Varicocele is a frequent disease in young male adults, and most of the clinical literature reports that surgical treatment is the main treatment, and some of them use (or combine with) medication (including Chinese medicine). Since the effect of drug treatment alone is not very good, the following description focuses on surgical treatment. The treatment of primary varicocele should be treated differently according to the presence or absence of clinical symptoms, the degree of varicose veins and the presence or absence of complications. For mild asymptomatic cases, they can be left untreated, and those with mild symptoms and no complications of infertility can be treated by non-surgical methods such as holding up the scrotum, applying local cold compresses and reducing sexual stimulation. For those who have obvious symptoms or have caused testicular atrophy, decreased semen quality and infertility, they should be actively treated surgically. Surgical methods mainly include traditional open surgery, laparoscopic surgery and interventional embolization. 1.Surgical indications: ①If the varicocele is infertile, there is abnormal semen examination, medical history and physical examination do not find other diseases affecting fertility, endocrine examination is normal, female fertility examination has no abnormal findings, regardless of the severity of varicocele, as long as the diagnosis of varicocele is established, surgery should be promptly. 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 by 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 (every 1-2 years), and once there is abnormal semen analysis, testicular shrinkage and texture softening, they should be operated promptly. (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. 2.Open surgical treatment (the following two traditional surgical routes): ① High ligation of the internal spermatic vein through the inguinal canal: it is commonly used because of its superficial location, wide exposure of the surgical field, small anatomical variation and local anesthesia, but there are more venous branches and more lymphatic vessels in this area, and there are also more arterial branches, which are closely related to the venous branches, so testicular atrophy may occur if it is damaged. The incidence of lymphedema is about 3%-40%, and the incidence of testicular atrophy is 0.2%, thus limiting its further promotion and application. The recurrence rate of the Palomo procedure is the lowest, but the postoperative incidence of syringomyelia or scrotal hydrocele and aseptic epididymitis is easy to occur, and the incidence rate is 6.6% as reported in the literature. In contrast, the modified Palomo procedure reduces the incidence of syringomyelia or scrotal effusion by simply ligating the arteries and veins in the spermatic cord while preserving other spermatic tissues and avoiding the lymphatic vessels together, thus preventing lymphatic flow obstruction. Compared with the traditional Palomo procedure, the incision of the modified Palomo procedure is moved upward, and the operation at this level can avoid damaging the subabdominal wall arteries and veins and avoiding the occurrence of postoperative syringomyelia or hydrocele, so it is more likely to be adopted clinically. 3, laparoscopic surgery treatment: laparoscopic spermatic vein high ligation compared with traditional open surgery it has the advantages of reliable effect, less injury, less complications, simultaneous bilateral surgery, fast recovery, short hospital stay, etc. Therefore, many clinicians believe that laparoscopy is mainly suitable for bilateral laparoscopic high ligation, obesity, history of groin surgery and recurrence after open surgery. The various advantages of laparoscopic high ligation of the spermatic veins over open surgery should be considered for open surgery via the inguinal route or retroperitoneal route, but not for microscopic open surgery via the low small incisional route under the external ring. Laparoscopic surgery will entail some intra-abdominal complications, such as bowel, bladder and large vessel injuries. In addition, laparoscopic surgery requires general anesthesia and is difficult to promote in primary hospitals because of the expensive equipment, high medical costs, and limitations of technical personnel. 4.Interventional spermatic vein embolization: With the development of interventional radiology, spermatic vein embolization or injection of sclerosing agent for the treatment of primary spermatic varicose veins has become a common method in developed countries. This method involves selective or super-selective injection of embolic material such as spring steel wire or sclerosing agent into the internal spermatic vein through a catheter to occlude the varicose vein (lead rubber can be used to protect the scrotum). Since all treatment steps are done within the vein, arteries, nerves and lymphatics are preserved, thus significantly reducing recurrence and complications such as testicular syringomyelia and testicular atrophy, and there is no effect on sexual function. This method is both a means of diagnosing varicocele and a good treatment method. Interventional embolization of varicocele has the advantages of no incision, less pain, avoiding post-surgical complications such as scrotal edema and hematoma, higher success rate than surgical ligation, lower recurrence rate, repeatability, and few complications than traditional surgical ligation, so it has become the preferred treatment for varicocele.