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Prostatotomy, external drainage of prostatic abscess, any approach; simple

CPT4 code

Name of the Procedure:

Prostatotomy, external drainage of prostatic abscess, any approach; simple

Summary

A Prostatotomy for external drainage of a prostatic abscess is a surgical procedure designed to remove an accumulation of pus within the prostate gland. This is a straightforward procedure meant to relieve discomfort and treat infection by draining the abscess.

Purpose

The procedure aims to:

  • Address prostatic abscesses that can cause severe pain, fever, and urinary difficulties.
  • Eliminate infection to prevent further complications.
  • Provide rapid resolution of symptoms and promote healing.

Indications

  • Severe pain or discomfort in the pelvic region.
  • Fever and chills suggesting an infection.
  • Difficulty urinating or urinary retention.
  • Diagnosed prostatic abscess confirmed via ultrasound or other imaging techniques.
  • Failure of conservative treatments such as antibiotics.

Preparation

  • Patients may be advised to fast for several hours before the procedure.
  • Stop certain medications, such as blood thinners, as directed by the healthcare provider.
  • Pre-procedural imaging, like an ultrasound, to locate and assess the abscess.
  • Blood tests to evaluate overall health and readiness for surgery.

Procedure Description

  1. The patient is placed under local or general anesthesia.
  2. The surgeon makes a small incision in the perineal region or uses a transrectal approach.
  3. Using specialized instruments, the surgeon accesses the prostate gland.
  4. The abscess is carefully drained of pus.
  5. The area is cleaned, and a drain may be placed to allow for continued drainage if necessary.
  6. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

The procedure is usually performed in a hospital or surgical center.

Personnel

  • Urologist or general surgeon.
  • Anesthesiologist or nurse anesthetist.
  • Surgical nursing staff.

Risks and Complications

  • Infection at the surgical site.
  • Bleeding.
  • Damage to surrounding tissues.
  • Recurrence of the abscess.
  • Adverse reactions to anesthesia.
  • Temporary urinary incontinence.

Benefits

  • Rapid relief from pain and other symptoms.
  • Elimination of infection.
  • Prevention of further complications related to the abscess.

Recovery

  • Pain management typically includes prescribed medications.
  • Avoid heavy lifting and strenuous activities for a few weeks.
  • Follow-up appointments to monitor healing and ensure no recurrence of the abscess.
  • Full recovery is generally expected within a few weeks.

Alternatives

  • Antibiotic therapy alone, although it may not be effective if the abscess is large or persistent.
  • Needle aspiration under ultrasound guidance, which is less invasive but may not drain the abscess completely.
  • Conservative management focusing on symptom relief, though not addressing the underlying issue.

Patient Experience

  • Patients may experience discomfort or pain during recovery, which can be managed with medication.
  • Some swelling and bruising at the incision site is normal.
  • Most patients feel a significant reduction in symptoms soon after the procedure.

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