1.What is varicocele The dilated, curved and lengthened trapezoidal plexus of the spermatic cord is called varicocele. Varicocele is mostly seen in young people aged 20 to 30, with an incidence of about 12. Infertility due to varicocele accounts for 9 to 41 of male infertility. Varicocele is usually asymptomatic and is mostly found during routine physical examinations, or painless earthworm-like masses in the scrotum are found during self-examinations, or during visits to the doctor because of infertility. Some patients may have symptoms such as cramping, vague pain and discomfort, which may be aggravated after prolonged standing or walking and may be relieved or disappear after lying down. It can be combined with varicose veins of lower limbs, hemorrhoids and other diseases. 2, varicocele causes male infertility, scrotal temperature, nutritional disorders, testicular endocrine dysfunction, the role of toxins, the destructive effect of oxygen free radicals, etc. Varicocele is related to semen abnormalities, testicular volume decrease, testicular atrophy, testicular perfusion decrease and testicular spermatogenic dysfunction, etc. 3, varicocele surgery indications ① varicocele infertility, the presence of abnormal semen examination, medical history and physical examination does not find other diseases affecting fertility, endocrine examination is normal, female fertility examination no abnormal findings, regardless of the severity of varicocele, as long as varicocele diagnosis once established, should be timely surgery. ②Severe varicocele with obvious symptoms, such as more standing after feeling the pain of scrotal swelling, easy to strain, etc., physical examination found that the testicles are obviously shrinking, even if there is fertility, can also consider surgery. (3) For adolescent varicocele, since it often leads to pathological and progressive changes in the testis, it is now advocated that surgery should be performed as early as possible for adolescent varicocele with testicular volume reduction, which can help prevent infertility in adulthood. The incidence of prostatitis and seminal vesiculitis in patients with varicocele increases significantly and is twice as high as that of normal people, so if the above two diseases exist at the same time and prostatitis is not cured for a long time, varicocele surgery is also recommended. ⑤ For patients with mild varicocele, if the semen analysis is normal, they should be followed up regularly, and once the semen analysis is abnormal, the testicles shrink and the texture becomes soft, they should be operated in time.