Treatment should be based on whether the patient is accompanied by infertility or abnormal semen quality, whether there are clinical symptoms, the degree of varicose veins and whether there are other complications. Treatment methods include general treatment, drug treatment and surgical treatment. Surgical treatment is the main treatment method, which can achieve ideal therapeutic effect.

1. General therapy

Including lifestyle, diet adjustment, physical therapy, etc. For example, quit smoking and limit alcohol, eat lightly and avoid exercise that increases abdominal pressure; Cooling therapy or scrotal support, etc.

2. Drug therapy

(1) drugs for varicocele

Aescin: anti-inflammatory, anti-exudation, collagen fiber protection, can gradually restore the elasticity and contraction function of vein wall, increase the speed of venous blood return and reduce venous pressure.

2) Flavonoids: anti-inflammatory, anti-oxidation, can improve venous tension, reduce capillary permeability, increase lymphatic reflux rate and reduce edema; To improve the pain symptoms caused by varicocele.

(2) Drugs to improve symptoms: Non-steroidal anti-inflammatory drugs such as ibuprofen can be used for local pain and discomfort.

(3) Drugs to improve semen quality: For patients with varicocele complicated with reproductive dysfunction and fertility requirements, drugs to promote spermatogenesis and improve semen treatment can be used.

3. Surgical therapy

First of all, secondary factors such as renal tumor, hydronephrosis, retroperitoneal tumor and ectopic blood vessels should be excluded. Surgical treatment of varicocele includes surgical treatment and interventional therapy (antegrade or retrograde).

Surgical treatment includes traditional inguinal ligation, retroperitoneal ligation, subgingival ligation, microsurgical inguinal ligation or subgingival ligation, laparoscopic spermatic vein ligation and so on.

Regardless of the severity of symptoms, primary VC with infertility or abnormal semen is the indication of treatment. At present, surgical treatments include high ligation of internal spermatic vein through inguinal canal, laparoscopic surgery, high ligation of internal spermatic vein through retroperitoneum, and interventional embolization of spermatic vein. Compared with inguinal canal surgery and laparoscopic surgery, retroperitoneal ligation of spermatic vein has the advantages of less surgical trauma, less damage to other blood vessels, less spermatic vein leakage, shorter operation time, lower operation cost, fewer postoperative complications and lower recurrence rate, and it is the first choice for the treatment of unilateral varicocele.

The improvement degree of semen parameters of patients treated by surgery combined with drugs is obviously better than that of patients treated by surgery alone.