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Repair incomplete circumcision

CPT4 code

Name of the Procedure:

Repair incomplete circumcision
Also known as: Circumcision revision, circumcision correction.

Summary

Repair of an incomplete circumcision is a surgical procedure to correct issues or complications arising from an initial circumcision that did not fully or properly remove the foreskin of the penis.

Purpose

This procedure is performed to address incomplete removal of foreskin that can cause issues such as pain, infection, or cosmetic concerns. The goal is to achieve a favorable functional and aesthetic outcome, ensuring the foreskin is adequately removed.

Indications

  • Persistent foreskin remnants after initial circumcision
  • Discomfort or pain related to the remaining foreskin
  • Frequent infections or inflammation (balanitis)
  • Dissatisfaction with the cosmetic result of the initial circumcision

Preparation

  • Patients may be advised to fast for 6-8 hours prior to the procedure.
  • Any blood-thinning medications or supplements may need to be adjusted or stopped as per doctor's instructions.
  • Diagnostic tests may include blood work to assess overall health and coagulation status.

Procedure Description

  1. Anesthesia: The procedure usually involves local anesthesia to numb the area or, in some cases, general anesthesia.
  2. Incision and Removal: The surgeon makes precise incisions to remove any remaining foreskin tissue.
  3. Hemostasis: Bleeding is controlled using cauterization or sutures.
  4. Closure: The surgical site is sutured neatly for optimal healing and cosmetic results.
  5. Dressing: A sterile dressing is applied to protect the area.

Duration

The procedure typically lasts between 30 minutes to an hour.

Setting

The procedure is generally performed in an outpatient clinic or a hospital's surgical center.

Personnel

  • Urologist or surgeon specialized in circumcision procedures
  • Surgical nurse
  • Anesthesiologist (if general anesthesia is used)

Risks and Complications

  • Infection at the surgical site
  • Bleeding or hematoma formation
  • Scarring or keloid development
  • Pain or discomfort during recovery
  • Rarely, issues such as urethral injury or unfavorable cosmetic results

Benefits

  • Relief from physical discomfort and pain
  • Reduced risk of infections and inflammation
  • Improved cosmetic appearance
  • Better overall hygiene

Recovery

  • Patients are typically advised to rest for a few days.
  • Pain management includes prescribed pain medication or over-the-counter pain relievers.
  • Avoidance of strenuous activities for at least two weeks.
  • Follow-up appointments to monitor healing progress.

Alternatives

  • Observation and non-surgical management if symptoms are mild and tolerable.
  • Topical treatments for managing infections or inflammation.
  • Complete recircumcision in cases where revision might not be suitable.

Patient Experience

During the procedure, if local anesthesia is used, the patient may feel some pressure but no pain. Post-procedure, there might be soreness and mild swelling, which are managed with pain medications and cold compresses. Most patients can resume normal activities within a few days, with full recovery typically taking a few weeks.

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