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A vasovasostomy, also known as vasovasorrhaphy, is a surgical procedure aimed at reconnecting the ends of the vas deferens, which is the duct that carries sperm from the testicles to the urethra. This procedure is typically performed following a vasectomy, a surgical method of male sterilization, where the vas deferens is cut or blocked to prevent sperm from entering the ejaculate. Additionally, a vasovasostomy may be indicated to repair an iatrogenic injury to the vas deferens that may have occurred during another surgical procedure. The operation involves making an incision in the scrotal skin over the previous surgical scar, allowing access to the vas deferens. The surgeon carefully pulls the vas deferens into the operative field, where the ends are prepared for reconnection. This preparation includes incising and dilating the ends of the vas deferens, introducing an angiocath into the lumen to facilitate irrigation with saline, and assessing the patency of the duct by examining the irrigation fluid for the presence of spermatozoa or sperm fragments. Once confirmed, the ends of the vas deferens are meticulously anastomosed, which can be done using either a single-layer or multiple-layer technique. After the reconnection is complete, the vas deferens is returned to the scrotum, and the incision in the skin is closed using absorbable sutures, ensuring a secure and effective healing process.
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The vasovasostomy or vasovasorrhaphy procedure is indicated for the following conditions:
The vasovasostomy procedure involves several critical steps to ensure successful reconnection of the vas deferens:
Post-procedure care for a vasovasostomy includes monitoring for any signs of complications, such as infection or hematoma formation. Patients are typically advised to avoid strenuous activities and heavy lifting for a specified period to promote healing. Follow-up appointments may be scheduled to assess the success of the procedure and to evaluate sperm production and fertility potential. It is important for patients to adhere to any specific instructions provided by their healthcare provider to ensure optimal recovery.
| Short Descr | REPAIR OF SPERM DUCT | Medium Descr | VASOVASOSTOMY VASOVASORRHAPHY | Long Descr | Vasovasostomy, vasovasorrhaphy | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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