Varicocele is also caused by impaired spermatic venous reflux. They are characterized by scrotal cramping, swelling and pain, which are aggravated by walking and exertion and relieved when lying down. If varicose veins are present during adolescence, fertility will be affected after marriage. Varicocele accounts for 14% of male infertility. In mild cases, elastic pants or scrotal brace can be worn, but in severe cases, high spermatic vein ligation is required. In varicocele, when standing, the scrotum is distended, with a feeling of heaviness and swelling, and even painful discomfort, which may radiate to the lower abdomen, groin or thighs, and is aggravated when standing and walking, and relieved after lying down and resting. Clinical symptoms and the degree of varicocele can be inconsistent; some patients with very severe varicocele can have no symptoms, while others with mild varicocele can have more severe cramping pain and even neurological symptoms such as insomnia, loss of appetite and dizziness. Because varicocele can have significant adverse effects on the testicles, it can cause abnormal semen quality in men. Studies have found that up to 54.8% of varicocele is associated with abnormal semen quality, which can affect male fertility. The incidence of varicocele is 39% in men with infertility and 60% to 70% in those with secondary infertility.