Epididymectomy; unilateral
CPT4 code
Name of the Procedure:
Epididymectomy; unilateral
(Epididymal surgery, Testicular duct removal)
Summary
An epididymectomy is a surgical procedure to remove one side of the epididymis, a tube at the back of the testicle that stores and carries sperm.
Purpose
- Medical Condition or Problem: Chronic epididymitis, spermatocele, or obstruction
- Goals: To relieve persistent pain, prevent recurrent infections, or alleviate blockages hindering sperm passage.
Indications
- Persistent or recurrent epididymitis unresponsive to medical therapy
- Large or symptomatic spermatocele
- Obstruction causing pain or fertility issues
- Other conditions causing chronic scrotal pain
Preparation
- Pre-Procedure Instructions: Follow fasting guidelines, typically no food or drink for at least 8 hours before the procedure.
- Medication Adjustments: May need to stop certain medications like blood thinners.
- Diagnostic Tests: Ultrasound of the scrotum, blood work, and any other relevant imaging tests.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A small incision is made in the scrotum.
- Isolation of Epididymis: The surgeon carefully isolates the epididymis from the testicle.
- Removal: The affected epididymis is removed surgically.
- Closure: The incision is closed with sutures.
- Dressing: Wound dressing is applied to prevent infection.
Duration
Typically, the procedure takes about 30 minutes to 1 hour.
Setting
Performed in a hospital or an outpatient surgical center.
Personnel
- Urologist or specialized surgeon
- Surgical nurses
- Anesthesiologist
Risks and Complications
- Common Risks: Infection, bleeding, and scrotal swelling.
- Rare Risks: Chronic pain, reduced fertility, and formation of hematomas.
- Management: Antibiotics for infections, pain management, and follow-up for complications.
Benefits
- Relief from chronic pain and recurrent infections
- Resolution of symptoms associated with spermatoceles
- Improvement in overall quality of life
- Benefits typically noticed within a few days to weeks post-surgery
Recovery
- Post-Procedure Care: Rest, application of ice packs, and wearing tight-fitting underwear or athletic supporter to reduce swelling.
- Recovery Time: Most patients recover within 1 to 2 weeks.
- Restrictions: Avoid heavy lifting, strenuous activities, and sexual activities until cleared by the doctor.
- Follow-Up: Appointments to monitor healing and address any complications.
Alternatives
- Conservative Management: Antibiotics for infections, pain management with medications.
- Aspiration or Sclerotherapy: Treatment of spermatoceles without surgery.
- Pros and Cons: Non-surgical options may provide temporary relief or be less effective, while surgical intervention offers a more definitive solution but involves surgical risks.
Patient Experience
- During Procedure: Patient will be under anesthesia, so there will be no pain or awareness during the procedure.
- After Procedure: Mild to moderate pain managed with prescribed painkillers, possible swelling, and discomfort, which generally subside within a few days.
- Pain Management: Ice packs and medications as prescribed to manage pain and swelling.