the face and this is usually accompanied by a positive outlook. The procedure can reshape, re contour, make the nose bigger or smaller, correct the breathing problem and correct any other associated deformity. Yet, it has limitations. Too many individuals seek plastic surgery to cure their emotional problems and for them rhinoplasty is only a partial cure. In search for vanity can sometimes lead to insanity. So one has to be realistic in their expectations and an honest discussion with the surgeon will go a long ways to help resolve any myths.

Men and Nose Jobs: part 2

2009-06-28T00:27:00.000-07:00

History of rhinoplasty

Surgery on the nose has been practiced since 3000 BC in Egypt. It was not known as rhinoplasty then, but basically involved cleansing and suturing of the wounds of the face suffered during the battles of those days.

Rhinoplasty as a cosmetic procedure appears to have been developed in the 15th century. However, the nose contouring and shaping did not become a surgical art until the 18th century. Cosmetic surgery on the nose has been practiced for about 120 years to help people cope with their unsightly nose.

With two major wars in the 20th century and the push towards anesthesia and anti sepsis, came better and more improved techniques to deal with injuries to the face. Over the last 3 decades, cosmetic surgery of the nose had been perfected into an Art (Michael Jackson is an exception –either bad surgeon, one too many surgeries on the nose or a lot of bad genes or bad luck). Today, the quality of surgery is excellent and most individuals remain satisfied with the procedure.
Age at rhinoplasty

Rhinoplasty is a permanent procedure and one has to have a firm commitment to the surgery. One cannot reverse the results after the surgery has been done. Generally, rhinoplasty should only be done in individuals who have completed their facial growth. The nose development is generally complete by the ages 17-19. The best time to have surgery is in the 20s. When surgery is done any earlier, the nose continues to grow and reshape, overriding the effects of the surgery- meaning that the surgery was a complete waste-both money and time.

All individuals can have rhinoplasty, as long as they have the ability to consent and are older than 20. Overall, most individuals are satisfied with the surgery and have no complaints, On the other hand, some individuals who tend to have cosmetic surgery are also anal (obsessive compulsive) and never satisfied-even if the surgery has been done well. These individuals should try some Prozac instead of undergoing surgery.

The best candidates for rhinoplasty are healthy men (both physically and mentally) and who have realistic expectations about what the surgery can and cannot do for them.

Men and Nose Jobs: part 1

2009-06-28T00:11:00.000-07:00

Rhinoplasty is surgery to reshape the nose. The procedure can make the nose larger or smaller; change the nose angle, alter the tip of the nose; or correct bumps, indentations, or any other defects in or around the nose.

Popularity of Rhinoplasty among men has been steadily increasing over the years and gained wider acceptance in North America. Although cosmetic surgery was once the domain of female only, this has changed over the past 2 decades. The number of cosmetic procedures being performed on males is fast catching up. At least 2-3 million males have undergone some type of plastic procedure in the past 2 years- and like their female counterparts- males also undergo very similar procedures.

For men, rhinoplasty is the second most popular plastic surgery procedure, behind liposuction.

Men suddenly want to get plastic surgery for several reasons. They all want to look handsome and appealing. The other reasons include the availability of more minimally invasive methods of surgery- thus less time off work and less prominent incisions. Also, today, there are a lot more cosmetic surgeons and the prices are affordable. No longer is cosmetic surgery only for Hollywood. Other reasons for the rhinoplasty may be due to the number of nasal injuries men suffer- whether from sports or trauma.

Finally, today’s aesthetic Corporate world also demands that men look appealing and successful. Many older men feel that it when it comes to position or promotion in a company, a younger person is always favored. Thus, cosmetic surgery is one way to try and level the playing field.

Rhinoplasty is almost always done to make the nose look better. The surgery can alter the shape, contour and angle of the nose and in most cases; it brings about a pleasing change to the face. The majority of men love looking good.

Does varicocele surgery improve fertility?

2009-06-06T05:52:00.000-07:00

There is absolutely no direct correlation between the presence of a varicocele and infertility. There is no doubt that about 40% of individuals who undergo investigation for infertility have been found to have varicoceles. But one has to know that there are many more individuals with varicoceles who go on to have normal sperm and have satisfactory pregnancy with their spouse. There are also many men who undergo varicocele surgery and yet fail to have normal sperm counts.

The questions remains, “what should one do with varicoceles”. There is no question that incidentally discovered varicoceles or varicoceles that produce no symptoms can be safely observed. All the data about testicular atrophy and decline in sperm counts are unproven and hypothetical facts put out by unscrupulous surgeons. Many men live their entire lives with varicoceles and do so without any undue problems.

Varicoceles continue to generate controversy among fertility experts. Despite conflicting evidence from various clinical studies, all the trials still recommend the surgical treatment of clinical varicoceles in men with infertility. However, it is incumbent on the surgeon to discuss the pros and cons of surgery for varicocele. A second opinion is not always a bad idea.

What are treatment options for varicoceles?

2009-06-06T05:42:00.000-07:00

There is a lot of debate whether varicoceles require any treatment. No medical therapies are available for either treatment or prevention; however analgesics (pain medications) may alleviate associated pain when present. Some doctors claim that no treatment is required. Others claim that treatment may benefit individuals who are infertile and have symptoms. The treatment involves removal of the vein mass which is supposedly causing the enlargement and infertility.

The timing of the varicocele is also debated. Some doctors claim that even though varicoceles may be detected in adolescence, the treatment can wait until the individual has any symptoms or is getting married. Others recommend varicocele repair in adolescence only if there is evidence of pain, testicular atrophy or if the sperm count is altered.

Observation for varicoceles

A varicocele is not of any great danger to health and one should not panic. For the young male in whom the varicocele is discovered incidentally, and there are no symptoms, the varicocele should be left alone.

For those males who are married and have a varicocele but are still able to have children, the varicocele should also be left alone.

For those who have mild pain or an ache and have no problems with sterility, supportive treatment with scrotal support should be tried first for at least 4-12 weeks.

Never go to a surgeon who recommends Varicocele repair without first giving you your options. In any case, in most cases where Varicoceles are treated, fertility is still not restored. If you have no pain and the varicocele does not bother you leave it alone.

Varicoceles FAQs: part 6

2009-05-21T14:46:00.000-07:00

What are surgical options for treatment of a varicocele?

There are three options to treat a varicocele and include
- Open surgical varicocele repair
- angiographic embolization- highly recommended
- laparoscopic method

What are results after surgery?

Surgery is hyped up to be the best treatment for Varicocele. It is estimated that in about 40-60 percent of men, sterility can be restored. However, real data are lacking and many men have undergone this surgery, needlessly. There are many men who have had their Varicocele fixed and still cannot conceive.

Do Varicocele recur after treatment?

Sure, recurrence of Varicocele is quite common. These recurrences may occur a few months or may even occur a few years later. In most cases, recurrence is due to poor technical surgery and leaving some small veins intact at first surgery. To obliterate a Varicocele; one has to ligate all small veins.

Who fixes a varicocele?

Urologists are physicians who specialize in the field of male genitals and most are decent surgeons.

What is embolization?

This is perhaps the best treatment for Varicocele. It is an easy procedure done by an interventional radiologist. One side of your groin is numbed with a local anesthetic and a small tube is passed into the vein. Using x rays, the Varicocele is identified in the scrotum and through the tube, glue like substances are injected into the Varicocele. Confirmation that the Varicocele is blocked is done with another x ray study and you are done. There is no general anesthesia, no incisions and the pain is minimal. You go home in the evening. Data on embolization are decent and recurrences are rare. However, the procedure is very expensive and there is still a question of whether the Varicocele should be treated in the first place.

Final Advice

There is a lot of conflicting advice on Varicoceles and how they may affect sterility. Surgery for Varicocele is strictly elective and no one should be rushed into. For best advice, talk to a reputable urologist. Ask questions and if in doubt seek a second opinion. Whilst there are some who say Varicocele affect sterility, there are is also data that show that Varicoceles have no bearing on sterility. The last thing you want is to undergo an unnecessary surgical procedure that has a real risk of damaging your sexual organ. If you have no symptoms- leave the Varicocele alone. If you have symptoms, wear scrotal support panties. Both are reasonable treatments.

One should only undergo Varicocele surgery if there is documentation of abnormal sperm and that one is unable to father a child.

Varicoceles FAQs: Part 5

2009-05-21T14:45:00.000-07:00

Are Varicocele life threatening?

No, varicoceles have no affect on health; they do not rupture nor cause severe pain.

Who should not undergo Varicocele treatment?

Despite what some physicians suggest, the majority of young males with Varicocele should be left alone if there are no symptoms.

Individuals with mild symptoms should wear a scrotal support (special panties should be worn) and this will ease the discomfort.

Married male who have a Varicocele and have no problems with fertility should stay away from surgeons.

Which individual with a Varicocele should be treated?

If one has symptoms, then a scrotal support should be worn. Varicocele is not life threatening nor is it an emergency; one should never be rushed into surgery. Varicocele surgery is purely an elective procedure and should be done after giving it a lot of thought. If the Varicocele is small and one has no symptoms or problems with fertility, just leave it alone.

Repair of a Varicocele is indicated when the couple has documented infertility and abnormal semen has been demonstrated.

Repair should be done when there is a significant discrepancy in size between the two testes.

Just having a Varicocele does not mean that you need surgery. Never go to a surgeon who recommends surgery without documenting that you have problems with semen.

Varicoceles FAQS: part 4

2009-05-21T14:44:00.000-07:00

How can Varicocele cause infertility?

Whether Varicoceles actually cause infertility is still in question. Some claim that engorged blood in the veins can lead to high temperatures that damage sperm. Sperms are very fragile and cannot tolerate high temperatures. All this is just speculation. During sexual intercourse, the banging and thrusting of the penis in the vagina leads to even higher temperatures, but sperms do just fine. So all this temperature theory
is a load of bull.

What other problems are associated with a varicocele?

The occasional individual with a Varicocele may have small testes. However, this is not a universal finding and it is meaningless. There is not a single study, which has shown a relationship between Varicoceles and small testes- it is believed to be a coincidental finding.

Why do some individuals develop Varicoceles suddenly?

Sometimes a sudden swelling may appear in the scrotum and this is most common on the left side. Usually sudden appearance of a Varicocele happens in elderly individuals and a cancer or a mass somewhere in the abdomen may be a reason. A CT scan will immediately determine if this is the case