55920 Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application

Name of the Procedure:

Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application

Summary

This procedure involves inserting needles or catheters into pelvic organs like the uterus or ovaries, or into genital areas (excluding the prostate), in order to implant radioactive materials used for cancer treatment.

Purpose

This procedure is utilized primarily for treating cancers within the pelvic region, like cervical or ovarian cancer. The goal is to deliver high doses of radiation directly to the tumor while minimizing exposure to surrounding healthy tissue.

Indications

• Diagnosed cancer in the pelvic region, such as cervical or ovarian cancer.
• Cases where external beam radiation therapy is not sufficient.
• Patients who are good candidates for brachytherapy, a type of internal radiation therapy.

Preparation

• Patients may be required to fast for a certain period before the procedure.
• Some medications, especially blood thinners, may need to be adjusted.
• Imaging tests like MRI or CT scans might be conducted to plan the procedure.

Procedure Description

1. The patient is positioned and anesthetized, either with local or general anesthesia.
2. Using imaging guidance (ultrasound, CT, or MRI), needles or catheters are precisely inserted into the target pelvic organs or genital areas.
3. Radioactive materials (radioelements) are placed inside these needles or catheters.
4. The radioactive elements remain for a specific period to deliver the required dose of radiation directly to the cancer cells.
5. The needles or catheters may be removed immediately or left in place for a prescribed time, depending on the treatment plan.

Duration

The procedure typically takes between 1 to 3 hours, depending on its complexity and the specific areas being treated.

Setting

This procedure is usually performed in a hospital, particularly in a specialized radiology or oncology department.

Personnel

• Radiologist or Oncologist (specialist performing the procedure)
• Anesthesiologist (administering anesthesia)
• Nurses and radiology technicians (assisting during the procedure)

Risks and Complications

• Infection at the insertion site
• Bleeding or hematoma formation
• Discomfort or pain at the treatment site
• Potential damage to surrounding organs or tissues
• Rarely, unintended radiation exposure to non-targeted areas

Benefits

• Targeted treatment that maximizes radiation to the tumor and spares healthy tissues
• Potentially higher success rate in eradicating tumors compared to external radiation therapy alone
• Reduced side effects compared to conventional radiation therapy

Recovery

• Patients may experience some discomfort or mild pain, manageable with prescribed pain medications.
• Activity might be restricted for a short period, particularly if anesthesia was used.
• Follow-up appointments will be necessary to monitor the effectiveness of the treatment and manage any side effects.
• Recovery time varies, but most patients resume normal activities within a few days to a week.

Alternatives

• External beam radiation therapy
• Surgical removal of the tumor
• Chemotherapy alone or in combination with other treatments
• Each alternative has its own set of benefits and drawbacks, influenced by the type and stage of cancer, as well as the patient’s overall health.

Patient Experience

• Patients may feel slight pressure or discomfort during the insertion of needles or catheters, especially if only local anesthesia is used.
• Post-procedure, there might be some tenderness at the insertion sites and a need for mild pain relief.
• Most patients tolerate the procedure well and can return home on the same day, with clear post-care instructions provided to manage any immediate aftereffects.