Hi,Dear,Thanks for your query to HCM. Dear I read facts of your query and reviewed it in context to your health issues submitted in your query. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is- Your current health issues seem to be due-failed Varicocelectomy. You need to Consult the old Urologist or New Urologist and work out the cause of failure of Varicocelectomy. You may need to investigate the testosterone levels,which could be less due to atrophic testes by now. Other Causes of failed Varicocelectomy- as incompetent Testicular Vein or Av-fistulas need to be ruled out by investigation with USG and Colour Doppler study and review by Second Urologist. You would need Micro-Vascular ligation of the incompetent Varicose veins, which drain the regurge venous flow to the testes causing congestion of testes and atrophy from improper oxygenation over a long time. Your sex act would improve in 3-6 mths time, depending on the atrophic damage, which may take some time in your case. Your sex problem is from low testosterone and needs to be corrected by Re-do-Varicocelectomy at hands of Expert Second Urologist urgently,as still you are quiet young. Till the time you need to be on Inj testosterone- 200 mg / biweekly for satsifying emergency sex desire. Also Sildenafil -50 mg -30 mts before the act would resolve your emergency needs. Hence Other causes-as cited above- need to be ruled out,by verification with Physician/and or Surgeon. Do s- Consult with Urologist and Surgeon who would investigate physically and by USG with Colour Doppler study if needed. This would fix the cause amongst the above or other possibilities. You need to treat it with Surgeon/ Urologist which should be done on priority and urgently to avoid further complications,as suggested above. This would resolve the complaints of your s. Constant followup with local family or specialist Urologist / Surgeon-for long term would give you long remissions in time to come,which would depend on meticulous followup treatment of your health concerns. Just don t worry and be patient and co-operate with your doctors,till you verify with your attending doctors. For early recovery-please follow above do s which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link- http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229 Wishing Good Healthy Life!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS