54200 Injection procedure for Peyronie disease

Name of the Procedure:

Injection Procedure for Peyronie Disease
Common names: Intralesional injection therapy, Collagenase injections
Medical terms: Intralesional collagenase clostridium histolyticum injection

Summary

Intralesional injection therapy for Peyronie's disease involves injecting a medication directly into the plaque on the penis to break down the collagen build-up causing the curvature and deformity. This non-surgical treatment is aimed at reducing the curvature and improving the function of the penis.

Purpose

The medical condition it addresses is Peyronie's disease, a condition characterized by the formation of fibrous scar tissue inside the penis leading to curved, painful erections.
The goals are to decrease penile curvature, reduce pain during erections, and improve the ability to engage in sexual intercourse.

Indications

• Significant penile curvature that causes distress or functional impairment.
• Pain during erections due to Peyronie's disease.
• Difficulty with sexual intercourse because of penile deformity.
• Visible plaque or scar tissue in the penis.

Preparation

• Patients may be advised to avoid blood-thinning medications for a specified period before the procedure.
• A physical examination and possibly an ultrasound of the penis may be required.
• Patients should inform healthcare providers of any allergies or current medications.

Procedure Description

1. The patient lies down in a comfortable position.
2. The penis is cleaned with an antiseptic solution.
3. Local anesthesia may be injected to numb the area.
4. Using a fine needle, the physician injects the medication directly into the plaque.
5. The procedure may involve a series of injections over a specified treatment period.
6. Gentle penile modeling or stretching may be performed afterward to help maximize the treatment effect.

Duration

The injection itself typically takes about 15-20 minutes, but the entire visit may take longer due to preparation and post-procedure observation.

Setting

This procedure is usually performed in an outpatient clinic or a urologist's office.

Personnel

• Urologist or trained medical specialist
• Nursing staff for assistance and patient care

Risks and Complications

• Common: Pain at the injection site, swelling, bruising.
• Rare: Penile fracture (a tear in the tunica albuginea), infection, hematoma, allergic reactions.
• Management includes pain relief, rest, and in severe cases, surgical intervention.

Benefits

• Reduction in penile curvature.
• Decreased pain during erections.
• Improved sexual function.
• Benefits may be realized gradually over several weeks to months.

Recovery

• Patients may need to limit physical activity for a few days post-injection.
• Avoiding sexual activity for several weeks as advised by the physician.
• Follow-up appointments to monitor progress and administer subsequent injections if needed.

Alternatives

• Oral medications (limited effectiveness).
• Shockwave therapy.
• Surgical correction (more invasive, longer recovery time).
• Penile traction therapy (device usage).

Pros and cons vary depending on the invasiveness, effectiveness, and patient's condition.

Patient Experience

• Mild discomfort or pain during and after the injection.
• Bruising and swelling at the injection site.
• Pain management can include over-the-counter pain relievers and applying ice packs.
• Gradual improvement in symptoms over the treatment period.