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Excision of extraparenchymal lesion of testis

CPT4 code

Name of the Procedure:

Excision of Extraparenchymal Lesion of Testis

  • Common names: Testicular lesion removal, Testicular mass excision
  • Medical term: Excision of extraparenchymal lesion of the testis

Summary

The excision of an extraparenchymal lesion of the testis involves surgically removing a mass that is located outside the testicular parenchyma (the functional tissue of the testis). This procedure aims to diagnose and prevent further complications from the lesion.

Purpose

  • Medical condition: Addresses the presence of benign or malignant lesions outside the testis.
  • Goals: To remove the lesion for diagnostic examination and prevent potential complications such as malignancy or discomfort.

Indications

  • Presence of a palpable lump in the scrotum.
  • Pain or discomfort in the testicular area.
  • Suspicion of tumor based on ultrasound or other imaging studies.
  • Rapid growth of a testicular mass.
  • Previous history of testicular cancer.

Preparation

  • Fasting: Typically required for 6-8 hours prior if general anesthesia will be used.
  • Medication adjustments: Discuss any blood-thinning medications with the doctor.
  • Diagnostic tests: Ultrasound, blood tests (such as tumor markers), and possibly MRI may be required beforehand.

Procedure Description

  1. Anesthesia: The patient is given general or regional anesthesia.
  2. Incision: A small incision is made in the scrotum to access the lesion.
  3. Lesion Removal: The lesion is carefully excised while preserving the surrounding healthy tissue.
  4. Closure: The incision is closed with sutures.
  5. Histological Examination: The excised tissue is sent for histopathological analysis to determine its nature.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity.

Setting

This procedure is usually performed in a hospital or surgical center.

Personnel

  • Surgeon (usually a urologist)
  • Assisting surgical team
  • Anesthesiologist
  • Nurses

Risks and Complications

  • Common risks: Infection, bleeding, hematoma.
  • Rare risks: Damage to surrounding tissue, recurrence of the lesion, testicular torsion, or infertility.

Benefits

The main benefits include:

  • Relief from symptoms associated with the lesion.
  • Accurate diagnosis of the lesion type.
  • Prevention of potential complications such as malignancy.
  • Benefits are usually realized immediately after recovery.

Recovery

  • Post-procedure care: Keep the area clean and dry, follow wound care instructions.
  • Activity restrictions: Avoid strenuous activities and heavy lifting for several weeks.
  • Follow-up: Typically involves a follow-up visit within a week to examine the incision and discuss pathology results.
  • Recovery time: Most patients recover within 1-2 weeks.

Alternatives

  • Surveillance: Monitoring the lesion with regular imaging studies.
  • Needle biopsy: Less invasive, but may not remove the entire lesion.
  • Pros and cons: Surveillance avoids the risks of surgery but may delay treatment if the lesion is malignant; needle biopsy is less invasive but may not be definitive.

Patient Experience

  • During the procedure: The patient will be under anesthesia and should feel no pain.
  • After the procedure: Mild to moderate pain managed with prescribed pain relievers; temporary swelling and bruising may occur.
  • Pain management: Pain medications and ice packs; wearing supportive underwear can help reduce discomfort.

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