Concierge urology · UK
Epididymectomy, explained honestly.
A day-case operation to remove the epididymis — most often for chronic post-vasectomy pain. Done under GA in a proper theatre, by a consultant urologist with an andrology interest.
Why patients choose us
- 01
A consultant urologist, in theatre
A named andrology-interested urologist, a proper day-case theatre, and general anaesthetic with local infiltration — not a shortcut.
- 02
Honest about outcomes
Epididymectomy helps 60–80% of men with post-vasectomy pain — worth saying out loud before you consent to surgery.
- 03
Independent, and free
We are paid by no clinic, so the recommendation — including whether surgery is the right step at all — is impartial.
Indicative pricing
What a private epididymectomy costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A unilateral epididymectomy in our network: £3,200–£5,500, home the same day.
| Procedure | Indicative range | Typical duration | Discharge |
|---|---|---|---|
| Epididymectomy — unilateral, day case | £3,200–£5,500 | 60–90 min | Same day |
| Epididymectomy — bilateral | £4,800–£7,500 | 90–120 min | 24-hour stay |
| Diagnostic spermatic cord block (trial) | £450–£850 | 20 min LA | Same visit |
| Scrotal ultrasound + tumour markers | £350–£650 | 30 min | 24–48 hours |
| Andrology consultation | £250–£450 | 30–45 min | Same visit |
| Post-op review (6 weeks) | Included | 20 min | Same visit |
Prices vary by clinic, by which urologist does the case, by whether one or both sides are operated, and by whether any extra work (cyst excision, vas ligation) is added on the day. We come back with a firm quote within one working day.
The problem
The right workup, the right block, and the honest conversation.
Epididymectomy for chronic scrotal pain is a good operation for the right patient — and a disappointing one for the wrong patient. The workup matters as much as the surgery.
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Sure it is the epididymis?
A scrotal ultrasound and tumour markers first, always — testicular pathology has to be excluded before we talk about surgery.
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Have you had a cord block?
A diagnostic local anaesthetic block that abolishes your pain is the best single predictor of a good result.
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Weighed the honest odds?
60–80% of men with post-vasectomy pain are better after surgery. A minority are unchanged, and a small subset feel worse.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the diagnostic block and the recovery window.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A day at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Site of pain, how long, triggers, whether you have had a vasectomy or previous infections.
- 02
Before
Specialist review comes first
An andrology-interested urologist reviews you — with a scrotal ultrasound and tumour markers if not already done — to rule out other causes.
- 03
Before
A trial of conservative care
Prolonged antibiotics, nerve-modulating medication or a diagnostic cord block are usually tried before surgery is offered.
- 04
On the day
Arrival at the day-case unit
Arrival, consent, and a chat with the urologist and anaesthetist. General anaesthetic with local infiltration for post-op comfort.
- 05
On the day
The procedure itself
A small 2–3 cm scrotal incision, the epididymis is carefully separated from the testis and removed. Typically 60–90 minutes.
- 06
On the day
Home the same day
Day case for one side; a 24-hour stay if both sides are done. Scrotal support, dissolvable sutures, written aftercare.
- 07
After
Recovery and review
Scrotal support for two weeks, no sex or heavy lifting for two to three weeks, off work one to two weeks. A review at six weeks.
Typical end-to-end: 3–6 weeks from enquiry to procedure. Full recovery: 2–3 weeks.
When it helps
When epididymectomy is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Chronic post-vasectomy pain syndrome
The commonest UK indication — dull, dragging scrotal pain months or years after vasectomy, unresponsive to conservative care.
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Chronic epididymitis
Persistent epididymal inflammation and tenderness that has not settled with prolonged courses of appropriate antibiotics.
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Recurrent painful epididymal cysts
Multiple or recurrent cysts (spermatoceles) causing genuine pain — when simple excision is not enough.
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Tuberculous epididymitis
A rare but recognised indication — usually alongside anti-TB medical therapy under specialist care.
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Sperm granuloma at the vasectomy site
A tender nodule of leaked sperm forming after vasectomy — a small subset need surgical removal.
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Failed conservative management
When antibiotics, anti-inflammatories, nerve-modulating drugs and a diagnostic cord block have all been tried without relief.
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A positive diagnostic cord block
A temporary local anaesthetic block that removes the pain is the best predictor that epididymectomy will help.
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Red flag: sudden severe pain
Acute, severe scrotal pain — especially in a younger man — is a surgical emergency (torsion). Go to A&E, not a clinic.
Procedure options
Epididymectomy is not the only option.
What each option on the table actually involves — and which fits which problem.
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Unilateral epididymectomy
Removal of the epididymis on the affected side. The commonest form of the operation. Day case under GA with local infiltration.
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Bilateral epididymectomy
Both sides in one sitting when pain is bilateral. Usually a 24-hour stay. Considered carefully given the additive risk.
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Diagnostic spermatic cord block
A local anaesthetic injection at the cord — if it abolishes your pain, epididymectomy is much more likely to help. A key step before surgery.
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Simple epididymal cyst excision
An alternative when a single, well-defined cyst is the source of pain — the epididymis itself is preserved where possible.
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Vasectomy reversal (alternative)
For some men with post-vasectomy pain, reversal relieves the pressure and the pain — worth discussing before choosing epididymectomy.
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Microsurgical spermatic cord denervation
A newer option that targets the nerves rather than the epididymis. Not offered everywhere — we say so if it might suit you.
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Continued conservative care
Nerve-modulating drugs, pelvic-floor physiotherapy and a pain-clinic referral remain reasonable if surgery is not right for you.
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Andrology consultation only
An honest discussion of whether surgery is the right step, and which pathway fits — no obligation.
Our vetted UK network
A small panel of urologists, we picked them.
Consultant urologists with an andrology or scrotal-pain interest across the UK. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every urologist in our network.
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Consultant urologists with an andrology or scrotal-pain interest, not general trainees
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General anaesthetic and day-case theatre with an anaesthetist present
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Diagnostic cord block offered first — never straight to theatre for chronic pain
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Realistic pre-op counselling on outcomes, and on the small subset who develop new pain
Safety and recovery
What to expect afterwards — honestly.
Epididymectomy is a common day-case operation with a modest recovery — but the outcomes for chronic pain are variable, and it is important to know that before consenting.
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Outcomes are variable — that is the honest answer
For post-vasectomy pain, roughly 60–80% of men are meaningfully better after surgery. A minority get no improvement, and a small subset feel worse.
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Haematoma is the commonest complication
A scrotal collection of blood affects 5–10% of men. Scrotal support, ice and rest for the first 48 hours make it much less likely.
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Infection risk 2–5%
Redness, swelling or discharge in the first two weeks — call the clinic the same day. Antibiotics are usually enough.
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Chronic testicular pain can persist or worsen
The operation is done to relieve pain, but a minority of men have ongoing or new pain after surgery. This is the single most important thing to weigh.
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Testicular atrophy is rare but real
The blood supply to the testis runs close to the epididymis. Careful technique keeps atrophy below 5%, but it is not zero.
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Fertility on that side is effectively lost
If the vas is intact, hormones and libido are unaffected — but sperm return via that testis is gone. It matters only if you are contemplating vasectomy reversal.
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Cosmetic irregularity is normal
The testis on the operated side often feels smaller or differently shaped. This is expected and rarely a problem.
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Recovery is quicker than you might expect
Scrotal support for two weeks, no sex or heavy lifting for two to three weeks, driving after 48 hours if comfortable, off work one to two weeks.
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Red flags
Fever, spreading redness, heavy scrotal swelling or severe pain after surgery are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the urologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and side operated
Why the procedure was done — post-vasectomy pain, chronic epididymitis, recurrent cysts — and which side or sides were treated.
- 02 Technique
Anaesthetic and surgical technique
General anaesthetic with local infiltration, the length of the scrotal incision, and whether the vas was tied and divided.
- 03 Findings
Epididymal appearance and histology
What the epididymis looked like at surgery, whether cysts or granulomas were present, and the histology of the removed tissue.
- 04 Impression
Recovery, activity limits, review timing
Read this first: expected recovery, when to return to sex, exercise and work, and when the six-week review is booked.
Recognised by major UK insurers
Cover for epididymectomy varies by insurer — usually funded when medically indicated for pain unresponsive to conservative care. We confirm cover before booking.
Frequently asked
Everything we get asked about epididymectomy.
Quick answers on outcomes, risks, fertility and how much time off work you actually need.
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What is an epididymectomy?
A day-case urology operation to remove the epididymis — the coiled tube behind the testis that stores sperm. It is done through a small 2–3 cm scrotal incision under general anaesthetic with local infiltration, typically taking 60–90 minutes.
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Who is it for?
Most commonly for chronic post-vasectomy pain syndrome, chronic epididymitis unresponsive to prolonged antibiotics, recurrent painful epididymal cysts, tuberculous epididymitis, and sperm granulomas at the vasectomy site.
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How likely is it to relieve my pain?
Honestly, 60–80% of men with post-vasectomy pain are meaningfully better after epididymectomy. A minority feel no different, and a small subset develop new pain — often elsewhere in the scrotum or groin. A diagnostic cord block beforehand is the best predictor of a good outcome.
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What are the main risks?
Haematoma in 5–10%, infection in 2–5%, ongoing or worsened chronic testicular pain in a minority, testicular atrophy from vascular compromise in under 5%, cosmetic irregularity, sperm granuloma at the vas stump, and — rarely — new pain in a different site.
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Will it affect fertility or hormones?
Hormones, libido and erections are unaffected. If the vas is intact, sperm production continues but sperm from that testis can no longer reach the ejaculate — which matters only if you are thinking about a vasectomy reversal later.
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How long is recovery?
Scrotal support for two weeks, no sex or heavy lifting for two to three weeks, driving after 48 hours if comfortable, and one to two weeks off work depending on your job. A review at six weeks.
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What should be tried before surgery?
A specialist andrology review, a scrotal ultrasound and tumour markers to exclude testicular pathology, a prolonged course of antibiotics if infection is suspected, nerve-modulating medication such as amitriptyline or gabapentin, and a diagnostic spermatic cord block. Only after these should surgery be offered.
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