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The event happened 4 weeks ago, but his symptoms have occurred for 2 weeks.
My best guesss: Sperm/semen need to be at a lower temperature than body temp (why testicles hang away from body). Varicoceles contain warm blood that would more likely cause infertility.
Varicocele is classically "bag of worms" feeling which they alluded to in the question "ill-defined soft masses palpated bilaterally, high in scrotum"