It appears that you may have varicocele which was identified by the physician and referred to the surgeon for operation. You should have undergone operation. Had it been done, your sperm count and motility should have increased. In 2007 your sperm count was 42 million with 11% active motile. Now it reduced to 1.2 million with no active motile sperms and only 2% sluggish motile. It shows a significant reduction in the sperm count and motility over the last 4 years. Varicocele causes progressive and duration dependent damage to the testis. As a result sperm motility will be reduced first followed by count. Over the years testis become atrophied and the production of male hormone (testosterone) will reduce. It will cause loss of sexual desire and erection. In other words you may develop an early andropause.

If there is a varicocele in an infertile man or in an unmarried man or a person who doesn’t have children, one must do microsurgical varicocelectomy. This is the latest scientific view and standard teaching on this matter. How ever in most of the places varicocele is usually operated using laparoscopic surgery or conventional surgery.

The most common complications of conventional varicocele operations are hydrocele, varicocele recurrence, and injury to testicular artery, spermatic cords etc. This may the reason why your Gynecologist advised against the surgery and advised for ICSI. A person having varicocele should undergo microsurgical varicocelectomy before going for IUI, IVF or ICSI to improve the sperm quality. It will reduce or nullify the adverse effect of ROS (reactive oxygen species) on the sperms. Presence of varicocele will reduce the percentage of success when going for artificial reproduction techniques.

In microsurgery the use of the operating microscope allows for reliable identification of spermatic cord, lymphatics, internal spermatic veins and venous collaterals, and the testicular artery or other arteries. So that chances for these complications are almost reduced to less than 1 percent. Repair of varicocele results in greater improvement in sperm motility and count.

Microsurgical varicocelectomy provides a safe and effective approach to varicocele repair with preservation of testicular function, improvements in semen quality, and improvements in pregnancy rates.

I have stopped practice at Calicut. Please consult me at Cochin.

For further details you may contact to 0484 - 2555301 or 0484 - 2555304 between 9.00am and 5.00pm from Monday to Saturday.

All sexual problems are treatable. Problems may be due to various reasons and has to be identified before planning the treatment.  Treatment may vary from sex therapy, medicines or surgery. It can be planned only after appropriate investigations and physical examination.  For further details you may contact to 0484 - 2555301 or 0484 - 2555304 between 9.00am and 5.00pm from Monday to Saturday.

There are different causes for premature ejaculation. This may be due to infection, inflammation, hypersensitivity, habituation or any other factors. First the etiology should be identified. Treatment may vary from medication to sex therapy or a combination of both based on the etiological factors. To decide the treatment you need to undergo a clinical evaluation including physical examination and investigations. With out that it cannot be treated. Definitely there is a cure for this problem. So please consult a doctor practicing modern medicine.

It appears that you are suffering from premature ejaculation. This may be due to various causes such as infection, inflammation, hypersensitivity, habituation or any other factors. First we have to find out the cause. Treatment may vary from medication to sex therapy or a combination of both based on the causes. To plan the treatment you need to undergo a clinical evaluation including physical examination and investigations. Based on the results it can be successfully treated.

There are different causes for premature ejaculation. This may be due to infection, inflammation, hypersensitivity, habituation or any other factors. First the etiology should be identified. Treatment may vary from medication to sex therapy or a combination of both based on the etiological factors. To decide the treatment you need to undergo a clinical evaluation including physical examination and investigations. With out that it cannot be treated. Definitely there is a cure for this problem. So please consult a doctor practicing modern medicine.

You may consult a neary Urologist and Gynaecologist. If not satisfied please visit our hospital.

For unmarried people or those who live alone it is considered as a normal activity that will help to release sexual tension. In certain people fast regular masturbation may cause premature ejaculation by habituation. Usually masturbation doesn cause any other health problems.

From our experience of treating thousands of patients with sexual problems from Kerala and outside it is found that 99% of men complaints of small penis got apprehension and doubt about the size of their sexual organ. It is only a concern, and not a fact. The size of flaccid penis is immaterial and it will keep on changing based on the atmospheric and body temperature. Most men worry about the size of the flaccid penis. The only published research study conducted in India on penile size is from Dr. Promodus Institute of Sexual & Marital Health which is published in the International Journal of Impotence Research (2007, 19,558-563). The mean erected length is found to be 13.01 cm with a SD of 1.62 cm.  The summary of this study is available at the Institute’s website (www.drpromodusinstitute.in) and the full paper is available in the internet at the journal’s site.

You need not worry about the penile size. You may consult a doctor who can examine your body and alleviate your apprehensions.

Erectile dysfunction is treatable. Treatment varies from sex therapy, medicines or surgery. It can be planned only after appropriate investigations and physical examination. Without  this we are unable to give an opinion.

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