Insertion of penile prosthesis; non-inflatable (semi-rigid)
CPT4 code
Name of the Procedure:
Insertion of Penile Prosthesis; Non-Inflatable (Semi-Rigid) Common names: Semi-Rigid Penile Implant, Non-Inflatable Penile Prosthesis
Summary
The insertion of a penile prosthesis involves surgically placing a non-inflatable, semi-rigid device inside the penis. This device helps men achieve and maintain an erection suitable for sexual intercourse.
Purpose
This procedure is used to treat erectile dysfunction (ED) that does not respond to other treatments like medication or therapy. The goal is to restore the ability to have erections, improve sexual function, and enhance overall quality of life.
Indications
- Severe erectile dysfunction unresponsive to medication or therapy
- Peyronie’s disease complicated by ED
- Need for a reliable solution for achieving erections
- Patient preference for a permanent and low-maintenance solution
Preparation
- Fasting typically required from midnight before the surgery
- Adjustment or discontinuation of certain medications (e.g., blood thinners)
- Preoperative tests like blood work, urinalysis, or cardiovascular assessments
- Shower and use antiseptic soap before arriving at the hospital or clinic
Procedure Description
- Patient is usually given general anesthesia or spinal anesthesia.
- A small incision is made at the base of the penis or in the lower abdomen.
- The surgeon places the semi-rigid rods in the penis.
- The incision is closed with sutures and a dressing is applied.
- A catheter may be temporarily placed to aid urination.
Duration
The procedure typically takes about 1-2 hours.
Setting
The surgery is generally performed in a hospital or an outpatient surgical center.
Personnel
- Urologist or specialized surgeon
- Anesthesiologist
- Surgical nurse
- Operating room technician
Risks and Complications
- Infection
- Bleeding or hematoma
- Device malfunction or displacement
- Erosion of the prosthesis through the skin
- Pain or discomfort
- Scar tissue formation
Benefits
- Reliable and effective solution for achieving erections
- Long-term and low-maintenance
- Can help restore sexual function and confidence
- Generally high satisfaction rates among patients
Recovery
- Initial pain and swelling managed with medication
- Restricted physical activity for about 4-6 weeks
- Follow-up appointments for monitoring and assessment
- Instructions on wound care and activity limitations
- Sexual activity typically can resume after 6 weeks
Alternatives
- Oral medications (e.g., Viagra, Levitra, Cialis)
- Vacuum erection devices (VEDs)
- Injectable or intraurethral medications
- Inflatable penile prosthesis
- Counseling or sex therapy
Patient Experience
During the procedure, patients are under anesthesia and will not feel anything. Post-procedure, they may experience discomfort, pain, and swelling, which can be managed with prescribed painkillers. Most patients are up and moving within a day or two but need to follow specific recovery guidelines. Sexual activity can usually be resumed in 6 weeks, with many patients experiencing satisfactory results.