Amputation of penis; complete
CPT4 code
Name of the Procedure:
Amputation of Penis; Complete
- Common Name: Penile Amputation
- Medical Term: Total Penectomy
Summary
Penile amputation is a surgical procedure to remove the entire penis. This may be necessary due to severe trauma, cancer, or other life-threatening conditions affecting the penile tissue.
Purpose
The procedure addresses conditions such as penile cancer, severe infection, or malignant tumors. The primary goal is to eliminate harmful tissue, prevent the spread of disease, or manage a traumatic injury, aiming to improve the overall prognosis and quality of life for the patient.
Indications
- Penile cancer (especially squamous cell carcinoma)
- Severe infections that do not respond to other treatments
- Traumatic injuries to the penis
- Non-malignant tumors that cannot be removed by conservative surgery
Preparation
- Fasting several hours before surgery
- Ceasing certain medications as advised by the surgeon (e.g., blood thinners)
- Blood tests, imaging studies (e.g., MRI or CT scans), and sometimes a biopsy to assess the extent of the disease
- Psychological assessment and counseling may be recommended
Procedure Description
- The patient is placed under general anesthesia.
- The surgical site is sterilized, and an incision is made at the base of the penis.
- The urethra is dissected and preserved to allow for future urinary function via an alternative route.
- The entire penis is removed, ensuring clear boundaries around the diseased tissues.
- The incision is closed, and a catheter is placed to help with urination during initial recovery.
- The patient is monitored in a recovery area post-surgery.
Duration
The procedure typically takes 2-3 hours, depending on the complexity of the case.
Setting
Penile amputation is performed in a hospital's surgical suite, where the patient can be closely monitored.
Personnel
- Lead Surgeon: Performs the amputation
- Surgical assistants
- Anesthesiologist: Manages anesthesia
- Nursing staff: Assists during surgery and initial recovery
Risks and Complications
- Common risks: Infection, bleeding, pain, and wound healing issues
- Rare risks: Urinary complications, chronic pain, psychological impacts
- Management: Infection control, pain management, counseling, and follow-up care
Benefits
- Removal of cancerous or diseased tissue
- Prevention of disease spread
- Potentially life-saving when dealing with severe infections or trauma
- Most benefits are realized shortly after the procedure once recovery begins
Recovery
- Initial hospital stay of a few days for monitoring
- Pain management with medications
- Catheter use for urination until the healing process allows normal function
- Wound care instructions provided by medical staff
- Follow-up appointments to monitor recovery and address any complications
- Expect a recovery period of several weeks
Alternatives
- Partial penectomy for less extensive disease
- Radiation therapy or chemotherapy for cancer
- Reconstructive surgery for structural issues
- Pros and Cons: Alternatives might preserve more tissue, but may have lower success rates for complete disease removal.
Patient Experience
- During: The patient will be under general anesthesia and will not feel pain.
- After: Post-operative pain managed with medication, initial difficulty with urination managed by catheter, potential emotional and psychological impacts, which warrants support.