Q: I am a 31 years old man who had surgical ligation (abdominal) for bilateral varicocele 4 months back. I often feel some pain on both sides at the place of operation. I also feel itching sensation over scrotum. But I hesitate thinking that the itching is coming from inside scrotum due to lack of blood supply or some other reason. I can't say exactly where the sense of itch is. Also, there is no increment in the sperm count after operation and the doctor says that I have oligospermia. Please advise.

A:There are two different sensations here; first, the discomfort at the site of surgery. Some pain is normal after surgery. This is associated with healing and typically occurs for several hours in the day initially, and for a few minutes a day after some months. However, you may have an occasional twinge even after 6 to 12 months. Do not worry; this is normal healing. Second, the discomfort in the scrotum. Your scrotum is getting used to some altered pressure dynamics after the varicocele ligation. There is no need to worry, if there is no unusual swelling. After 4 months, the discomfort should have gone away, but it may continue for longer in some patients. I personally do not think you need to do anything about it, but you should check with your doctor as well. In patients with oligospermia, the sperm count improves in 33%-66% of cases. If you had large varicoceles before surgery, there is a higher chance of the sperm count improving. If you had very small varicoceles (also called occult varicoceles), the chance of improvement is less. This does not sound very encouraging, but the treatment of oligospermia is not very successful, and surprisingly varicocele ligation is one of the most effective operations for male infertility. You can imagine how poor the results are after other operations for infertility!