Name of the Procedure:

Testosterone Pellet Implantation (S0189)

• Common Name: Testosterone Pellet
• Medical Term: Subcutaneous Testosterone Pellet Implantation

Summary

Testosterone pellet implantation is a procedure in which small pellets containing testosterone are placed under the skin to provide a steady release of the hormone for therapy. The pellet is typically inserted into the subcutaneous tissue of the hip or buttock.

Purpose

The procedure aims to treat conditions related to low testosterone levels such as hypogonadism in men. It helps restore normal testosterone levels and alleviates symptoms such as fatigue, depression, decreased libido, and muscle mass loss.

Indications

• Symptoms of low testosterone, including fatigue, depression, and decreased libido
• Diagnosed hypogonadism
• Male patients who require a steady, long-term release of testosterone.
• Patients who may have difficulty with daily or weekly testosterone treatments

Preparation

• Fasting is not typically required.
• Patients may need to adjust or temporarily discontinue certain medications as advised by the healthcare provider.
• A blood test to measure current testosterone levels may be required before the procedure.

Procedure Description

1. Preparation: The patient's hip or buttock area is cleaned and disinfected.
2. Anesthesia: Local anesthesia is administered to numb the area.
3. Incision: A small incision is made in the skin.
4. Insertion: A trocar, a specialized instrument, is used to insert the testosterone pellets into the subcutaneous tissue.
5. Closure: The incision is closed, usually with steri-strips or surgical glue.

Duration

The procedure typically takes about 15-30 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a doctor's office.

Personnel

• Physician (endocrinologist or urologist)
• Nurse or medical assistant

Risks and Complications

• Common Risks: Bruising, swelling, pain at the insertion site.
• Rare Risks: Infection, pellet extrusion, bleeding, allergic reaction.
• Complications can often be managed with medication or minor surgical intervention.

Benefits

• Steady, long-term release of testosterone
• Improved symptoms of low testosterone
• Reduced frequency of treatment compared to other methods such as injections or gels

Recovery

• Patients can usually go home shortly after the procedure.
• Mild discomfort at the insertion site is common and can be managed with over-the-counter pain relievers.
• Avoid strenuous activities and swimming for a few days.
• Follow-up appointments may be scheduled to monitor hormone levels and symptoms.

Alternatives

• Testosterone Injections: Require frequent dosing but allow for easier dosage adjustments.
• Transdermal Testosterone: Gels or patches applied to the skin; can cause skin irritation.
• Oral Testosterone: Less common due to potential liver toxicity.

Patient Experience

• During the procedure: Patients might feel pressure or minor discomfort during insertion.
• After the procedure: Some mild soreness and bruising at the insertion site are expected. Most patients report feeling symptomatic relief within a few weeks. Pain management includes using ice packs and over-the-counter pain medications as advised.