CPT® Code 55605

1. Indications

Vesiculotomy is indicated for various conditions affecting the seminal vesicles, which may include:

• Abdominal Pain Persistent discomfort in the abdominal region that may be associated with seminal vesicle disease.
• Pelvic Pain Discomfort localized in the pelvic area, potentially linked to issues with the seminal vesicles.
• Penile Pain Pain experienced in the penile region, which may be symptomatic of underlying seminal vesicle pathology.
• Pain with Ejaculation Discomfort or pain occurring during the ejaculation process, indicating possible complications with the seminal vesicles.
• Pain with Urination Discomfort experienced during urination, which may suggest inflammation or obstruction related to the seminal vesicles.
• Low Volume of Semen A reduction in the amount of semen produced, which can be a sign of seminal vesicle dysfunction.
• Blood in Semen Hematuria or the presence of blood in the semen, which may indicate a serious condition requiring surgical intervention.
• Blood in Urine Hematuria or the presence of blood in the urine, potentially linked to seminal vesicle issues.

2. Procedure

The procedure for vesiculotomy involves several critical steps, which are detailed as follows:

• Step 1: Patient Preparation The patient is positioned appropriately, and anesthesia is administered to ensure comfort during the procedure. Preoperative assessments and imaging studies may be conducted to evaluate the condition of the seminal vesicles.
• Step 2: Surgical Approach The surgeon selects the surgical approach, which may be through the retropubic space or via a perineal incision. The choice of approach depends on the specific clinical scenario and the extent of the disease.
• Step 3: Accessing the Seminal Vesicles For a retropubic approach, the bladder is carefully retracted to provide access to the seminal vesicles. This step is crucial for visualizing and exposing the glands adequately.
• Step 4: Dissection and Exposure The surgeon performs dissection around the seminal vesicles to expose them fully. This may involve careful manipulation of surrounding tissues to avoid damage to adjacent structures.
• Step 5: Performing the Vesiculotomy Once the seminal vesicles are adequately exposed, the surgeon proceeds with the vesiculotomy, which involves making an incision to open the vesicles for further evaluation or treatment.
• Step 6: Closure After the procedure is completed, the surgeon ensures hemostasis and closes the incision site using appropriate suturing techniques. Postoperative care instructions are provided to the patient.

3. Post-Procedure

Following a vesiculotomy, patients may require specific post-procedure care to ensure proper recovery. This may include monitoring for any signs of complications such as infection or excessive bleeding. Patients are typically advised to rest and may be prescribed pain management medications to alleviate discomfort. Follow-up appointments are essential to assess healing and address any ongoing symptoms. The expected recovery time can vary based on the individual and the complexity of the procedure, but patients should be informed about potential changes in urinary or sexual function as part of their recovery process.