CPT® Code 55870

1. Indications

Electroejaculation is indicated for men who are unable to achieve ejaculation due to various neurological conditions. The following conditions may warrant the use of this procedure:

• Spinal Cord Injury - Patients with injuries to the spinal cord may experience disruptions in the neural pathways that facilitate ejaculation.
• Demyelinating Neuropathies - Conditions that damage the myelin sheath of nerves can impair the ability to ejaculate.
• Diabetes - Diabetic neuropathy can affect the nerves involved in the ejaculation process.
• Pelvic/Spinal Surgeries - Surgical interventions in the pelvic or spinal regions may lead to complications that affect ejaculation.

2. Procedure

The electroejaculation procedure involves several critical steps to ensure successful sperm collection. The first step is to empty the bladder using a catheter, which is essential to prevent any interference during the procedure. Following this, a lubricant, such as simulated human tubal fluid or plasminate, may be instilled into the bladder to facilitate the process. Next, a digital rectal examination and/or anoscopy is performed to accurately locate the prostate gland, which is crucial for the subsequent steps. Once the prostate is located, a rectal probe is carefully inserted and positioned against the prostate. The procedure then involves delivering electrical energy through the probe. This energy is administered at increasing frequencies and amplitudes, which stimulates the prostate and leads to ejaculation. The goal is to achieve successful ejaculation, at which point the ejaculate is collected into a specimen container. Additionally, the bladder may be catheterized again to collect any retrograde ejaculate that may occur. After the completion of the procedure, the rectal probe is removed, and a final examination of the rectum may be conducted using anoscopy to check for any thermal or other injuries that may have resulted from the procedure.

3. Post-Procedure

Post-procedure care for electroejaculation involves monitoring the patient for any immediate complications or discomfort. It is important to assess for any signs of thermal injury or other adverse effects resulting from the procedure. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. Additionally, any instructions regarding follow-up care, potential side effects, or signs of complications should be clearly communicated to the patient. The collection of sperm may be analyzed for motility and viability, and further reproductive options can be discussed based on the results of the ejaculate analysis.