Spermatic cord pain could result from a number of issues, including hydrocele of the spermatic cord (the build-up of fluid in cavities surrounding it), spermatic cord blockage, chronic epididymitis (painful inflammation of a tube at the back of the testicles), or because of a twisted spermatic cord. Dr. Hayden will consult with the patient to determine the best course of spermatic cord pain treatment.
A vasectomy procedure involves the severing and sealing of the left and right vas deferens and results in male sterilization. Getting a vasectomy, is considered a form of permanent contraception for males, though Dr. Hayden can attempt a vasectomy reversal in a separate (and obviously later) procedure. The recovery time from a vasectomy procedure is short: most men will return to regular physical activity within a week.
Repair of varicocele
A varicocele is when veins inside the patient’s scrotum have become enlarged. They are similar to varicose veins which develop in the leg and can affect up to 15% of adult males. Testicular varicocele treatment might involve varicocele surgery, where Dr. Hayden will make a small incision below the groin. Recovery time from varicocele repair surgery will vary according to the extent and nature of the complaint.
Excision of cyst / tumour ± orchiectomy (removal of testis)
Chronic pain in the testicles and spermatic cord region might be evidence of an epididymal cyst (a spermatocele) or perhaps testicular cancer. In the case of the former, Dr. Hayden may do spermatic cord or epididymal cyst removal surgery. The removal or excision of a spermatic cord or epididymal cyst is a relatively uncomplicated surgical procedure, and recovery time is swift. However, in other cases, testicle removal surgery (orchiectomy) might be advised. A simple orchiectomy involves removing the testicle through the scrotum. A radical orchiectomy procedure (the complete removal of the testicle and part of the spermatic cord through a groin incision) will be done when testicular cancer is suspected. If both testicles are removed, this is called a bilateral orchiectomy. This is usually done for permanent androgen (testosterone) deprivation therapy in advanced prostate cancer. The recovery time from orchiectomy surgery will vary from patient to patient.
Dr. Hayden may do a vasogram in the context of male infertility investigations. The vasography procedure involves a vasotomy (a small incision in the vas deferens), which is then injected with a contrasting dye and subjected to an x-ray study in theatre to observe the course and perhaps diagnose vasal obstruction. A vasogram is often accompanied by a testis biopsy and sperm retrieval. The recovery from a vasogram procedure is swift.
Repair of inguinal hernia
A hernia is a condition that occurs when an organ or fatty tissue is pushed through its surrounding muscle or connective tissue (fascia), usually as a result of strenuous physical activity. One of the most common forms is a groin hernia (also known as an inguinal hernia), which will almost certainly require hernia repair surgery in order to correct. Inguinal hernia repair is one of the most commonly performed surgeries in the world, and will involve Dr. Hayden making an incision of about 6-8cm over the hernia. He will then manipulate the protruding organ or fatty tissue back into the patient’s abdomen, before lining the abdominal wall with mesh in order to strengthen it at the point where the hernia pushed through. Sometimes the patient’s own tissue is used to strengthen the defect. Recovery time from inguinal hernia surgery is about 1-2 weeks for light physical activity, and 2-4 weeks for more strenuous exercise (and even longer for heavy lifting).
Dr Hayden will make an incision below the groin and open the spermatic cord, exposing the spermatic veins. He will then divert the blood flow by clamping or suturing the vessels. After the procedure, the incisions will be stitched closed.
The exact duration of the procedure is difficult to predict. In most cases, the procedure takes under 45 minutes.
Dr Hayden prefers patients to be under general anaesthesia for a vasectomy – it helps to have optimal control over a procedure where complications are especially undesirable.