First of all there is a difference between the treatment and prognosis of cremasteric cleft in adults and the surgical treatment and prognosis of cremasteric cleft disease in children. For children the vast majority of children will develop normally after surgery as long as they are asymptomatic prior to the visit (1-3 months after birth). In adult patients with cremasteric bifida, there are two types of cases: one is when the patient has no abnormal symptoms until he or she reaches adulthood and finally is diagnosed with cremasteric bifida after experiencing back pain and leg weakness. In this case, surgery is absolutely suitable for treatment, and the symptoms can be completely or partially relieved after surgery, especially some symptoms that are mainly back pain can be significantly relieved after surgery. For patients who did not have the conditions for surgery or incomplete surgery in the past, as they grow older, the symptoms are usually already obvious by the time they reach adulthood, including foot entropion, urinary and fecal incontinence, etc. Individual patients even have more serious complications such as hydronephrosis and renal insufficiency. In other words, there is already serious neurological impairment, and even after receiving the ideal crestal plexus release surgery (nerve release surgery), it is usually impossible to completely reverse the impairment of urinary and fecal function, as well as the motor impairment of the lower legs and feet. So, does it still make sense for adults to have surgery? In fact, for most adults with cremasteric cleft, surgery is absolutely necessary to prevent severe neurological damage, i.e. to avoid paralysis. Of course, for patients who are already unable to stand, there is no need to undergo surgery. In conclusion, cremasteric cleft disease is a disease in which symptoms develop gradually with age and may also be unchanged at one time and significantly worse at another. The earlier the surgical intervention, the more neurological function will be preserved and the less sequelae will be formed by the disease. Surgery for adult cremasteric cleft requires neurophysiological testing, and in cases of the lipoma type also requires the assistance of an ultrasonic suction knife to be very safe, meaning that a reasonable procedure will not aggravate the patient’s condition. There are also individual cases in which complete surgery may affect the blood flow to the crista terminalis because the nerve damage is too severe, or because the crista terminalis is significantly malformed, and the symptoms may worsen if the surgery is reluctant. In such cases, it is necessary to have continuous neurophysiological monitoring during the surgery, and if there is a risk of nerve damage during the release of the cremaster or nerve, we will stop the surgery to avoid causing medically induced neurological impairment. In conclusion, the exact treatment plan for these cases requires a combination of MRI, ultrasound, neurophysiological examinations and laboratory tests to be determined prior to surgery. In some special patients, it is also wise to terminate the surgery if there are abnormal changes in neurological function intraoperatively. These patients may not be able to avoid paralysis eventually, but the surgeon cannot cause premature paralysis as a result of the surgery. For the neurological impairment that has already occurred in adult patients with cremasteric cleft, there are treatment options to compensate for this functional deficit, and subsequent treatment includes: for orthopedic limbs (orthopedic braces and surgery); improving renal function, bladder function, and individual patients may be considered to receive sacral nerve stimulator to improve urination and defecation; and improving neurological recovery through stem cell transplantation, hyperbaric oxygen, and Chinese medicine rehabilitation, etc. .