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Urology · UK

Scrotal surgery - precise, discreet, consultant-led.

Adult scrotal surgery - hydrocele repair, epididymal cyst excision, microsurgical varicocele repair, scrotal lump excision and scrotoplasty. Consultant urologist-led, day-case in almost every scenario, with proper ultrasound and tumour-marker workup first.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private scrotal surgery costs in the UK.

Indicative ranges across our partner UK units.

In short

£2,800–£4,500, home the same day.

Procedure Indicative range
Hydrocele repair (Jaboulay or Lord's), one side £2,800–£4,500
Bilateral hydrocele repair £3,800–£6,000
Epididymal cyst / spermatocele excision £2,200–£3,800
Microsurgical subinguinal varicocelectomy, one side £3,500–£6,000
Bilateral microsurgical varicocelectomy £5,500–£9,000
Scrotal lump excision with histology £1,800–£3,500
Scrotoplasty (redundant scrotal skin) £3,500–£6,500
Urology consultation only £250–£400

Prices vary by hospital, by the consultant, by whether the case is unilateral or bilateral, and by whether microsurgical technique (for varicocele) is used.

The problem

Scrotal surgery is where corners get quietly cut.

A varicocele repaired without magnification recurs. A hydrocele aspirated instead of Jaboulay comes back. A lump excised without ultrasound is a missed cancer.

  • Microsurgery for every varicocele

    Loupe or microscope magnification is what separates a 2 percent recurrence from a 15 percent one. Non-negotiable for fertility cases.

  • Aspiration is not treatment for hydrocele

    Simple aspiration recurs almost every time. Jaboulay or Lord's is definitive and day-case.

  • Ultrasound before every scrotal excision

    A discrete lump can be paratesticular (safe) or intratesticular (cancer). We never operate without knowing which.

When it helps

When scrotal surgery is the right step.

The situations we see most, plus one red flag that means specialist review urgently rather than a routine booking.

  • Hydrocele (painless scrotal swelling)

    Fluid collection around the testis - transilluminates on examination. Repair when it is symptomatic, uncomfortable or bothersome.

  • Epididymal cyst or spermatocele

    A round, smooth, separate lump above the testis - usually benign. Excision when symptomatic or large enough to bother.

  • Varicocele with fertility concern

    A "bag of worms" feel above the testis, often on the left. Microsurgical repair improves sperm parameters in around 60–70 percent.

  • Varicocele with pain or asymmetry

    Aching dull pain on standing, or an atrophic testis - surgical indication independent of fertility.

  • Recurrent scrotal cyst or hydrocele

    Repeat swellings after previous aspiration or surgery - proper excision or Jaboulay repair rather than another aspiration.

  • Scrotoplasty (redundant scrotal skin)

    Age-related or post-weight-loss scrotal skin excess causing hygiene, comfort or cosmetic concerns - surgical reduction.

  • Sebaceous or pilar cyst on scrotal skin

    Discrete skin cysts on the scrotal wall - excision under local anaesthetic when symptomatic or growing.

  • Red flag: solid intratesticular mass

    Any solid, hard lump felt within the testis needs urgent (two-week) urology-oncology workup - not a routine outpatient booking.

Procedure options

Different pathologies, different techniques - one thing in common.

Hydrocele, cyst, varicocele or lump - each has a specific technique. The common thread is proper workup and consultant-level execution.

  • Jaboulay hydrocele repair

    Standard hydrocele operation - the sac is opened, everted around the testis and closed. Low recurrence, standard approach for medium and large hydroceles.

  • Lord's plication for small hydrocele

    For thin-walled, small hydroceles - plicating rather than excising the sac. Less dissection, less swelling. Not suitable for thick-walled sacs.

  • Epididymal cyst excision

    Precise dissection of the cyst off the epididymis - with care to preserve the tubules if fertility matters. Sent for histology routinely.

  • Microsurgical subinguinal varicocelectomy

    The gold standard varicocele operation - 3 cm subinguinal incision, loupe or microscope magnification, artery and lymphatic preservation. Lowest recurrence and hydrocele rates.

  • Laparoscopic varicocelectomy (alternative)

    Bilateral cases sometimes done laparoscopically. Higher hydrocele rate than microsurgical - not our first choice.

  • Embolisation of varicocele (interventional radiology)

    Coil embolisation via femoral vein - a non-surgical alternative, particularly for recurrent varicocele.

  • Scrotal lump excision with histology

    Excision of paratesticular lumps - dermoid cysts, lipomas, adenomatoid tumours - with routine histology to confirm benignity.

  • Scrotoplasty

    Reduction of redundant scrotal skin, with careful preservation of blood supply and cosmesis. Local anaesthetic day-case for most cases.

Safety and recovery

What to expect afterwards - honestly.

Adult scrotal surgery is well established. The important conversations are haematoma prevention, recurrence rates by technique, and - for varicocele - realistic fertility expectations.

  • Day-case for almost everything

    Home the same day. Small operations under local anaesthetic in the treatment room; hydrocele, varicocele and lump excision under GA or spinal in theatre.

  • Scrotal haematoma

    The most common complication - a boggy blue-purple scrotum for 2–4 weeks. Scrotal support and ice-pack use in the first 48 hours reduces its size. Under 3 percent need drainage.

  • Wound infection

    Under 2 percent in clean day-case scrotal surgery. Prophylactic antibiotics are not routine but used at surgeon discretion. Call same-day for spreading redness, discharge or fever.

  • Recurrent hydrocele

    Around 5 percent after Jaboulay, higher after Lord's for larger sacs, higher again after simple aspiration. Choice of technique matters.

  • Varicocele: hydrocele and recurrence

    Hydrocele in around 5 percent after non-microsurgical repair, under 1 percent with microsurgery. Recurrence 2–5 percent microsurgical, higher for other techniques.

  • Testicular atrophy (varicocele)

    Rare and specific to inadvertent testicular artery injury - under 1 percent with proper microsurgical technique.

  • Chronic scrotal pain

    A small minority develop persistent scrotal ache after any scrotal surgery - often nerve-related. Preventive gentle handling and cord-avoidance techniques reduce it.

  • Fertility after varicocelectomy

    Sperm parameters improve in 60–70 percent by 3–6 months. Pregnancy rate improves modestly. Expectations set honestly before consent.

  • Red flags after surgery

    Rapidly enlarging scrotum, severe pain, fever, breathlessness, or new hard testicular lump on the other side need same-day team review, not a routine call.

Reading your notes

Your notes in four parts. Read the last one first.

Whether hydrocele, cyst, varicocele or lump, the operation note the urologist sends you keeps to the same shape.

A UK consultant urologist reviewing a scrotal ultrasound report

A quiet reminder

Clinical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through your notes before your review, just ask.

  1. 01 Header

    Diagnosis, side and procedure

    Which pathology (hydrocele, cyst, varicocele, lump), which side, and which specific technique was used.

  2. 02 Technique

    Approach and magnification

    Incision site, use of loupes or microscope (for varicocele), preservation of testicular artery and lymphatics.

  3. 03 Findings

    Anatomy, contents and adjacent structures

    Fluid volume in a hydrocele, cyst characteristics, condition of the epididymis and vas, and any incidental findings.

  4. 04 Impression

    Aftercare, histology and semen plan

    Read this first: wound care, scrotal support duration, activity restrictions, histology follow-up, and semen analysis timing for varicocele cases.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Scrotal surgery is usually covered when symptomatic or diagnostically indicated. Purely cosmetic scrotoplasty is typically self-pay.

Frequently asked

Everything we get asked about scrotal surgery.

Quick answers on hydrocele, varicocele, fertility, cost and recovery.

  • How do you tell a hydrocele from a cyst or a varicocele?

    A hydrocele is a fluid collection around the testis - it transilluminates when a light is shone through it, and the testis often cannot be felt separately. An epididymal cyst is a discrete round lump above the testis, and the testis feels separately. A varicocele feels like a bag of worms above the testis, often on the left, and reduces when you lie down. All three are cleared up definitively by scrotal ultrasound - which we always do before surgery.

  • What is microsurgical varicocelectomy and why does it matter?

    Microsurgical subinguinal varicocelectomy uses an operating microscope or high-magnification loupes through a 3 cm groin-level incision. The magnification allows the surgeon to identify and preserve the testicular artery and lymphatic vessels while dividing every dilated vein. It has the lowest recurrence rate (2–5 percent) and lowest post-op hydrocele rate (under 1 percent) of any varicocele technique - which is why it is the gold standard for fertility-driven repair.

  • How much does private scrotal surgery cost in the UK?

    Roughly £2,800–£4,500 for hydrocele repair, £2,200–£3,800 for epididymal cyst excision, £3,500–£6,000 for microsurgical varicocelectomy, £1,800–£3,500 for scrotal lump excision, and £3,500–£6,500 for scrotoplasty. Consultation is £250–£400.

  • How long is recovery after scrotal surgery?

    Home the same day. Back to office work in 3–7 days, driving from 3–5 days when comfortable, and no heavy lifting or cycling for 3–4 weeks. Snug scrotal support day and night for the first week and daytime for the second week substantially reduces swelling and bruising.

  • Will scrotal surgery affect my fertility?

    Elective hydrocele or epididymal cyst surgery has a small but real risk of affecting sperm transport if the epididymis or vas is inadvertently injured - under 2 percent in experienced hands. If future fertility matters, we say so before consent and consider sperm banking. Microsurgical varicocelectomy usually improves fertility rather than harming it.

  • Can I just aspirate a hydrocele instead of surgery?

    You can, but almost every hydrocele returns within weeks to months after simple aspiration, and repeated aspiration carries infection risk. It has a place - a frail patient not fit for surgery, or a temporary comfort measure - but it is not a definitive treatment. Jaboulay or Lord's repair gives lasting closure with a low recurrence rate.

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