Hello Doctor, I need your help. I have a problem with my scrotal that get swell when I go to toilet and when I go out for a run, walking...etc. And i'm also suffered with erectile dysfunction. One doctor said that the scrotal swelling could be likely hydrocele or varicocele. Are one of them related to my erectile dysfunction problem? I need to know which of them either hydrocele or varicocele that I might have. Can you please take a look at the pics of my swelling scrotal. Here is the pictures of my swelling scrotal: http://oi61.tinypic.com/35c4njm.jpg http://oi61.tinypic.com/2i03dw8.jpg http://oi57.tinypic.com/207ajj5.jpg Can you please let me know which one of them (hydrocele or varicocele) that I might have? Thanks! Source: HealthTap, https://www.healthtap.com/ask_docs  1:38a

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OK, let's take a look  1:39a
Hello doctor  1:39a
if you need to see the pics here it is  1:39a

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Hi There, There is a trick to telling hydrocele apart from varicocele  1:39a

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hydrocele is full of fluid, if you put a light onto the scrotum the whole thing will "transilluminate"  1:39a
can you tell me what I do have?  1:39a
from what you can see in the picture?  1:40a
varicocele is a collection of blood vessels, so it lights up a little but not as much as the hydrocele  1:40a
lets see  1:40a
so what I might have then?  1:40a
it's hard to tell just with the visual, but really, neither hydrocele nor varicocele should cause ED  1:41a
have you seen a urologist yet? or was this your general doc that gave you the advice before?  1:41a
are they related to my erection problem?  1:41a
do I have hydrocele or varicocele?#  1:42a
Im going to see the urologist but i need to have MRI scan first before my doctor get the full result  1:42a
It is super hard to tell without an exam, although if you could put a light on the testicle, in a dark room and directly touch the area, i miht be able to tell more  1:42a
gosh, am MRI is awfully expensive! usually you can tell just with an experienced clinician in a physical exam!  1:43a
how old were you when the scrotal swelling started?  1:43a
Oh ok fair enough. Do you know which one of them cause my scrotal to swell when I go to toilet to have a poo?  1:43a
Has this " always been this way" or did it have a " start"  1:44a
yeah but in my country i get free MRI scan because i paid tax  1:44a
usually varicoceles do not change in size much,  1:44a
i have this for 2 years now  1:44a
BUT for a hydrocele, if it is a "communicating hydrocele" that connects through, it would increase size potentially when Bearing down to have a BM  1:44a
And you have noticed increase in swelling with Bearing down to have a bowel movement?  1:45a
oh right so I must have hydrocele then because when I have bowel movement it start to swelling in my scrotal sack?  1:45a
i'm not really sure but short of  1:45a
My gut feeling, from what you have told me is that it is a hydrocele  1:45a
It is easy to fix surgically, if it's causing you trouble, BUT this may not be the cause of the ED, I am concerned.  1:46a
When do you get MRI then?  1:46a
soon?  1:46a
Oh thank you very much, i will let the urologist to know  1:46a
i am going to have it on 1st july  1:47a
well i have my scrotal swell like a mild so it must be related to my ED problem?  1:47a
Oh, Good, that is not too long! Be sure and have the urologist check your testosterone also  1:47a
that could be a contributing factor to ED, and it's easy to fix  1:47a
i will do  1:47a
did it seem the ED started the same time as the swelling?  1:47a
yes  1:47a
Gosh, I hate your having to go through this!  1:48a
i dont get morning erection and when i'm with my partner  1:48a
I know i hate it and i want to get it sort it out  1:48a
You are on the right path, just be patient and keep communicating progress to your partner, things will get resolved!  1:49a
so are you sure that it related to my ED problem and are you sure that it is a hydrocele that cause my scrotal to swell when I have the bowel movement?  1:49a
It can if it is a "communicating hydrocele" meaning the connection to the abdominal cavity area is persistent  1:49a
if so i will let my doctor to know when he get the full results  1:50a
yes, I wish I could have been of more help, I will recommend a general health checklist for you and also one on ED, to help you sort this out  1:50a
Ok thank you, do i need to have surgery?  1:51a
You may need to have surgery  1:51a
luckily whether it is varicocele or hydrocele, the surgery is pretty straightforward  1:51a
Oh ok I hope it will get the problem sort it out.  1:51a
best of luck! If you have any other questions please do check back with me on healthtap! Thanks for trusting us!  1:52a
Thank you for your help today  1:52a
oh sure that's what we're here for! take care!  1:52a
cheers  1:52a
good bye


Source: HealthTap, https://www.healthtap.com/ask_docs/transcript/45554