We often encounter infertile men in the clinic and find more cases of varicocele and patients are more confused. We would like to share with you the knowledge about varicocele in our guide. The incidence of varicocele accounts for about 10-15% of the male population and is mostly seen in young adults. Varicocele mostly occurs on the left side, but recently it has been found to occur bilaterally in up to 40% or more. In adolescents, there is a significant correlation between the prevalence of varicocele and age. Recent studies have reported a prevalence of 2%-ll% in prepubertal children, 9.5%-162% in adolescents, and 9%-26% in late adolescence. It is now recognized that varicocele can affect fertility and is one of the major causes of male infertility. It has been documented that approximately 40% of primary infertility and 80% of secondary infertility in adult males have varicocele. Clinically, varicocele is classified into four grades: Grade III: dilated veins can be seen protruding from the scrotal skin when the patient is standing, like a mass of earthworms, which can be easily palpated. Grade II: The dilated veins are very easily palpable on palpation but cannot be seen. Grade I: not obvious on palpation, but may be present on Valsalva test. Grade 0: No manifestation of varicocele symptoms and cannot be seen on Valsalva test. What patients need surgery? It is clearly mentioned in the guidelines: (1) Indications for surgery ①If the varicocele is infertile, there is abnormal semen examination, no other diseases affecting fertility are found in medical history and physical examination, normal endocrine examination, and no abnormal findings in female fertility examination, regardless of the severity of varicocele, surgery should be performed as soon as the diagnosis of varicocele is established. ②Severe varicocele with obvious symptoms, such as more standing that is to feel the pain of scrotal swelling, etc., physical examination found testicular obvious shrinkage, even if there has been fertility, the patient has the desire for treatment can also consider surgery. Clinical observation shows that the incidence of prostatitis and seminal vesiculitis in patients with varicocele increases significantly and is twice as high as normal people, so if the above two diseases exist at the same time and prostatitis is not cured for a long time, varicocele surgery can be chosen. ④For adolescent varicocele, since it often leads to pathological and progressive changes in the testes, it is now advocated that adolescent varicocele with testicular volume reduction should be treated with surgery as early as possible to help prevent infertility in adulthood. ⑤ For patients with mild varicocele, if the semen analysis is normal, they should be followed up regularly, and once there is abnormal semen analysis, testicular shrinkage and softening of texture, they should be operated promptly. (6) For patients with varicocele accompanied by oligospermia due to non-obstructive factors, simultaneous testicular biopsy and varicocele surgery is recommended to help perform assisted reproduction. For patients with varicocele, we mainly perform minimally invasive laparoscopic ligation of high spermatic veins, which is less invasive, less painful, and has a shorter hospital stay, especially for patients with bilateral varicocele, and can solve both sides of the problem at once. I have routinely performed microscopic varicocele ligation. Our department is equipped with the first VTI Doppler vascular detector imported from the United States in the western region, which can be used for microscopic varicocele ligation to accurately identify arteries during surgery, reduce accidental artery injury and avoid postoperative testicular atrophy and other complications. Microsurgery requires advanced and fine equipment, and our department has imported Zeiss S88 high-end microscope. The fine surgical skills and sophisticated instruments and equipment provide a solid foundation to ensure the successful implementation of the surgery and good postoperative results.