I. What is varicocele? Varicocele is the dilatation and tortuosity of the trapezius plexus of the saphenous vein, which is an important cause of male infertility, accounting for about 15% of the male population and 35%-40% of the male infertility population. Because of the anatomical location, it is easy to occur on the left side, but recently it has been found that bilateral occurrence is not uncommon. What are the manifestations and dangers of varicocele? Normal sperm development and maturation in the testes requires a cold local environment in the testes, but in the case of varicocele, poor reflux leads to blood stagnation, which in turn leads to high scrotal temperature, affecting poor sperm quality and eventually leading to infertility. Since the venous system is connected on both sides, the sperm function of the testes on the opposite side is also affected. At the same time, blood stagnation in the spermatic vein can lead to testicular swelling and discomfort. Third, do patients with varicocele need to be treated? What kind of modality is more appropriate? Whether primary varicocele needs to be treated and what kind of treatment should be taken should be treated differently according to whether the patient has infertility or abnormal semen quality, whether there are clinical symptoms, the degree of varicocele and whether there are other complications. At present, the commonly used treatment methods are mainly surgical methods, psychological intervention, scrotal support method, cooling therapy, medication, diet regulation and so on, but at present, mainly surgical methods are used. What kind of varicocele needs surgery? Surgery can be considered in the following cases: 1. If the varicose veins can be palpated during scrotal palpation or the symptoms are obvious, and the testicles are found to be significantly shrunken during physical examination, surgery can be considered even if the patient has already given birth. 2, combined with male infertility, excluding other causes of male infertility and female factors, regardless of the degree of varicocele, should be timely surgery. 3, varicocele combined with recurrent vesiculitis, prostatitis, surgery can be considered. 4, adolescents with varicocele accompanied by testicular volume reduction, advocate early surgery. 5.Seminal fluid treatment abnormalities, those who have fertility requirements, regardless of the degree of varicocele, should be operated in time. V. How many types of surgery are there? The surgical treatment of varicocele mainly includes retroperitoneal spermatic vein high ligation, laparoscopic spermatic vein high ligation and microscopic spermatic vein ligation. Currently, the level of surgery and medical equipment varies from hospital to hospital in China, so does the type of surgery used. The spermatic cord contains blood vessels (including the internal spermatic artery and the internal spermatic vein) and lymphatic vessels, and varicocele surgery requires ligation of all spermatic veins while protecting the internal spermatic artery and lymphatic vessels. Due to the anatomical characteristics of the spermatic cord and the different surgical approaches and sites, the three surgical approaches currently in use have different surgical outcomes and postoperative complication rates. The main postoperative complications include recurrence, syringomyelia, and testicular atrophy due to testicular artery injury. Microscopic spermatic vein ligation has unparalleled advantages over other surgical methods in terms of surgical results and complications. What are the advantages of microscopic spermatic vein ligation? Currently, microscopic ligation has become the procedure of choice for the treatment of varicocele in the United States. In China, due to the constraints of concept, technical level and equipment conditions, it is only carried out in a small number of large hospitals and is far from popular, but there is an emerging trend like a spring. At present, our department has carried out this operation since 2015, and now we have performed microscopic ligation of the spermatic vein via small incision under the external ring according to the international standard operation, and the treatment effect is very satisfactory. Through microscopic spermatic vein ligation, we can maintain the integrity of the vas deferens and its vascular system because the testicular arteries, lymphatic vessels and veins with small diameters are magnified 10 times under microscopic static, and at the same time we can clearly free and ligate all the internal veins of the spermatic cord, and at this time we can also ligate the branches of the external veins of the spermatic cord because of the trans-inguinal incision. Therefore, the postoperative complication rate and the overall assessment of the improvement of semen parameters and conception rate of microscopic technique spermatic cord ligation are significantly better than other methods.