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Scrotal exploration

CPT4 code

Name of the Procedure:

Scrotal Exploration (Scrotal Surgery or Testicular Exploration)

Summary

Scrotal exploration is a surgical procedure where a surgeon opens the scrotum to investigate and treat underlying issues such as testicular torsion, infections, or testicular masses.

Purpose

This procedure addresses conditions affecting the testicles, epididymis, or other scrotal contents. The goal is to diagnose and, if possible, treat the cause of acute scrotal pain or other abnormalities.

Indications

  • Acute or severe scrotal pain, often from testicular torsion
  • Swelling or masses felt within the scrotum
  • Suspected infections or abscesses
  • Unexplained scrotal or testicular symptoms

Preparation

  • Fasting for at least 6-8 hours before the procedure
  • Adjustment or discontinuation of certain medications such as blood thinners
  • Preoperative diagnostic tests like scrotal ultrasound or blood work

Procedure Description

  1. Anesthesia is administered; either general or local based on the case.
  2. A surgical incision is made in the scrotum.
  3. The surgeon examines the testicles, epididymis, and surrounding tissues.
  4. Depending on findings, corrective actions such as detorsion (for testicular torsion), removal of masses, or drainage may be performed.
  5. After completing the necessary interventions, the incisions are closed with sutures.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

This surgery is usually performed in a hospital operating room or a specialized surgical center.

Personnel

  • Surgeon (typically a urologist)
  • Anesthesiologist or nurse anesthetist
  • Surgical nurses and assistants

Risks and Complications

  • Infection
  • Bleeding or hematoma
  • Scarring
  • Testicular damage or loss
  • Anesthesia-related risks
  • Persistent pain

Benefits

  • Relief from acute scrotal pain
  • Preservation of testicular function
  • Resolution or diagnosis of underlying problems
  • Prevention of further complications, such as infertility or sepsis

Recovery

  • Occasional pain and swelling controlled with medications
  • Application of ice packs to reduce swelling
  • Wearing supportive underwear for comfort
  • Limited physical activity for a few weeks
  • Follow-up appointments to monitor recovery

Alternatives

  • Non-surgical management (in cases where appropriate)
  • Imaging and close monitoring (for less acute presentations) Pros:
  • Less invasive Cons:
  • May not resolve urgent issues like torsion or abscess

Patient Experience

The patient may feel discomfort or slight pain during the recovery phase, which can be managed with pain medications. Icepacks and supportive underwear can enhance comfort. Full recovery typically spans a few weeks, with most people resuming normal activities thereafter.

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