00926 Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal

Name of the Procedure:

Anesthesia for Procedures on Male Genitalia (including Open Urethral Procedures); Radical Orchiectomy, Inguinal

Summary

Radical orchiectomy is a surgical procedure to remove one or both testicles, typically performed when cancer is present. The procedure involves an incision in the groin and is conducted under anesthesia to ensure the patient does not feel pain.

Purpose

The primary purpose of a radical orchiectomy is to remove cancerous testicular tissue to prevent the spread of cancer. The expected outcome is the complete removal of the affected testicle(s) and a reduction in cancer risk.

Indications

• Presence of testicular cancer
• A non-resolving testicular mass or tumor
• Testicular damage beyond repair

Preparation

• Patients may be required to fast for several hours before the procedure.
• Medication adjustments may be necessary, particularly for blood thinners.
• Preoperative tests may include blood work, imaging studies (like ultrasounds or CT scans), and physical exams.

Procedure Description

1. Anesthesia: General anesthesia is administered to the patient, ensuring they are unconscious and pain-free during the surgery.
2. Incision: A small incision is made in the groin area.
3. Isolation and Removal: The testicle and spermatic cord are isolated and removed through the incision.
4. Closure: The incision is then closed with sutures or staples.

Tools: Scalpel, retractors, clamps, sutures or staples.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Radical orchiectomy is usually performed in a hospital or surgical center operating room.

Personnel

• Surgeon (usually a urologist)
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Common risks: Bleeding, infection, hematoma formation.
• Rare risks: Injury to surrounding structures, chronic pain, fertility issues.
• Management: Antibiotics for infection, proper wound care, and pain management.

Benefits

The primary benefit is the removal of cancerous tissue which can lead to a significant reduction in cancer risk. Patients often experience a quick return to baseline activities with minimal long-term impact on sexual function if one testicle remains.

Recovery

• Postoperative care includes pain management, wound care, and monitoring for any complications.
• Patients typically stay in the hospital for a short period for observation.
• Recovery time can range from 2 to 4 weeks, with restrictions on heavy lifting and strenuous activities.
• Follow-up appointments are necessary to monitor healing and assess overall health.

Alternatives

• Surveillance: Regular monitoring without immediate surgery.
• Radiation or chemotherapy: Depending on the cancer type and stage.
• Pros and cons often involve balancing immediate surgical intervention against potential side effects of alternative treatments.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, some discomfort and swelling are normal, but pain can be managed with medication. Patients should follow all postoperative instructions for care and activity restrictions to ensure smooth recovery.