Injection procedure for retrograde urethrocystography
CPT4 code
Name of the Procedure:
Retrograde Urethrocystography
Common name(s): Cystography, Retrograde Cystography
Summary
Retrograde urethrocystography is a diagnostic imaging procedure used to visualize the urethra and bladder. It involves injecting a contrast dye into the urethra to highlight the urinary structures for X-ray imaging.
Purpose
Medical Condition or Problem it Addresses:
- Identifying urethral strictures, injuries, and abnormalities.
- Diagnosing bladder injuries or conditions such as fistulas or diverticula.
Goals or Expected Outcomes:
- To provide detailed images of the urethral and bladder structures.
- To assist in diagnosing and planning appropriate treatments for urinary issues.
Indications
Symptoms or Conditions Warranting the Procedure:
- Difficulty urinating or painful urination.
- Blood in urine (hematuria).
- Repeated urinary tract infections.
Patient Criteria:
- Suspected urethral or bladder injuries.
- Evaluation prior to urological surgeries or interventions.
Preparation
Pre-procedure Instructions:
- Patients may be asked to fast for a few hours before the procedure.
Antibiotics may be prescribed to prevent infection.
Diagnostic Tests or Assessments:
- Routine blood and urine tests might be recommended.
- Allergy testing for contrast dye if needed.
Procedure Description
Step-by-step Explanation:
- The patient lies flat on the X-ray table.
- The genital area is cleaned and sterilized.
- A catheter or special syringe is inserted into the urethra.
- Contrast dye is gently injected into the urethra and bladder.
- X-ray images are taken as the dye fills the urinary structures.
- The catheter is removed once imaging is complete.
Tools and Equipment:
- Sterile catheter or syringe, contrast dye, X-ray machine.
Anesthesia or Sedation:
- Local anesthetic gel may be applied to the urethra for comfort.
Duration
The procedure typically takes about 30 to 45 minutes.
Setting
Usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
Healthcare Professionals Involved:
- Radiologist performing the imaging.
- Urologist may assist or oversee the procedure.
- Nurses for patient preparation and support.
Risks and Complications
Common Risks:
- Mild discomfort or burning during urination post-procedure.
- Infection.
Rare Risks:
- Allergic reaction to the contrast dye.
- Urethral injury.
Complication Management:
- Antibiotics for infections.
- Immediate medical attention for severe allergic reactions.
Benefits
Expected Benefits:
- Accurate diagnosis of urinary tract issues.
- Improved treatment planning based on detailed imaging.
Realization of Benefits:
- Often immediate as the images are reviewed shortly after the procedure.
Recovery
Post-procedure Care:
- Drink plenty of fluids to help flush out the dye.
- Monitor for signs of infection such as fever and report any severe symptoms.
Expected Recovery Time:
- Typically, patients can resume normal activities almost immediately.
- Mild discomfort may last for a day or two.
Follow-up:
- Follow-up appointments may be scheduled to discuss the results.
Alternatives
Other Treatment Options:
- Ultrasound imaging.
- MRI of the urinary tract.
Pros and Cons of Alternatives:
- Ultrasound: No radiation exposure but less detailed.
- MRI: High detail without radiation but more expensive and not always available.
Patient Experience
During the Procedure:
- Mild discomfort or pressure when the catheter is inserted.
- Cold sensation as the contrast dye is injected.
After the Procedure:
- Possible burning sensation during urination.
- Fluid intake is encouraged to alleviate discomfort and flush out the dye.
Pain Management and Comfort Measures:
- Local anesthetic gel for the urethra.
- Over-the-counter pain relief if needed post-procedure.