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Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis

CPT4 code

Name of the Procedure:

Removal of Non-Inflatable (Semi-Rigid) or Inflatable (Self-Contained) Penile Prosthesis, Without Replacement

Summary

This procedure involves surgically removing a non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis without replacing it with a new prosthesis. It is done under anesthesia to ensure the patient doesn't feel pain during the procedure.

Purpose

This procedure addresses issues related to malfunctioning or infected penile prostheses. The goal is to remove the faulty or problematic device to relieve symptoms such as pain, infection, or mechanical failure.

Indications

  • Chronic pain or discomfort from a penile prosthesis
  • Infection of the prosthesis
  • Mechanical failure of the device
  • Erosion of the prosthesis into surrounding tissues

Preparation

  • Fasting for at least 6-8 hours before the procedure
  • Avoiding certain medications as advised by the healthcare provider
  • Undergoing diagnostic tests like blood work or imaging studies to assess the condition and plan the surgery

Procedure Description

  1. The patient is administered general or regional anesthesia.
  2. An incision is made near the location of the prosthesis.
  3. The prosthesis is carefully detached and removed.
  4. The surgical site is examined for any infection or other issues.
  5. The incision is then closed using sutures.
  6. A sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This surgery is usually performed in a hospital or a specialized surgical center.

Personnel

  • Surgeon (urologist)
  • Anesthesiologist
  • Surgical nurse
  • Operating room technician

Risks and Complications

  • Infection
  • Bleeding
  • Damage to surrounding tissues
  • Scar tissue formation
  • Anesthetic complications

Benefits

  • Relief from pain or discomfort
  • Resolution of infection
  • Improved quality of life
  • Prevention of further complications associated with a malfunctioning prosthesis

Recovery

  • Patients can expect to stay in the hospital for a day or two for observation.
  • Pain management will be provided as needed.
  • Instructions about wound care and activity restrictions will be given.
  • Recovery varies but typically spans a few weeks.
  • Follow-up appointments will be necessary to monitor healing.

Alternatives

  • Antibiotic therapy for minor infections (may not be effective for severe infections)
  • Retaining the prosthesis if replacement is an option (offering a different prosthetic solution)

Patient Experience

During the procedure, the patient will be under anesthesia and won’t feel any pain. Afterward, they may experience some discomfort or pain, which will be managed with medication. Most patients need a few weeks to recover fully and should follow medical advice for the best outcome.

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