Irrigation of corpora cavernosa for priapism
CPT4 code
Name of the Procedure:
Irrigation of Corpora Cavernosa for Priapism
Summary
Irrigation of the corpora cavernosa is a medical procedure used to treat priapism, a prolonged and often painful erection. The procedure involves flushing the blood out of the corpora cavernosa, the erectile tissue in the penis, to relieve the erection.
Purpose
The procedure addresses priapism, a condition where an erection lasts longer than four hours. The goal is to relieve the erection and prevent permanent tissue damage and potential erectile dysfunction.
Indications
- Erection lasting longer than four hours
- Painful erection
- Lack of response to initial treatments for priapism
- Medical history of priapism or conditions that predispose to priapism (e.g., sickle cell anemia)
Preparation
- The patient may need to fast for a few hours before the procedure.
- Stop certain medications as advised by the healthcare provider.
- Blood tests and an ultrasound may be performed to assess the severity and cause of the priapism.
Procedure Description
- The patient is positioned comfortably, usually on an examination table.
- Local anesthesia is applied to numb the penile area.
- A sterile needle is inserted into the corpora cavernosa.
- A saline solution is injected to flush out the trapped blood.
- The procedure may be repeated multiple times until the blood is sufficiently drained.
- In some cases, medications may be injected to further reduce the erection.
Duration
The procedure typically takes about 30 minutes to an hour.
Setting
The procedure is usually performed in an outpatient clinic, emergency room, or hospital setting.
Personnel
- Urologist or surgical specialist
- Nurses or medical assistants
- Anesthesiologist, if required
Risks and Complications
- Infection at the needle insertion site
- Bleeding or bruising
- Pain during and after the procedure
- Potential for recurring priapism
- Rare risk of damage to penile tissue leading to erectile dysfunction
Benefits
- Immediate relief from the prolonged erection
- Prevention of permanent damage to the erectile tissue
- Restoration of normal blood flow and function
- Quick resolution of pain associated with priapism
Recovery
- Mild discomfort or swelling is expected post-procedure.
- Prescription of pain relievers or anti-inflammatories, if necessary.
- Avoidance of sexual activity and strenuous physical activity for a few days.
- Follow-up appointments to monitor healing and function.
Alternatives
- Oral or injected medications to reduce the erection.
- Aspiration alone without irrigation.
- Surgical shunt procedures for more severe or refractory cases.
- Each alternative has its own risk-benefit profile compared to irrigation.
Patient Experience
- Initial discomfort from needle insertion and local anesthesia.
- A sense of relief as the erection resolves.
- Post-procedure soreness, manageable with prescribed pain relief.
- Instructions provided to ensure proper recovery and prevent recurrence.