51880 Closure of cystostomy (separate procedure)

Name of the Procedure:

Closure of cystostomy (separate procedure), also known as cystostomy tube removal or cystostomy closure.

Summary

In layman's terms, this procedure involves the removal of a tube (cystostomy tube) that was previously inserted into the bladder through the abdominal wall to help with urine drainage. The procedure then closes the opening left by the tube.

Purpose

This procedure is done to close the opening into the bladder once it is no longer needed. It helps restore normal urinary function and reduces the risk of infections and other complications associated with having a cystostomy tube in place.

Indications

• The patient's underlying condition requiring the cystostomy tube has resolved.
• The urinary tract has healed sufficiently to allow normal urination.
• There is no longer a need for external urinary drainage.
• Good bladder function has been confirmed through tests.

Preparation

• Patients may need to fast for a certain period before the procedure if general anesthesia is used.
• Medications, especially blood thinners, may need to be adjusted as per the doctor’s advice.
• Pre-procedure tests may include urine tests and imaging studies like an ultrasound or cystogram to ensure the bladder is functioning correctly.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered based on the surgeon's assessment.
2. Preparation: The surgical area is cleaned and sterilized.
3. Tube Removal: The cystostomy tube is carefully removed.
4. Closure: The small opening in the bladder and the abdominal wall is closed using sutures.
5. Final Steps: The area is cleaned, and a sterile dressing is applied to the incision site.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeons specialized in urology.
• Surgical nurses and assistants.
• Anesthesiologist or nurse anesthetist if general anesthesia is used.

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Persistent leakage of urine from the healing site.
• Injury to surrounding organs or structures.
• Anesthesia-related risks.

Benefits

• Restoration of normal urinary function.
• Reduced risk of urinary infections associated with long-term cystostomy.
• Improved quality of life and comfort.

Recovery

• Post-procedure monitoring in the recovery room.
• Pain management typically involves over-the-counter pain relievers; stronger medications may be prescribed if needed.
• Patients can usually go home the same day.
• Keep the incision site clean and dry.
• Follow-up appointments to monitor healing and ensure there are no complications.
• Most patients can resume normal activities within a few days but should avoid strenuous activity for about 4 weeks.

Alternatives

• Continued use of the cystostomy tube for those who still require urinary drainage.
• Intermittent catheterization if bladder function is not fully restored.
• These alternatives may have different benefits and risks compared to cystostomy closure.

Patient Experience

• Patients might feel a slight discomfort during the removal and closure process.
• Pain at the incision site can be managed with medications.
• Patients are likely to experience a significant improvement in daily comfort and urinary function post-recovery.