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February 19, 1982

Treatment of Varicoceles

JAMA. 1982;247(7):979. doi:10.1001/jama.1982.03320320019017

To the Editor.—  The article on "Balloon Occlusion of the Internal Spermatic Vein for the Treatment of Varicoceles" by Patrick C. Walsh, MD, and Robert I. White, MD (1981; 246:1701), is indeed interesting. This technique of using a detachable balloon to occlude the internal spermatic vein to cure varicocele is ingenious and obviously effective. However, I would take issue with the statement, "This procedure can be performed easily, without general anesthesia or surgical incision, on an outpatient basis." For expertly trained radiologists, this procedure may be performed easily, but for the average physician or surgeon, this is not a simple maneuver and would be difficult to perform.It appears to me that this mechanism is much more complicated than the simple ligation of the internal spermatic vein at the internal inguinal ring that cures most varicoceles readily. This can be done in any outpatient surgery under local or general anesthesia