Hi. Thanks for your query and an elucidate history. First of all get the proper diagnosis by getting ultrasonography and color doppler examination. Remember the first step of any treatment is the diagnosis. Unless you have a perfect diagnosis , taking any medicines or therapy is just waste and worst of all you are increasing your problems. Well for grade 1 and 2 caricocele no treatment is required except for scrotal support, avoid exposure to cold, avoid coughing , constipation and strenuous exercises which increase intra-abdominal pressure. Semen analysis for sperm quantity and quality is a must to determine whether you need surgery or medical management ( there is no perfect one). Only grade 3 with pain and / reduced sperm count needs surgery. So go for the perfect diagnosis as a first step.