54430 Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral

Name of the Procedure:

Corpora cavernosa-corpus spongiosum shunt (Priapism operation), unilateral or bilateral

Summary

The corpora cavernosa-corpus spongiosum shunt procedure, commonly known as a priapism operation, is a surgical method used to alleviate prolonged and painful erections (priapism) that are not related to sexual activity and do not subside naturally.

Purpose

This procedure addresses priapism, a condition where an erection persists for hours beyond or without sexual stimulation. The goal is to alleviate the erection, restore comfort, and protect erectile function by draining excess blood from the penis.

Indications

• Persistent erection lasting more than four hours (ischemic priapism).
• Severe pain and discomfort.
• Risk of permanent erectile tissue damage.
• Failure of conservative treatments like aspiration and medication.

Preparation

• Fasting for at least 6 hours before the procedure.
• Avoidance or adjustment of certain medications (e.g., blood thinners) as advised by the doctor.
• Undergoing a physical examination, blood tests, and potentially penile ultrasound to assess blood flow and tissue health.

Procedure Description

1. The patient is administered local or general anesthesia depending on the case's complexity and patient preference.
2. Sterile drapes are placed around the surgical area.
3. The surgeon makes a small incision in the penis to access the corpora cavernosa.
4. A shunt is created between the corpora cavernosa and corpus spongiosum to allow blood to drain from the engorged area.
5. The incision is closed with sutures and bandaged.

Tools and equipment used include scalpels, shunt devices, and sutures. The procedure typically involves sedation or general anesthesia to ensure patient comfort.

Duration

The procedure usually takes about 30 minutes to 1 hour.

Setting

The procedure is typically performed in a hospital operating room or a specialized surgical center.

Personnel

• Urologic surgeon
• Anesthesiologist
• Operating room nurses and surgical technicians

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Risk of erectile dysfunction.
• Scar tissue formation.
• Recurrence of priapism.

Benefits

• Rapid relief from painful and prolonged erections.
• Preservation of erectile tissue and function.
• Prevention of long-term complications associated with untreated priapism.

Recovery

• Pain management with prescribed medications.
• Keeping the penis elevated to reduce swelling.
• Avoiding strenuous activities and sexual intercourse for a specified period.
• Follow-up appointments to monitor recovery and penile function.

Alternatives

• Aspiration of blood from the penis.
• Intracavernosal injection of medications to induce detumescence.
• Oral or intravenous medication administration. Each alternative has different success rates and risks which should be discussed with a healthcare provider.

Patient Experience

During the procedure, the patient will be under sedation or general anesthesia, ensuring they do not feel pain or discomfort. Post-procedure, some discomfort and swelling may be experienced, manageable with pain medications and rest. Full recovery can take several weeks, during which follow-up care is crucial.