Aspiration of bladder; by trocar or intracatheter
CPT4 code
Name of the Procedure:
Aspiration of bladder; by trocar or intracatheter
Common name(s): Bladder Aspiration, Percutaneous Bladder Aspiration
Technical or medical terms: Suprapubic Aspiration, Bladder Drainage by Trocar
Summary
Bladder aspiration is a medical procedure that involves emptying the bladder by inserting a needle or catheter directly through the lower abdomen. This can be done using a trocar or intracatheter to collect urine for diagnostic purposes or to relieve urinary retention.
Purpose
Bladder aspiration is used to address urinary retention, collect sterile urine samples for diagnostic tests, and relieve discomfort when traditional catheterization is not possible or recommended. The goal is to safely and effectively drain urine from the bladder.
Indications
- Severe urinary retention or failure to void
- Need for a sterile urine sample, particularly in infants and young children
- Acute urinary obstruction caused by conditions such as benign prostatic hyperplasia (BPH), bladder stones, or tumors
- Situations where urethral catheterization is contraindicated or unsuccessful
Preparation
- Patients may be advised to fast for a few hours before the procedure.
- Blood and urine tests may be required to assess kidney function and infection.
- Patients should inform their doctor about any medications they are taking, especially blood thinners.
- An ultrasound may be performed to locate the bladder and ensure proper placement of the trocar or catheter.
Procedure Description
- The patient is positioned lying on their back.
- The lower abdomen is cleaned and sterilized.
- Local anesthesia is administered to numb the area.
- A small incision is made in the lower abdomen above the pubic bone.
- A trocar or intracatheter is carefully inserted into the bladder through the incision.
- Urine is aspirated through the device into a collection container.
- Once the bladder is drained, the trocar or catheter is removed.
- The incision site is cleaned and covered with a sterile dressing.
Duration
The procedure typically takes around 15 to 30 minutes.
Setting
Bladder aspiration is usually performed in an outpatient clinic, hospital, or surgical center.
Personnel
- Urologist or trained physician
- Nurse or medical assistant
- Radiologist or ultrasound technician (if imaging is used)
Risks and Complications
- Infection at the insertion site
- Bleeding or hematoma formation
- Injury to the bladder or surrounding organs
- Pain or discomfort during and after the procedure
- Risk of urine leakage into the abdominal cavity leading to peritonitis
Benefits
- Immediate relief from urinary retention and discomfort
- Obtaining sterile urine samples for accurate diagnosis
- Minimally invasive with a quick recovery time
- Effective when urethral catheterization is not possible
Recovery
- Patients may experience minor pain or discomfort at the insertion site.
- Pain can be managed with over-the-counter pain relievers.
- Patients are usually advised to rest for the remainder of the day.
- Keep the insertion site clean and dry to prevent infection.
- A follow-up appointment may be scheduled to check for any complications.
Alternatives
- Urethral catheterization: Inserted through the urethra, but may not be feasible in all cases.
- Intermittent self-catheterization: Requires patient training and coordination.
- In-dwelling Foley catheter: Left in place for continuous drainage but carries a risk of infection.
- Percutaneous nephrostomy: Direct drainage from the kidney for upper urinary tract issues.
Patient Experience
During the procedure, patients will be under local anesthesia, which minimizes pain but may still feel some pressure or discomfort. After the procedure, there may be mild pain at the insertion site, which can be managed with painkillers. Most patients can resume normal activities within a day or two but should follow medical advice regarding any restrictions or further care.