Treatment of severe varicocele: 1. If it is left spermatic varicocele, which is related to anatomical factors, it is recommended to perform ultrasound of spermatic cord and urological ultrasound, and surgical ligation can be chosen if there is no contraindication to surgery. The surgical method can be chosen as trans-laparoscopic internal spermatic vein high ligation or microsurgical spermatic vein ligation, which can be recovered by restorative treatment after surgery. 2. If the varicose veins are severe bilaterally, the presence of retroperitoneal compression factors is considered, and it is recommended to perform retroperitoneal CT examination to clarify whether there are retroperitoneal lesions causing bilateral lesions. If the compression is caused by retroperitoneal lesion, it is suggested to treat the primary disease, then the varicocele can be relieved naturally.3. Ultrasound examination of renal vascular nutcracker syndrome is needed to exclude whether secondary varicocele is caused by nutcracker syndrome. If the secondary severe varicocele is caused by Nutcracker syndrome, then it is necessary to go to vascular surgery to perform renal vein protection surgery, and the varicocele can be relieved since then.