Can a subclinical varicocele cause pain?

[hoser75]

I've been having testicle/groin pain over the last few weeks. I've had it before, but it was really intense over the last little while. I've also experienced shooting perineum pain.

My doctor did a prostate exam and urine sample - prostate was good, urine was clean. He also did an ultrasound, and the results said that I have a "subclinical varicocele". He put me on Cirpo for the pain and booked me to see a urologist, who I'm going to see this week.

The research that I've done online talks about fertility, but I can't find anything about a subclinical varicocele causing pain. Can it? Or is it not clinically relevant? I've read about Chronic Pelvic Pain Syndrome too and I'm wondering if that could be the cause.

Thanks for your time.

[hoser75]

Thank you so much for your reply it means a lot - the only follow up question I have is in regards to chronic prostatitis. Is that still possible considering that my prostate was considered normal after a rectal exam?

[Bhupinder Kaur, MD]

Hello,

Thanks for posting your query.

I can understand your concern for the testicular, groin and perineal pain.
If you have been diagnosed as subclinical varicocele on ultrasound , it needs further evaluation. Pain is not a presenting symptom of subclinical or clinical varicocele. If there is any pain then it is not acute or severe but just a subtle pain or a feeling of heaviness. If you are having severe pain then there may be some additional cause other than varicocele. You have got an ultrasound but you may need doppler studies to confirm the diagnosis.

Your concern regarding chronic pelvic pain syndrome is genuine. It is usually caused by chronic prostatitis and is characterized by pelvic or perineal pain without evidence of urinary tract infection and lasting longer than 3 months. The pain can range in severity and can be present in the perineum, testicles, tip of penis, pubic or bladder area. Moreover it effects young and middle aged men.

There are no definitive diagnostic tests for diagnosing chronic pelvic pain syndrome but various tests should be done to exclude other conditions which may be presenting with similar symptoms. For example, Bladder neck hypertrophy and urethral stricture may both cause similar symptoms through urinary reflux and can be excluded through flexible cystoscopy and urodynamic tests. Urine examination has come out normal but you can get PSA levels for prostatitis, videourodynamic tests and anal sphincter electromyography (EMG) done.

Hope that this information helps and hope that you get better soon.

Wishing you good health.