00936 Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy

Name of the Procedure:

Anesthesia for procedures on male genitalia, including open urethral procedures; radical amputation of the penis with bilateral inguinal and iliac lymphadenectomy.

Summary

This procedure involves the removal of the penis and surrounding lymph nodes under anesthesia. It is performed to treat certain aggressive or advanced penile cancers.

Purpose

Medical Condition

• Advanced or aggressive penile cancer.

Goals

• To remove cancerous tissue and prevent the spread of cancer.
• To improve survival outcomes and potentially alleviate symptoms caused by the tumor.

Indications

Symptoms/Conditions

• Diagnosed penile cancer, particularly when it has not responded to other treatments.
• Presence of cancer in the adjacent lymph nodes.

Patient Criteria

• The patient must be medically fit to undergo major surgery.
• Suitable for patients with confirmed lymph node involvement.

Preparation

• Patients must fast for at least 8 hours before surgery.
• Medications may need adjustment; patients should consult their doctor.
• Preoperative tests may include blood tests, imaging studies, and a physical examination.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and feels no pain during the procedure.
2. Incision: Incisions are made around the penis and in the groin area.
3. Radical Amputation: The penis is removed along with the tumor.
4. Lymphadenectomy: The surgeon removes lymph nodes in the inguinal and iliac regions to prevent cancer spread.
5. Closure: The incisions are closed with sutures or staples, and dressings are applied.

Tools and Equipment

• Scalpel, surgical scissors, retractors, sutures, and staples.
• Specialized instruments for lymph node dissection.

Anesthesia

• General anesthesia is used.

Duration

The procedure typically takes several hours, depending on the extent of the lymphadenectomy.

Setting

Performed in a hospital setting, usually in an operating room.

Personnel

• Surgeons specialized in urology or surgical oncology.
• Anesthesiologists.
• Surgical nurses and assistants.

Risks and Complications

Common Risks

• Bleeding and infection.
• Reaction to anesthesia.

Rare Risks

• Blood clots.
• Lymphedema (swelling caused by lymph fluid).

Management

• Postoperative antibiotics to prevent infection.
• Pain management strategies.
• Close monitoring post-surgery for any complications.

Benefits

• Removal of cancerous tissue which can be life-saving.
• Reduction in the risk of cancer spreading to other parts of the body.
• Potential improvement in symptoms and quality of life.

Recovery

• Hospital stay for several days post-surgery.
• Pain management with prescribed medications.
• Instructions for wound care and activity restrictions.
• Follow-up appointments for monitoring and additional treatments if needed.
• Complete recovery may take several weeks to months depending on individual circumstances.

Alternatives

• Radiation therapy.
• Chemotherapy.
• Less radical surgeries like partial penectomy.
• Each alternative has its own benefits and risks, and the choice depends on the stage of cancer, overall health of the patient, and personal preferences.

Patient Experience

• Patients will be under general anesthesia during the procedure and will not feel anything.
• Post-procedure, patients may experience pain, soreness, and swelling at the surgical sites.
• Pain will be managed with medications, and patients will receive detailed care instructions to ensure a smooth recovery.