Clinical manifestations of varicocele Primary varicocele is usually asymptomatic if the lesion is mild, and is only found during physical examination. If the symptoms are serious, the main manifestation is a feeling of swelling and hidden pain in the affected scrotum, and the symptoms are aggravated by walking or standing for a long time, and the symptoms can be relieved or disappear after lying down and resting. If the varicose veins do not disappear when lying down, they may be secondary and the cause should be identified. Varicocele can affect sperm production and semen quality because of the stasis of dilated veins, increased local temperature, C02 accumulation in testicular tissues, and increased concentration of catecholamines, cortisol, and prostaglandins in the blood, which affect the spermatogenic function of the testes; there are abundant anastomotic branches between the venous systems of bilateral testes, which often also affect the spermatogenic function of the testes on the healthy side. Among the many factors of male infertility, varicocele is a factor that cannot be ignored. Prolactin adenoma is a type of pituitary tumor that accounts for more than 40% of the total incidence of pituitary adenomas. The main clinical manifestations are: headache, menstrual disorders and amenorrhea in women, breast lactation during non-lactating periods, and decreased libido and impotence in male patients. Prolactin adenomas can be classified according to their own size as microadenomas, macroadenomas, and giant invasive adenomas. Treatment of varicocele Surgery is the main treatment method and can achieve the desired treatment effect. Some of them are also treated with (or combined with) drugs. Secondary factors such as renal tumors, hydronephrosis, retroperitoneal tumors, and ectopic vessels should be excluded first. Primary VC with infertility or semen abnormality is an indication for treatment regardless of the severity of the symptoms. Currently, surgical treatment includes high ligation of the internal spermatic vein via inguinal canal, laparoscopic surgery, high ligation of the internal spermatic vein via retroperitoneum, and spermatic vein interventional embolization. Compared with inguinal canal surgery and laparoscopic surgery, retroperitoneal high ligation of spermatic veins has the advantages of less surgical trauma, not easy to damage other blood vessels, not easy to miss ligation of spermatic veins, short operation time, low operation cost and postoperative complications, low recurrence rate, etc. It is the preferred treatment for unilateral varicocele. The degree of improvement of semen parameters and pregnancy rate of those who have surgery combined with medication are significantly better than the treatment of surgery alone.