Modified high varicocelectomy: outpatient microsurgical procedure

Fifty patients underwent modified high varicocelectomy as outpatients. Twelve of the 22 unilateral varicocelectomies were performed under local anesthesia. All patients tolerated the procedures well, and none required admission to the hospital. The modified high approach, which exposes the area above the internal inguinal ring and of the posterior spermatic cord, is straightforward and insures that both internal spermatic and cremasteric veins can be ligated. Use of the operating microscope prevents the inadvertent ligation of the testicular artery and lymphatics.