Varicocele is an abnormal dilatation of the spermatic veins in the scrotum. The incidence is 15% in adult and adolescent males and less in prepubescent. It is more frequent on the left side and is associated with the left side being 8 to 250 px longer than the right side, with the left spermatic vein entering the renal vein at a right angle, or it may be due to venous valve insufficiency, renal vein thrombosis or other retroperitoneal tumor compression. In severe varicocele, increased temperature in the ipsilateral scrotum and pathophysiological changes in the testes are the cause of low fertility in adult men. I. Clinical manifestations Mild cases are asymptomatic, while severe cases may have a feeling of scrotal swelling. II. Diagnostic points 1. The scrotum presents a typical earthworm pouch-like shape, which is like curved cords when touched. 2.If the scrotum and penis also have varicose veins, it means there are varicose veins leading to the femoral vein. 3.The varicose veins are significantly reduced when lying flat, which is primary. No decrease for obstructive, need further examination for the cause. 4.If available, spermatic venography can be done to choose the appropriate treatment. Treatment plan and principles 1.High spermatic vein ligation without dilated veins on the surface of penile scrotum. The varicose vein is obviously reduced in lying position, compressing the inner ring of inguinal canal, while standing immediately afterwards, the veins in the scrotum do not expand immediately. It indicates that it can be controlled and is appropriate to use. 2.Low ligation to compress the internal ring of inguinal canal is used if the expansion of intra-scrotal veins cannot be controlled. Ligation of all varicose veins. 3.Laparoscopic varicocele ligation can be used for those who have the condition and is more suitable for those who have bilateral varicocele in adolescence.