CPT® Code 54865

Epididymal exploration, with or without biopsy, is a surgical procedure aimed at investigating the epididymis, particularly in cases where infertility is suspected due to an obstructed epididymis accompanied by azoospermia, which is the absence of sperm in the semen. This procedure is typically indicated when there is a need to assess the condition of the epididymis, which is a coiled tube located at the back of the testis that plays a crucial role in the maturation and storage of sperm. The exploration is performed through a midline scrotal incision, allowing direct access to the epididymis. During the procedure, the testis is carefully delivered from the scrotal sac, and the tunica vaginalis, a protective layer surrounding the testis, is opened to facilitate examination of the epididymis. Utilizing an operating microscope, the surgeon can closely inspect the epididymis under magnification to identify any abnormalities. An obstructed epididymis typically presents with dilated tubules that may appear yellowish due to the accumulation of macrophages, which are immune cells that digest remnants of degenerated sperm that have been trapped due to the obstruction. If necessary, the surgeon may puncture or open the epididymal tunic to access the tubules for biopsy purposes. After the exploration and any biopsies are completed, the puncture sites or incisions in the tunic are meticulously closed, and the tunica vaginalis is sealed in a watertight manner to prevent inflammation and the formation of adhesions. Finally, the testicle is repositioned, and the scrotal incision is closed with sutures, ensuring proper healing and recovery.