Indications for surgery 1, varicocele infertility, the presence of abnormal semen examination, medical history and physical examination did not find other diseases affecting fertility, normal endocrine examination, female fertility examination without abnormal findings, regardless of the severity of varicocele, as long as the diagnosis of varicocele once established, should be timely surgery. 2.Severe varicocele with obvious symptoms, such as more standing that is to feel the pain of scrotal swelling, etc., physical examination found that the testicles are obviously shrinking, even if there is fertility, the patient has a desire for treatment can also be considered for surgery. 3, clinical observation found that the incidence of prostatitis, seminal vesiculitis in patients with varicocele is significantly increased, twice as much as normal people, so if the above two diseases exist at the same time, and prostatitis is not cured for a long time, you can choose to perform varicocele surgery. 4, for adolescent varicocele, because it often leads to pathological and progressive changes in the testicles, it is currently advocated that adolescent varicocele with testicular volume reduction should be treated with surgery as early as possible, which can help prevent infertility in adulthood. 5.For patients with mild varicocele, if the semen analysis is normal, they should be followed up regularly (every 1-2 years), and once the semen analysis is abnormal, the testicles shrink and become soft in texture, they should be operated in time. 6. For patients with varicocele accompanied by oligospermia due to non-obstructive factors, it is recommended to perform testicular biopsy and varicocele surgery at the same time to help perform assisted reproduction. Contraindications to surgery A history of abdominal infection and open pelvic surgery with extensive adhesions is a contraindication to high level ligation of the internal spermatic vein.