Varicocele is a common disease in young adult men with an incidence of about 15%. However, most patients have no obvious symptoms and are only detected during physical examination. The few patients who have symptoms mainly feel painful scrotal swelling, sometimes radiating to the groin and perineum. The symptoms worsen after prolonged standing or walking and are relieved after lying down and resting. Of course, in severe cases, the pain may affect walking or cause neurological weakness. The above symptoms are sometimes similar to prostatitis, and when the examination is not careful, it is often treated as prostatitis, which is not effective. In fact, during the examination, a worm-like mass of varicose veins can be seen above the front of the scrotum in a standing position, and ultrasound examination can clarify the degree of varicose veins, so that the diagnosis is basically clear. What causes varicocele? Varicocele is a pathological phenomenon in which the varicose veins of the spermatic cord are dilated, tortuous and elongated due to poor reflux caused by various reasons. 99% occur on the left side and 1% are bilateral. The causes are abnormal or defective internal spermatic vein valves, injection of the left internal spermatic vein at right angles into the left renal vein causing difficulty in blood return, atrophy and relaxation of the fibrous sheath of the spermatic muscle, and degeneration of the trapezius plexus. In addition to the uncomfortable symptoms varicocele can cause, many clinical patients with varicocele also have a combination of oligozoospermia and azoospermia, which affects fertility. This is mainly due to the reflux of metabolites such as catecholamines in the blood that affect the spermatogenic function of the testes, as well as the lack of good reflux to the testes, which affects the temperature regulation of the scrotum and is detrimental to sperm development. Therefore, if you suspect the disease, you should go to a hospital to check the quality of sperm along with a clear diagnosis. Early treatment is needed to avoid further deterioration of sperm quality, which may affect fertility. For asymptomatic or mildly symptomatic patients, if the examination reveals no abnormal sperm quality, observation can be considered. However, it is necessary to first of all keep a relaxed mood, avoid anger that hurts the liver and spicy food; secondly, pay attention to the combination of work and rest, prevent strenuous exercise, heavy physical labor and prolonged standing; finally, abstain from sexual intercourse and often wear tight underwear or use a scrotum support to prevent the scrotum from falling down. For patients with obvious symptoms or sperm abnormalities, surgical treatment is available. Some patients can regain their fertility after surgery. The principle of surgery is to cut and ligate the internal spermatic vein high above the internal inguinal ring. The current surgical options are open surgery, laparoscopic high ligation of the spermatic vein and microscopic ligation of the spermatic vein. The first one is a traditional surgical procedure and the latter two are minimally invasive surgical procedures. Laparoscopic surgery mainly reflects the advantage of high ligation, while microscopic surgery mainly reflects the advantage of precise ligation without missed ligation and wrong ligation. It is a common disease in young and strong men, but for patients over 35 years old with sudden onset, careful examination is necessary to exclude that it is caused by compressive lesions, such as: renal tumor, ureteral tumor, retroperitoneal tumor, hydronephrosis, perirenal pus accumulation, vagus vessel, iliac vein obstruction, etc. It is worth paying attention to the fact that the degree of varicocele is not proportional to the self-perceived symptoms, so the disease should not be treated idly, and the primary cause should be investigated and targeted treatment should be carried out to avoid delaying the disease.