Varicocele is an abnormal expansion, lengthening and tortuosity of the trapezius plexus in the spermatic cord. It is a common disease in men, mostly in young adults between the ages of 20 and 30, with an incidence of about 10% to 15% of the male population. 1.How do varicocele occur? Varicocele is caused by poor blood flow in the spermatic vein due to various reasons and is formed in the veins. It occurs mostly on the left side and accounts for 80% to 90% of the total incidence. The reason is related to male anatomical characteristics. 2.What are the common manifestations of varicocele? Persistent or intermittent swelling, vague or dull pain in the scrotum or testicles, often radiating to the perineum and groin on the same side. It is obvious after prolonged standing or prolonged walking, and relieves after lying down or resting. Patients with severe symptoms may have headache, fatigue, neuropsychiatric symptoms and sexual dysfunction. The affected scrotum and testicles are lower than the healthy side when the patient is standing, and in severe cases, earthworm-like varicose veins are visible and palpable. The Valsalva test can help determine the presence of varicose veins, i.e., the patient holds his breath when standing to increase abdominal pressure, so that the blood return is blocked, which helps to find veins with inconspicuous varicose. 3.The varicose veins can be divided into three degrees according to the severity. Degree I: varicose veins are not visible when standing, but only palpable. varicose veins increase during Valsalva test and disappear after lying down. Degree II: varicose veins can be seen and palpated when standing, and can be reduced or disappeared when lying down. Grade III: The varicose veins around the spermatic cord, epididymis and scrotum have obvious varicose veins, and the varicose disappears slowly or not after lying down. 4.Does varicocele cause male infertility? Varicocele accounts for 2% to 15% of the causes of male infertility. At present, it is believed that varicocele will lead to blood stasis in the veins, resulting in increased local temperature, CO2 accumulation in testicular tissues and increased levels of blood cortisol, catecholamines, 5-hydroxytryptamine and prostaglandins, thus affecting the blood supply to the testes and normal spermatogenic function and causing male infertility. 5.How to treat varicocele? The effective treatment for varicocele is surgery (high level ligation of spermatic veins). However, not every patient needs surgery. For those who have no obvious symptoms and signs, no fertility requirements or normal sperm quality, they may not be treated.