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Hello this is Dr. Salama MD,
With a history of significant trauma, the most likely cause of pain and shrinkage is scarring either directly of the testis or of the nerves/blood vessels.Varicoceles are caused by problems with venous drainage at the level of the kidney and may or not be currently present and maybe have been there before the injury. A varicocele is not generally caused by a testicular injury.
I would recommend getting a testicular ultrasound as soon as you can to get a good idea of what's going on whether it's a varicocele or something else.
On a standard urine drug test both of them are detected as their metabolites and since they are both in the same class of medications they will be unable to differentiate from the two.
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It all depends on the extent of the scarring which is difficult to say without the ultrasound results.
If the vasculature is affected then it's unlikely that any surgery or treatment would help but if it's something else, it's possible.
Is there anything else I can help you with?