Microsurgical Treatments for pain in the Testis (testicle) and Scrotum

Best life clinic attracts patients from all over the United Kingdom and abroad for advanced microsurgical vasectomy reversal procedures. We also offer microsurgical treatments for pain in the scrotum and testicles. About 10% of men who had vasectomy do suffer from long-standing pain in the testicle and scrotum. Sometimes this pain can be very debilitating.

Causes for pain in the scrotum

  1. Pain after vasectomy (Post-Vasectomy Pain)
    1. Pain can be due to pressure building up in the epididymis. Usually, the pain can start very early after the vasectomy and may continue as a long-standing one.
    2. Chronic inflammation in the epididymis is assumed to be due to the ongoing irritation and pressure from the sperm fluid after the blockage was created intentionally by vasectomy. The epididymis (a thin string or sausage-like structure at the back of the testicle that transports sperms from the testicles to vas) can look swollen and feel tender. This change may be easily misdiagnosed as epididymitis and treated with antibiotics on more than one occasion by the GP or urologist.
    3. Development of a painful nodule at the vasectomy site called a sperm granuloma:  This is felt like a pea size swelling at the place where the vas was cut and can feel tender to touch.
  2. Retractile Testis: is a condition caused by the spasm (contraction) of a sleeve of muscle called Cremaster that surrounds the spermatic cord (a bundle of structures like blood vessels and vas that comes to the testis from the groin). The pain due to the retractile testis can be accompanied by the testis’s upward lift towards the groin. Retractile testes can result from changes caused by vasectomy, trauma, pressure by wearing tight trousers and irritation of the nerve supplying this muscle at the spine level by other conditions.
  3. Nerve pain caused by the irritation of the sensory nerves by sperm granuloma or other conditions mentioned above.
  4. Other causes for pain include infections, varicocele and referred pain due to different reasons.

The potential options of treatment

  1. Non -operative treatment: You may try at first using pain killers or get referred to a pain clinic. You should try this option as much as possible before embarking on the invasive options mentioned below.
  2. Epididymectomy: Surgical procedure to remove the epididymis and the granuloma.  This is an appropriate option if the epididymis is swollen and tender due to a long-standing inflammation called granuloma. Previous vasectomy or infection of the epididymis may cause these painful changes.
  3. Microsurgical Vasectomy reversal may help if the pressure build-up is the cause of the pain. You are aware that your fertility is likely to be regained after reversal, and you will have to resort to other contraception methods.
  4. Removal of the granuloma at the vasectomy site or from areas of inflammation due to infection or trauma
  5. Microsurgical De-innervation of the testis. Sometimes there may not be a detectable cause in the scrotum, but we may be able to prove pain to arise from the scrotum. We can do this by giving a local anaesthetic block and see if the pain gets relieved temporarily. If it does, this is an option. This procedure can also be combined with other procedures mentioned in this section.
  6. Microsurgical Varicocele Repair: This is the option if you have a significant size varicocele (varices in the scrotum like the varices in the legs)
  7. Removal of Testicle: This will be the ultimate option which we will not recommend until every other option is exhausted fully

Call us for a face-to-face consultation if you suffer from long-standing testicular pain and would like to be assessed and consider the treatment options.

Cost of Clinical Assessment

Cost of Face-to-face consultation: £240

Combined consultation and Diagnostic Local anaesthetic block: £350

The cost of any other tests like scans, blood tests and procedures will be disclosed when giving such recommendations.