Varicocele is the dilatation, thickening and tortuosity of the trapezius plexus in the spermatic cord. The incidence of varicocele is about 10-15% in the general population, and in male outpatient clinics, if you carefully go for scrotal palpation combined with scrotal ultrasound, varicocele can reach about 1/3 of patients, and most of them occur on the left side. There are two main effects of varicocele on men: one is the discomfort of swelling at the spermatic cord and scrotum; the other is that it may affect the quality of semen through various mechanisms, thus affecting fertility. The principle of treatment in Western medicine is two words: surgery! Unless you have other diseases or problems that are not suitable for surgery. Of course if you can do without surgery, who would like to do without surgery, according to personal clinical experience, varicocele surgery or no surgery, when to operate. One, the following issues should be considered: First, what is the quality of the current semen? If the semen quality is very good and people don’t feel any cramping and discomfort, surgery is not recommended for the time being. The “Male Science” edited by academician Guo Yingluo clearly states that varicose veins without obvious symptoms and normal fertility generally do not require surgery. The actual spermatozoa are not only the most important part, but also the most important part of the spermatozoa. 2, oligospermia, clinical experience, sperm density <10x10e6 / ml, regardless of surgery or drug treatment, clinical efficacy is not good, it is recommended to take artificial insemination or in vitro fertilization, do not consider surgery. 3, normal sperm density, preferably can be >30x10e6 pcs/ml, just poor sperm vitality, drug treatment is a big room for improvement. After Chinese medicine and proprietary Chinese medicine treatment, the semen quality of most patients can be improved, and very most of them can fully meet the standard semen quality in about one and a half months, so why rush to surgery? As for the uncomfortable swelling at the spermatic cord and scrotum, Chinese medicine activates blood circulation and resolves blood stasis, and benefits qi ascending in solving this symptom is a very simple matter. 4, of course, if the quality of semen still does not improve significantly after a period of Chinese medicine, Chinese medicine treatment, it is still recommended to consider surgery, at any time, one more way means one more chance. Third, if you have no fertility requirements, because of the varicocele caused by the spermatic cord, scrotum swelling discomfort has affected the quality of life, you can immediately surgery. Because you have to understand a few points: 1, simply because the sperm quality is bad due to varicocele, the effect of surgery is certain, however there are many reasons that can cause the sperm quality to be bad, varicocele is just one of the factors, unless you can 100% hold this big crime on the head of varicocele, you will have no absolute reason to kill it. 2, after surgery, the spermatic cord, the scrotum at the swelling discomfort can generally be quickly lifted, the original varicose veins generally began to collapse after three months, but the surgeon simply will not take the initiative to mention or tell you in great detail: for semen quality, the probability of improvement is about 50%; and the other 50%, is because of the local antigen exposure after surgery, which triggers the body’s immune response to produce anti-sperm Antibodies, the quality of semen after surgery may even be worse than the original. Therefore, I do not advocate “immediate surgery” for varicocele! Surgery is not the end of the story!