Dr. CARLO A. BRAVI Urologist and Andrologist
Penoscrotal Surgery
Mr. Bravi offers expert surgical management of various conditions affecting the penis and scrotum. These procedures are performed with precision and discretion, prioritizing both functional outcomes and patient comfort. In most cases, these conditions are first assessed through a testicular (scrotal) ultrasound, a non-invasive imaging test that helps confirm the diagnosis by visualizing internal structures such as the testes, epididymis, and scrotal contents. An important aim of this scan is to exclude the presence of a testicular tumour, as early detection of testicular cancer is critical to successful treatment.
Ultrasound also allows for accurate identification of benign conditions like fluid collections, cysts, or vascular changes, helping guide appropriate treatment planning. Ultrasound allows for accurate identification of abnormalities like fluid collections, cysts, or vascular changes, guiding appropriate treatment planning.
Peno-scrotal surgery may be recommended to treat a range of benign conditions, including:
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Hydrocele: a painless swelling caused by fluid accumulation around the testicle
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Varicocele: enlargement of the veins within the scrotum, which may be associated with discomfort or fertility concerns
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Epididymal cysts: fluid-filled sacs in the epididymis, often found incidentally but occasionally causing discomfort
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Phimosis: a condition where the foreskin is too tight to be pulled back over the head of the penis
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Other minor penile or scrotal abnormalities: such as skin tags, cysts, or cosmetic concerns
In cases where a suspicious mass is identified and there are concerns for testicular cancer, a radical orchidectomy—surgical removal of the entire affected testicle—is usually recommended both for diagnosis and treatment. At the time of surgery, a testicular prosthesis can be offered for those who wish to maintain natural appearance and body image. Early intervention is key, and this procedure is performed safely and promptly to ensure the best oncological outcomes.
Once diagnosed, treatment options will be tailored to your specific needs. When surgery is indicated, Mr. Bravi provides individualized care using minimally invasive or open surgical techniques as appropriate, aiming for quick recovery, optimal function, and a discreet cosmetic outcome.
Conditions Treated
Hydrocele
A hydrocele occurs when fluid builds up in the sac around the testicle. It can cause swelling and a feeling of heaviness in the scrotum. Surgery (hydrocele repair) involves removing the fluid sac to prevent recurrence.
Varicocele
A varicocele is a swelling of the veins that drain the testicle, often described as feeling like a “bag of worms.” It can lead to discomfort and, in some cases, affect fertility. Surgical correction aims at improving blood flow and reducing pressure.
Epididymal Cysts
These are fluid-filled lumps near the testicle, usually painless but sometimes uncomfortable. If they grow large or cause discomfort, they can be removed via a surgical procedure.
Phimosis / Tight foreskin
This is a condition in which the foreskin is too tight to be retracted over the head (glans) of the penis. While it can be normal in young children, persistent or symptomatic phimosis in adolescents or adults may lead to discomfort, hygiene difficulties, pain during erections, or recurrent infections such as balanitis (inflammation of the glans).
Treatment is considered when phimosis causes symptoms or interferes with daily activities. Depending on the severity and patient preference, management options include:
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Topical steroid creams to soften and gradually loosen the foreskin
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Limited surgical release (preputioplasty) to preserve the foreskin while relieving tightness
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Circumcision, a definitive surgical procedure that removes the foreskin entirely
The choice of treatment is tailored to the individual’s symptoms, age, and desired outcome. All procedures are performed with care to ensure minimal discomfort and a smooth recovery.
What to Expect
Most procedures are performed as outpatient or day-case surgeries, meaning that an overnight hospital stay is usually not required. Depending on the type and complexity of the surgery, anaesthetic options may include local, spinal, or general anaesthesia.
The surgical techniques used are designed to minimise scarring, with small, discreetly placed incisions. Recovery is generally swift, and most patients are able to return to normal activities within 7 to 10 days.
It is normal to experience some mild bruising, swelling, or tenderness following the procedure.
Mr. Bravi provides comprehensive aftercare guidance and follow-up to ensure that healing progresses comfortably and without complications.
