Left scrotal asymmetry and pain ā€“ muscle/nerve issue or vascular? Persistent after varicocelectomy

Men's health
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Hi everyone. Have been dealing with a persistent problem on the left side of my scrotum. The left scrotum is noticeably more sagging and hanging lower than the right side, which causes constant discomfort.There is also a dull ache and discomfort on the left side of the scrotum and pelvic area. If the left scrotum is touched, the pain becomes sharp.The left scrotum temporarily improves or even returns to a more normal position (sometimes the left testicle even protrudes forward compared to the right) in these situations:

  • During a bowel movement or for about 10ā€“15 minutes afterwards

  • For a short time after a muscle relaxant injection

  • After gently massaging the left perineum (near the anus) or the painful area on the left scrotum

  • During massage of the lower left abdomen

I had a microsurgical varicocelectomy on the left side some time ago. After the surgery, ultrasounds showed normal veins for several months, but my symptoms did not improve at all. Later the varicocele recurred.Additionally, I have similar dull pain in the left pelvic area and premature ejaculation, which started around the same time as the scrotal problem and seems to be connected to it.Iā€™m confused about the cause. Is this primarily a vascular problem (and I should investigate pelvic veins further)? Or is it more likely a muscular or nerve-related issue ā€” such as pelvic floor muscle spasms, pelvic floor dysfunction, or irritation/compression of the genital nerves?Has anyone experienced something similar? Especially the combination of one-sided scrotal sagging that improves after defecation or massage, along with no relief after varicocelectomy.Thank you in advance for any shared experiences.

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