CPT® Code 54231

Dynamic cavernosometry is a specialized diagnostic procedure used to assess the vascular pressure within the corpus cavernosum, which is essential for achieving and maintaining an erection. This procedure involves the use of vasoactive drugs, such as papaverine or phentolamine, which are injected directly into the corpora to induce relaxation of the arterial and sinusoidal tissues. The process begins with the administration of a local anesthetic to minimize discomfort during the procedure. A fine needle, typically ranging from 27 to 30 gauge, is employed to inject the vasodilatory agent, facilitating the necessary physiological response. Following this, a larger 19-gauge butterfly needle is inserted into the corpus cavernosum at a precise vertical angle relative to the penile axis, allowing for adequate movement during the erection phase. A perfusion pump is then connected to this needle, delivering normal saline into the tissue until an erection is achieved. Throughout the procedure, the vascular pressure is continuously monitored, with the goal of reaching approximately 150 mm/Hg. Once this pressure is attained, the infusion of saline is halted, and the pressure within the cavernosum is measured. A rapid decrease in pressure, along with the loss of erection, may indicate potential vascular leakage, providing critical information for further evaluation and management of erectile dysfunction.