Lysis or excision of penile post-circumcision adhesions
CPT4 code
Name of the Procedure:
Lysis or Excision of Penile Post-Circumcision Adhesions
Summary
This procedure involves the removal or separation of adhesions (scar tissue) that can form between the skin of the penis and the glans (head) following a circumcision. These adhesions can cause discomfort, difficulty with hygiene, or other complications.
Purpose
The procedure addresses penile adhesions that develop after circumcision. The primary goal is to eliminate the adhesions, relieve symptoms, and prevent further complications. Expected outcomes include improved comfort, better hygiene, and normal appearance and function of the penis.
Indications
- Discomfort or pain in the penis
- Difficulty with penile hygiene
- Inflammation or infection due to adhesions
- Cosmetic concerns or abnormal appearance of the penis
- Difficulty in retracting the foreskin, if any remains
Preparation
- Follow a fasting protocol if general anesthesia will be used.
- Adjust or discontinue certain medications as advised by your doctor.
- Undergo pre-procedure examinations, such as a physical examination and possibly blood tests, to ensure fitness for surgery.
Procedure Description
- Patient is positioned comfortably, and anesthesia (local or general) is administered.
- The area around the penis is cleaned and sterilized.
- Using surgical instruments, the surgeon carefully dissects and removes the adhesions.
- Any necessary repairs to the penile tissue are performed.
- Sutures may be applied to close the incision if required.
- A dressing is applied to protect the area post-surgery.
Duration
The procedure typically takes about 30 minutes to an hour, depending on the extent of adhesions.
Setting
This procedure is commonly performed in an outpatient clinic or a surgical center. Hospital settings may also be used if necessary.
Personnel
- Surgeon (typically a urologist)
- Nurse or surgical assistant
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Scarring and recurrent adhesions
- Pain or discomfort during recovery
- Rarely, damage to penile tissue
Benefits
- Relief from pain and discomfort
- Improved penile hygiene
- Cosmetic improvement
- Prevention of further complications
- Benefits typically realized within a few weeks post-procedure
Recovery
- Follow post-operative care instructions, including keeping the area clean and dry.
- Pain management may include prescribed medications or over-the-counter pain relievers.
- Avoid strenuous activities and sexual activity until cleared by the doctor.
- A follow-up appointment may be scheduled to monitor healing and address any concerns.
- Most patients can resume normal activities within a week, although complete recovery can take a few weeks.
Alternatives
- Conservative management with topical treatments and manual separation of minor adhesions.
- Observation for spontaneous resolution, commonly in younger patients.
- Each alternative has its own risks and benefits; conservative approaches might have a longer duration but avoid surgical risks.
Patient Experience
During the procedure, patients under local anesthesia might feel minimal discomfort or pressure, while those under general anesthesia will be completely unaware. Post-procedure, mild to moderate pain or discomfort is common and can be managed with medication. Most patients report significant relief from symptoms and improved quality of life following complete recovery.