Preоperаtive Diаgnоsis: 1. Chrоnic left orchiаlgia2. Chronic epididymitis Postoperative Diagnosis: Same Procedure: Left inguinal orchiectomy Anesthesia: Local standby: 0.25% Marcaine, 1% Xylocaine, 1/1 dilution. Total 25 cc used as inguinal block.Estimated Blood Loss: Minimal This is an 82-year-old man with chronic left gonadal pain due to chronic epididymitis. This has failed to respond to conservative measures and has caused him marked discomfort in the left groin. As a result, we recommended that he consider outpatient orchiectomy. The risks and potential complications were discussed and informed consent obtained. The patient was given Ancef IV as well as IV sedation and placed on the operating table in the supine position. The lower groin and abdomen were shaved, prepared, and draped in the standard fashion. The external inguinal ring was identified, and an area just distal to the external inguinal ring was anesthetized with the local anesthetic, and a small transverse incision was made down to the spermatic cord. The testis was then brought out through the inguinal incision after the spermatic cord blockade with local anesthetic. The testis was separated from the scrotum by incision in the gubernaculum with needle tip Bovie. The spermatic cord was identified, dissected back to the external inguinal ring, and bisected with a curved Kelly clamp and then clamped and transected with Metzenbaum scissors. The spermatic cord was closed with suture ligature of 0 Vicryl and a free tie of 0 Vicryl proximal to this on each side of the spermatic cord. The incision was inspected for hemostasis. No further bleeding was noted, and the testis was delivered for pathological evaluation. The Scarpa’s fascia was closed with interrupted 2-0 Vicryl, and the skin was closed with a running 4-0 Vicryl subcuticular closure. Steri-Strips and four by fours were applied as a dressing. He was returned to the recovery room in stable condition. Estimated blood loss was minimal. First-Listed Diagnosis: Diagnosis: First-Listed Procedure: Hint: the procedure requires a modifier Note: Orchialgia CAN occur with epididymitis, but it is NOT always a symptom.
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