One of the major causes of infertility in men is the presence of varicocele, but does it necessarily mean that the disease requires surgery? The answer is not necessarily. There is a great deal of information published in the media that makes varicocele look quite scary and serious, and strongly advocates “cutting it off”. In fact, not all patients with varicocele will affect their fertility and need surgery. The key depends on the severity of the varicocele and the damage to the testicles. This can be reflected by the semen routine of the patient. If the semen quality is generally of medium to high level, the sperm density is in the normal range, only the activity rate is slightly decreased or the activity is slightly poor, and the testicles are of normal size and volume (10 to 20 ml), and the testicular function is not greatly damaged, then the semen quality will be further improved through Chinese herbal treatment of tonifying qi and benefiting sperm, regulating qi and removing stagnation, and activating blood stasis, and surgery is generally unnecessary. Sometimes the quality of semen in these patients after surgery is not as good as before surgery, so it is important to be cautious about whether to use surgery for patients with varicocele. Where the testicular volume is reduced (below 10 ml) and the semen density and vitality are also bad, in the case that conservative treatment with Chinese medicine is ineffective for more than three months to six months, it indicates that the testicular function is obviously impaired and the degree of varicocele is severe, which seriously affects the semen quality, surgery should be used early. However, surgery is not a panacea. About 40% to 60% of patients will have improved semen quality, and nearly half of them can achieve fertility after surgery, but there are still some patients who are difficult to improve. Of course, the results of the surgery vary from one report to another. This is related to the type and level of surgery, the patient’s physical condition and the original spermatogenic ability. So surgery is a last resort in a sense. There was another middle-aged man who also had this condition, but he felt some swelling in the spermatic cord. I asked him, “Do you have children?” He said that his children were already in their teens and he was not going to have any more children. Then I told him that there was no need for surgery and that he might as well use Chinese herbal medicine. Of course, patients suffering from this disease should pay attention to the prevention of varicocele, focusing on the following aspects: 1, less browse information about sex, unmarried young people should avoid frequent sexual impulses and masturbation; married men to abstain from sex, neither too often, nor long-term abstinence, in order to reduce the degree of genital congestion. At the same time, sexual activity should not be too long, so as not to overcrowd the blood. 2, control the amount of exercise, not too much. Usually lift heavy objects, increase abdominal pressure of heavy labor and exercise should also be reduced or avoided. 3, keep the bowels open, prevent habitual constipation, avoid forceful defecation. 4. For those who have obvious symptoms, you can wear elastic underwear under the guidance of your doctor and gently hold up your scrotum with your hands while wearing them, so that the scrotum can be held up by the elasticity of the underwear to reduce the drop and pull, and to help blood flow back and reduce blood flow depression. In addition, you can also use a scrotal support, or use cold compresses or cold water sitz baths on the scrotum to make local venous vasoconstriction, which helps the recovery of varicose areas. The first consideration in treatment is Chinese medicine. This disease belongs to the category of “tendon hernia” in Chinese medicine. The pathogenesis of this disease is mainly due to blood stasis and blockage of ligaments and Qi deficiency. Chinese medicine focuses on differentiated treatment, which varies from person to person, and selects treatment methods such as tonifying the middle and benefiting the qi, lifting the trapped and moving the stagnation, and activating the blood to remove stasis. Generally, after 2 to 3 months of treatment, most patients have different degrees of improvement in sperm quality, and many couples have been relieved of their suffering as a result. Most of the surgeries are performed by high ligation of the internal spermatic vein or by high ligation with diversion. The quality of semen and pregnancy rate will be further improved if chorionic gonadotropin is used in conjunction with the surgical treatment. However, if there is no sperm in the original semen, you may not expect sperm to appear even after surgery, so surgery is futile.