Treatments — Scrotal & Andrology
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.
Zeiss operating microscope available for procedures requiring the highest precision — varicocele repair and microsurgical reconstruction.
No long NHS waiting lists. Procedures typically arranged within weeks of consultation.
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
Many scrotal conditions — while usually benign — cause significant discomfort, anxiety, and impact on quality of life. On the NHS, waiting times for non-urgent scrotal surgery can stretch to 12–18 months. Private care with Mr. Jesuraj means a consultation within days and surgery arranged promptly.
All scrotal procedures at Tees Urology are performed by Mr. Manohar Jesuraj — Consultant Urological Surgeon, FRCS Urol — personally. Not by a junior surgeon or trainee. His microsurgical expertise, developed over two decades, means even complex reconstructive procedures are performed to the highest standard.
⚠️ 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.
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.
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.
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.
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.
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.
Your Journey
What to Expect
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.
Recognised by all major insurers — BUPA · AXA PPP · Vitality · Aviva · Cigna | Self-funding patients always welcome | Fixed transparent fees
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Appointments at Best Life Clinic, Stockton-on-Tees — Monday, Thursday and Friday. Most patients seen within 7 days. No GP referral required.