Hi,Dear,Thanks for your query to HCM. Dear I read facts of your query and reviewed it in context to your query health issues. I understood your health concerns and feel Concerned about them. Based on the facts of your query reply is- Yes-the Varicocele could be painful with heaviness and could result in to nil ejaculation. But other accompanying causes, need to be ruled out- as- Accompanied Inguinal Herniation / Or Testicular tumour/ and BEP for your advanced age, needs to be ruled out by USG study of the abdomen. Treatment-Suggested- If its only- Varicocele, UroSurgeon is the right Specialist doctor to fix the issues you have. If any accompanied ailments are there, a team of Surgeon and UroSurgeon would fix the health issues you have. Treatment with Micro-Vascualr Surgery for selective ligation of the pampiniform plexus , would reduce the retrograde venous flow and would correct the Chronic Venous Insufficiency in your case- with resultant Testicular atrophy. USG and Color doppler study of the Affected scrotum would fix the diagnosis. Just don t worry till you verify with your attending doctors. Need to Check with Urologist if things don t recover. -Other causes need to be verified with your family GP doctor, as the facts may be different what you submitted. -For this Second opinion from PCP-or Gp doctor and if need be with Urologist-is needed who would do proper investigation after proper physical assessment to resolve your health issues. -for early recovery-please follow above do s which would resolve your issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS