### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, im 19 male . 175 cm . 78 kg .i ve bilateral varicocele .. I had scrotal high resolution ultra sonography &color duplex .. They revealed :both testes and epididymes show normal size with normal echopatten vascularity . No focal lesions the rt. Pampiniform plexus is dilated & tortuous with reflux on valsalva maneuver . The dominant vein measures 3.6 mm on valsalva maneuver in the standing position.The Lt. Pampiniform plexus the same as the right but its 3.5 mm bilateral minimal simple hydocelesno intra-scrotal hernial sacs could be detectedand i had a Casa test it showed :conc. 160 million/mlcount / ejaculate 480 milprogressive motility 50 % motility ratio 60%class A sperms (according to motility ) 20%class B 30%class c 20%class d 30 %normal morph. Sperms 75 %TZI 1.00SDI 0.45vol. 3 mlph 7.4 white blood cells 1-3rbcs 0-1spermatogenic cells 0-1 n.b my testosteron-total is 3.8 before receiving treatment which is Daflon 500 .. 2 tablets per day my qestions are :1  - what is the level of my varicocele ?2- Am I supposed to have surgery now ?it causes little pain3- can i practice sport without increasing my varicocele ? What sports ?4- what sould i do so that my varicocele doesnt increas ?Thnx in advance .

### output:

HelloThanks for query. Based on the report of your ultrasound scanning and color Doppler study of your scrotum and Semen analysis report that you have uploaded I would like to state that you have bilateral grade 2 Varicocele. However, your semen analysis report is absolutely within normal range as per WHO standards. Answers to your queries are detailed below .1) You have grade 2 Varicocele 2) Surgery for Varicocele is advised only in a situation when person is infertile and have Varicocele which is presumed to be a cause for infertility. You do not need surgery now 3)Yes you can practice sport of your choice 4)Avoid the exercise that will increase intro abdominal pressure like Weight lifting, pull-ups etc. Chat Doctor. 