Penile & Scrotal Conditions
Penile / Scrotal conditions and Vasectomy
These include various lumps, bumps and skin conditions around the genitalia. Cancers are relatively rare but very treatable and therefore an early expert opinion can be provided at South Coast Urology. Most conditions are benign but can significantly affect quality of life by causing pain and irritation or by inhibiting sexual activity.
Foreskin problems / Circumcision
At birth the foreskin is not retractile. Over time this changes and it usually retractile by the late teenage years, but for some it can be later. If the foreskin is traumatised or develops a skin condition such as balanitis xerotica obliterans, then it may split, particularly during sex, and be very painful.
The tightness is described as a phimosis. Occasionally these may ease with topical treatments such as steroids or simply be helped by a physical protection such as a condom. However, if persistent then a circumcision may be required. Occasionally, the issue is secondary to a tight frenulum (Banjo string) or a narrow ring restriction. The former is often improved by a frenuloplasty and the latter occasionally improved by a preputioplasty.
Circumcision is a day case procedure taking 30-40 mins. Most are performed under general anaesthetic but can be done under local anaesthetic.
Testicular Cancer
The vast majority of scrotal lumps are benign. Lumps outside the testicle are rarely cancer. Testicular cancer is the commonest cancer in men aged about 20 – 50 and although rare above this age, there are certain forms that occur.
A physical examination by a South Coast Urology expert is likely to provide rapid reassurance or concern. We will often recommend an ultrasound to confirm the findings and may suggest further blood tests.
If you are unfortunate and testicular cancer is diagnosed, the important fact to remember is that the vast majority are cured.
Hydrocoele / Fluid around testicle
This is a benign condition and does not require treatment unless the swelling is causing bother. The precise cause is often unknown but they can occur secondary to trauma or operations in the groin. It is usually a smooth fluctuant swelling and is not usually painful. It is important to rule out a hernia and we usually suggest an ultrasound to check the underlying testicle is normal.
They are treated by a day case operation taking about 40 mins under a general anaesthetic.
Epididymal cyst
These are cysts that form in the tubes behind the testicles. They are benign but can cause discomfort or get in the way as they get larger.
An expert examination by one of the South Coast Urology surgeons is likely to confirm the diagnosis but we will often suggest an ultrasound to confirm. If necessary, epididymal cysts can be excised under a general anaesthetic in a procedure taking about 40 mins.
Varicocoele / varicose veins in scrotum
These are more common on the left side and might be present in up to 10% of men, but most cause no problems. They are likened to a ‘bag of worms’. They may cause a simple swelling or can ache, particularly with prolonged standing or sitting. They have been implicated as a potential cause of infertility, but it seems likely that, at worst, they may affect sperm quality.
Diagnosis is usually based on examination and an ultrasound.
If none bothersome, they require no treatment. if problematic, they can be treated with embolisation by an interventional radiologist or by a day case operation under general anaesthetic taking about 45 mins.
Vasectomy
Most vasectomies are carried out under local anaesthetic but a general anaesthetic is an option. One of the South Coast Urology surgeons will meet you to take a full medical history and carry out an examination . They will then discuss the pros and cons of this form of contraception for you and advise on the most appropriate method.
- Vasectomy is the most effective method of male sterilisation
- It should always be regarded as “irreversible”
- You will not be sterile immediately, but will need to continue with alternative contraception until you have been given the “all-clear” from your post-operative semen tests after at least 12 weeks and 20 ejaculations
- Late failure, due to the ends joining themselves back together, occurs in 1 in 2000 men
- There is no evidence that vasectomy causes any long-term health risks (e.g. testicular cancer, prostate cancer)
- Troublesome chronic testicular pain severe enough to affect day-to- day activities in up to 5%