CPT® Code 54435

The procedure described by CPT® Code 54435 involves the creation of a fistula in the corpora cavernosa of the glans penis, specifically aimed at relieving a condition known as priapism. Priapism is a prolonged and often painful erection that is not associated with sexual desire or stimulation. The fistulization process can also be referred to as an Ebbehoj or Winter procedure, both of which are minimally invasive surgical techniques. These procedures are typically performed under local anesthesia, allowing for pain control while minimizing the need for more extensive surgical intervention. During the procedure, the patient is positioned supine, and the penis is meticulously prepared and draped to maintain a sterile environment. A large bore biopsy needle or a scalpel tip is then carefully inserted through the glans penis into the corpora cavernosa, where a core of tissue is excised. This excision facilitates the drainage of accumulated blood, which is essential for alleviating the symptoms of priapism. To enhance the drainage process, gentle pressure may be applied from the base of the penis toward the glans, effectively milking the blood out of the corporal tissue. Following the procedure, the fistula is allowed to close spontaneously, which is a critical aspect of the healing process.