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Excision of lesion of spermatic cord (separate procedure)

CPT4 code

Name of the Procedure:

Excision of Lesion of Spermatic Cord

Summary

Excision of a lesion of the spermatic cord is a surgical procedure to remove abnormal growths or masses found in the spermatic cord, which is a bundle of fibers and tissues running from the abdomen to the testicles.

Purpose

This procedure addresses problems like tumors, cysts, or other abnormal growths in the spermatic cord. The goal is to remove the lesion to prevent complications such as pain, infection, or potential malignancy.

Indications

  • Presence of a palpable mass in the spermatic cord area
  • Pain or discomfort in the groin or testicle
  • Suspicion of malignancy
  • Diagnostic imaging showing abnormalities in the spermatic cord
  • Unresolved infection or cysts

Preparation

  • Patients may be instructed to fast for 6-8 hours prior to the procedure.
  • Blood tests, ultrasound, or MRI may be performed to assess the lesion.
  • Temporary cessation of blood-thinning medications might be necessary.
  • An informed consent form must be signed.

Procedure Description

  1. The patient is positioned and given anesthesia, typically general or local with sedation.
  2. The surgical area is sterilized.
  3. A small incision is made in the groin or scrotum to access the spermatic cord.
  4. The surgeon isolates and excises the lesion carefully, ensuring no damage to adjacent structures.
  5. The incision is then closed with sutures.
  6. The excised tissue is sent for pathological examination.

Duration

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

Setting

The procedure is typically performed in a hospital or outpatient surgical center.

Personnel

  • Surgeon (usually a urologist)
  • Surgical nurse
  • Anesthesiologist
  • Surgical technologist

Risks and Complications

  • Infection
  • Bleeding or hematoma formation
  • Injury to adjacent structures like blood vessels or nerves
  • Scarring
  • Recurrence of the lesion
  • Anesthesia-related risks

Benefits

  • Removal of potentially harmful or painful lesions
  • Relief from associated symptoms such as pain or discomfort
  • Prevention of potential complications like malignancy

Recovery

  • Patients may go home the same day or require an overnight stay, depending on the case.
  • Pain and swelling are managed with medications.
  • Activity restrictions for a few days to weeks; avoid heavy lifting and strenuous activities.
  • Follow-up appointment for wound inspection and to discuss pathology results.

Alternatives

  • Monitoring the lesion with regular imaging and check-ups if asymptomatic and benign.
  • Aspiration or drainage if the lesion is a cyst.
  • Minimally invasive procedures depending on lesion type.
  • The pros and cons of alternatives will vary; less invasive options might be less definitive but also carry lower immediate surgical risks.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Postoperatively, mild to moderate pain and swelling are common, managed by prescribed pain medications. Discomfort is expected to decrease significantly within a few days, with full recovery occurring within a few weeks.

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