Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral
CPT4 code
Name of the Procedure:
Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral.
Summary
Anesthesia for male genital procedures, especially for addressing an undescended testis, involves administering medication to prevent pain and discomfort during the surgical procedure. An undescended testis is a condition where one or both of the testicles have not moved into the scrotum before birth.
Purpose
This procedure addresses the condition of undescended testis (cryptorchidism), which, if untreated, can lead to fertility problems, testicular cancer, and other complications. The goal is to ensure the safe and pain-free completion of surgery to reposition the undescended testis.
Indications
- One or both testicles have not moved into the scrotum (undescended testis).
- Diagnosed cryptorchidism in infant or child.
- Risk factors such as family history of undescended testis or premature birth.
- Complications from past undescended testis procedures or conditions.
Preparation
- Patients (or guardians) will receive pre-procedure instructions, including fasting for a specific period before surgery.
- Medication adjustments might be necessary, especially if blood thinners or other medications are involved.
- Pre-surgery assessments might include blood tests and a physical examination.
Procedure Description
- The patient is placed under general anesthesia, ensuring complete unconsciousness and lack of pain.
- An anesthesiologist will monitor vital signs throughout the procedure.
- For the surgical aspect, the surgeon will make an incision to locate the undescended testis and guide it into the scrotum.
- Sutures might be used to keep the testis in its new position.
- The incision is then closed and bandaged.
Tools and equipment used include standard surgical instruments and anesthesia delivery systems.
Duration
The procedure typically lasts 1 to 2 hours.
Setting
This procedure is performed in a hospital or specialized surgical center.
Personnel
- Anesthesiologist
- Surgeons specializing in pediatric or male genital surgery
- Surgical nurses and aides
- Post-anesthesia care unit (PACU) nurse
Risks and Complications
- Common risks: nausea, vomiting, drowsiness from anesthesia.
- Rare risks: allergic reaction to anesthesia, infection, bleeding, injury to surrounding tissues or organs, anesthesia complications.
Benefits
- The repositioned testis will function more normally.
- Reduced risk of future fertility problems and testicular cancer.
- Improved cosmetic appearance of the genital area.
Benefits are usually realized within a few weeks of recovery.
Recovery
- Patients are monitored in the PACU until fully awake.
- Pain management will be provided, often with prescription or over-the-counter pain relief.
- Instructions will include wound care, activity restrictions, and follow-up appointments.
- Full recovery typically takes a few weeks, although normal activities might resume sooner under the guidance of the healthcare provider.
Alternatives
- Hormone therapy: sometimes used to stimulate testicular descent but less effective.
- Observation: monitored to see if testis descends naturally in infants.
- Delaying surgery: in some cases, surgery might be postponed until the child is older.
Each alternative has pros and cons, often weighed based on the child’s age, health condition, and parental preferences.
Patient Experience
- Patients will not feel anything during the surgery due to general anesthesia.
- Post-procedure, there might be some pain and swelling at the surgical site, which can be managed with medication.
- The child might feel drowsy and disoriented as they wake up from anesthesia but will gradually return to normal.
Ensuring comfort and painless recovery is a priority, with pain management strategies and support from healthcare providers.