Treatments & surgery
I offer only evidence-based treatments. Where an operation is not the right answer for you, I will say so — and explain what is.
Most of the operations below are microsurgical or reconstructive, meaning they are performed under an operating microscope or rebuild anatomy rather than simply remove or widen it. They are technically demanding, they are performed in relatively few centres, and outcomes depend substantially on how often the surgeon does them.
That is the honest reason to be selective about who operates. Several of these procedures — microTESE, vasectomy reversal, urethroplasty, redo hypospadias repair — are effectively one-chance operations. A first attempt that does not work leaves scar tissue that makes the second attempt harder and less likely to succeed. A meaningful proportion of my practice consists of putting right operations performed elsewhere, and the second operation is almost always the harder one.
How treatment decisions are made
Every plan starts with establishing the cause, not the procedure. In practice that means:
- A proper examination. A surprising number of men arrive having been diagnosed on a scan report alone. Examination frequently changes the diagnosis, particularly in fertility and reconstructive cases.
- Targeted investigation. Tests are chosen to answer a specific question, not ordered as a routine panel.
- The full range of options, including no treatment. Watchful waiting is a legitimate choice for a mild stricture, a stable minor curvature or an asymptomatic varicocele, and I will say so rather than propose an operation.
- Realistic outcomes. Not headline success rates, but what the evidence and my own results suggest for your specific anatomy, history and previous surgery.
- Time to decide. Almost nothing here is urgent. Priapism is the exception, and it is an emergency.
Where surgery is performed
Consultations are at HCA Healthcare UK outpatient centres at The Shard and Canary Wharf. Surgery takes place in HCA facilities with the anaesthetic, imaging and, for fertility procedures, embryology support that these operations require — microTESE in particular depends on having an experienced embryologist working alongside the surgeon in theatre.
You will be given a written surgical plan, a quotation covering surgeon, anaesthetist and hospital fees, and a clear recovery timeline before any date is booked. See fees and insurance.
Procedures in detail
microTESE sperm retrieval
Microsurgical testicular sperm extraction — the technique with the best chance of finding sperm in men whose testicles produce almost none.
Read moreMicrosurgical vasectomy reversal
Restoring natural fertility after a vasectomy, performed under the operating microscope with a two-layer technique.
Read moreVaricocele microsurgery
The most commonly identified correctable cause of male infertility, repaired with the technique that has the lowest recurrence and complication rates.
Read morePenile prosthesis (implant)
For men in whom other erectile dysfunction treatments have failed, implant surgery has among the highest satisfaction rates of any procedure in men's health.
Read moreUrethroplasty
Open reconstruction of the urethra — the definitive treatment for urethral stricture, rather than another temporary stretch.
Read moreAdult hypospadias repair
Primary and redo reconstruction in adults, including men whose childhood repair has broken down decades later.
Read moreOnco-fertility & fertility preservation
Cancer treatment can permanently affect fertility. Preserving the option of biological children should be discussed before treatment starts — and there are options even if it already has.
Read moreOptilume balloon
A minimally invasive option for selected urethral strictures, combining dilatation with a drug intended to reduce scar re-formation.
Read moreRobotic reconstruction
Buccal graft reconstruction of bladder neck, ureteric and PUJ strictures, performed robotically — with the largest experience of this type of reconstruction in the UK.
Read moreSurgery is a decision, not a default
A significant proportion of the men I see do not need an operation, or need a different one from the one they arrived expecting. A proper assessment establishes the cause first. Where surgery is right, I will explain the alternatives, the realistic outcome and the risks in plain language, and give you time to decide.
Speak to my team
Appointments at The Shard and Canary Wharf are arranged by my PA, Jeanette Bush. Tell us briefly what the problem is and we will find the right clinic slot for you.