Cavitational ultrasonic surgical aspiration (CUSA) 

A few EMPD patients also report success Cavitational Ultrasonic Surgical Aspiration (CUSA) procedures when a small area of extramammary Paget’s disease (EMPD) needs to be removed. 

Using low frequency ultrasound energy, a CUSA device dissects and fragments tissue. The unit is similar in size to an handheld ultrasound device while it also inlcudes an aspirator to remove tissue particles. It has advantages of limited blood loss, improved visibility and less collateral tissue impacts than traditional surgery. 

Treatments for extramammary Paget’s disease (EMPD) often differ but frequently include one or more of the following: Mohs surgery, wide local excision (WLE) surgery, topical creams, carbon dioxide (CO2) laser, photodynamic therapy (PDT), cavitational ultrasonic surgical aspiration (CUSA), radiation therapy, skin grafts, and chemotherapy.