Conversation: The conversation between human and AI assistant.
[|Human|] right varicocele pain for more than 3 years, can surgery be delay?  hi im 22 years old, im suffering for right varicocele for more than 3 years, it has mid pain but it is tolerable :) . My doctor advised me that surgery is NOT necessary. he advised me that i can have surgery after marriage, when fertility is issue, my question is that can i have surgery after 5 more years? im am suffering varicocele more than 3 years now. is my doctor advise right? thanks! :
[|AI|]  Hello there mate! Varicocele is 15-20% men problem of which only 40 percent has infertility problem. Varicocele is associated with impaired semen quality. Why don't you do a semen analysis to see where you stand. Its 80 to 90 % left testicle in your case its right, bit atypical presentation. Which grade your varicocele is? You did not mention but as you advised surgery it must be grade three. If its just visible on inspection, if occurs with bearing down or Valhalla maneuver then it's small, if palpable without bearing down than moderate. So you see for yourself where do you stand. Now you said delay, well it can be delayed if indications for surgery are not met and symptomatic treatment is helping you. If testicular volume is less than 20 ml and length remember not all varicocele lead to infertility. 10 to 15 % of fertile people have it. Plus if you early treat it is will prevent infertility plus you are 22 only I believe if you operate now you won't lose your fertility.so if you have pain in testicle, size and volume I mentioned, and your semen analysis comes abnormal I am afraid you would have to go for the repair instead of delaying it. Some authorities correlate right sided varicocele with abdominal retroperitoneal pathologies so I would recommend abdominal U/s and CT with scrotal Doppler sonography(high resolution color flow) to be on the safer road too.let's discuss some surgical options. There are 3 approaches. 1.through groin2.through abdomen3.below groin there are interventional radiological approaches too with minimal invasion. Providing the expertise are there. So in nut shell if you fit the criteria for surgery as I mentioned you should have a surgery because it will involve your left one too if left unsure, and it will progress. Its outcome will be good.rest correlating your condition clinically with the situation is the best option and the surgeon whose hand and eyes are on your testicles can decide better, from here I can advise sincerely only with the provided facts which will never be enougChatDoctorpared to one confrontation of patient and doctor. Any ways I will be here to help if you need regards Chat Doctor.