Scrotal Surgery — Cysts, Hydrocele & Varicocele
Consultant-led microsurgical procedures for the full range of scrotal conditions — epididymal cysts, hydrocele, varicocele, and vasectomy. Discreet, expert care in a private setting with rapid surgical access.
Microsurgical Precision
Zeiss operating microscope available for procedures requiring the highest precision — varicocele repair and microsurgical reconstruction.
Rapid Surgical Access
No long NHS waiting lists. Procedures typically arranged within weeks of consultation.
Day Case Procedures
Most scrotal procedures are performed as day cases under local or general anaesthetic — you go home the same day.
OVERVIEW
Expert Scrotal Surgery — When You Need It
Erectile dysfunction affects an estimated 1 in 5 men in the UK — rising significantly with age, but increasingly common in younger men too. Despite being so prevalent, most men delay seeking help for years due to embarrassment or the mistaken belief that nothing can be done.
ED is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It can be caused by physical factors, psychological factors, or — most commonly — a combination of both. Understanding which is driving your symptoms is the key to effective treatment.
Importantly, ED in men under 50 is associated with an increased risk of cardiovascular disease. The blood vessels that supply the penis are small and can show signs of disease earlier than larger vessels. A proper assessment is therefore not just about sexual function — it can be an important health check.
Important — Always Investigate First
Any new scrotal swelling, lump or change should always be assessed by a specialist before surgery is considered. Ultrasound examination is routine. Testicular cancer, while uncommon, must be excluded — and the management is completely different from benign conditions.
Mr. Jesuraj will always ensure a proper diagnosis before recommending any procedure.
PROCEDURES OFFERED
Scrotal Surgical Procedures
Each procedure is tailored to your specific condition and anatomy — with a full explanation of what is involved, the risks, and the expected recovery.
Epididymal Cyst Excision
Removal of benign fluid-filled cysts from the epididymis
Epididymal cysts are common, benign fluid-filled sacs that develop behind the testicle. Most are asymptomatic and require only reassurance. Surgery is considered when the cyst causes significant discomfort, is enlarging, or is causing the patient significant distress.
The cyst is carefully excised through a small scrotal incision, preserving the surrounding epididymis and testicular blood supply. Mr. Jesuraj uses loupe or microscope magnification to ensure precision.
DAY CASE · LOCAL OR GA
ANAESTHETIC
Local or general anaesthetic
SETTING
Day case — home same day
DURATION
30–45 minutes
RECOVERY
1 week — avoid strenuous activity
RETURN TO WORK
3–5 days (desk work)
Hydrocelectomy
Surgical repair of fluid collection around the testicle
A hydrocele is a collection of fluid within the tunica vaginalis — the lining that surrounds the testicle. It typically causes a smooth, painless swelling that transilluminates (glows when a light is shone through it). Large hydroceles cause significant discomfort and affect quality of life.
Surgical treatment (hydrocelectomy) involves everting or excising the sac of fluid. This is a reliable, definitive procedure with excellent results. Aspiration (needle drainage) is a temporary measure that is rarely recommended as recurrence is almost certain.
DAY CASE · GA
ANAESTHETIC
General anaesthetic
SETTING
Day case — home same day
DURATION
30–45 minutes
RECOVERY
1–2 weeks
RETURN TO WORK
5–7 days (desk work)
Microsurgical Varicocele Repair
Treatment of enlarged scrotal veins — the most common correctable cause of male infertility
A varicocele is a dilatation of the pampiniform venous plexus within the scrotum — similar to varicose veins in the leg. It is found in 15% of the general male population and in up to 35% of men presenting with infertility. Varicoceles raise scrotal temperature, impairing spermatogenesis.
Microsurgical varicocele repair (subinguinal microsurgical varicocelectomy) is the gold standard technique. Using the Zeiss operating microscope, Mr. Jesuraj identifies and ligates the dilated veins while carefully preserving the testicular artery, lymphatics and vas deferens — minimising the risk of hydrocele formation and testicular atrophy that is associated with non-microsurgical approaches.
★ MICROSURGICAL · DAY CASE
ANAESTHETIC
Local or general anaesthetic
SETTING
Day case
DURATION
45–90 minutes
RECOVERY
1–2 weeks
FERTILITY IMPACT
Improvement in 60–70% of infertile men
Vasectomy
Permanent male contraception — consultant-led procedure
Vasectomy is a highly effective, permanent form of male contraception performed under local anaesthetic. A private vasectomy with Mr. Jesuraj includes a full pre-operative consultation, counselling and semen testing follow-up — performed by a consultant urologist, not a GP.
LOCAL ANAESTHETIC · 30 MINS
ANAESTHETIC
Local anaesthetic
DURATION
15–30 minutes
RECOVERY
48 hours rest
EFFECTIVENESS
>99.9% — confirmed by semen test
Circumcision & Foreskin Surgery
For phimosis, BXO (lichen sclerosus) and recurrent balanitis
Circumcision is indicated for phimosis (tight foreskin), Balanitis Xerotica Obliterans (BXO / penile lichen sclerosus), recurrent balanitis, and foreskin tears. BXO is a progressive scarring skin condition that can affect the foreskin, glans and urethra — early treatment significantly improves outcomes.
Preputioplasty (foreskin widening) is an alternative to circumcision in selected patients where the foreskin can be preserved. Mr. Jesuraj will advise on the most appropriate procedure based on your specific condition, including biopsy where BXO is suspected.
DAY CASE · LOCAL OR GA
ANAESTHETIC
Local or general anaesthetic
SETTING
Day case
DURATION
30–45 minutes
RECOVERY
2–4 weeks — avoid intercourse
FERTILITY IMPACT
Routinely sent if BXO suspected
Microsurgical Denervation of the Spermatic Cord
For post-vasectomy pain syndrome and chronic orchalgia
For men with persistent scrotal pain — including post-vasectomy pain syndrome and chronic orchalgia that has failed all other treatments — microsurgical denervation of the spermatic cord offers a surgical option. Under the operating microscope, the pain-transmitting nerves are selectively divided while preserving the testicular artery, vas deferens and lymphatics.
This complex procedure requires specialist microsurgical expertise. Mr. Jesuraj is one of a small number of surgeons in the UK with the training and equipment to perform this procedure safely.
★ SPECIALIST MICROSURGERY
ANAESTHETIC
General anaesthetic
SETTING
Day case
DURATION
60–90 minutes
SUCCESS RATE
Significant pain improvement in ~75% of selected patients
What to Expect
Book a Consultation
A full consultation with Mr. Jesuraj. Examination and ultrasound arranged. Diagnosis confirmed before any surgical discussion.
Procedure Booked
Surgery arranged promptly — typically within weeks. Full pre-operative information provided including consent and preparation advice.
Day of Surgery
Mr. Jesuraj sees you before and after the procedure. Most scrotal procedures are day cases — you go home the same day.
Recovery & Follow-up
Written post-operative instructions. Follow-up appointment included. Mr. Jesuraj is accessible if you have concerns during recovery.
Interested?
Book a consultation with Mr. Jesuraj to find out if you are a suitable candidate. Appointments available within days.