Ureteroplasty, plastic operation on ureter (eg, stricture)
CPT4 code
Name of the Procedure:
Ureteroplasty, Plastic Operation on Ureter (e.g., Stricture)
Summary
Ureteroplasty is a surgical procedure performed to correct a narrowing (stricture) or blockage within the ureter, which is the tube that connects the kidney to the bladder. This condition can obstruct the flow of urine and cause kidney damage.
Purpose
Ureteroplasty aims to restore normal urine flow from the kidney to the bladder, alleviating pain, preventing infections, and preserving kidney function. It addresses conditions like ureteral strictures or obstructions caused by scar tissue, congenital defects, or previous surgeries.
Indications
- Recurrent urinary tract infections
- Persistent flank pain
- Decreased kidney function
- Identified ureteral stricture on imaging tests (e.g., ultrasound, CT scan)
- Difficulty in urine drainage
- History of urological surgeries leading to scarring
Preparation
- Patients may be instructed to fast for 8-12 hours before the procedure.
- Blood tests, urine tests, and imaging studies like CT scans or MRIs are conducted beforehand.
- Certain medications, especially blood thinners, may need to be paused under doctor's advice.
- An informed consent form must be signed.
Procedure Description
- The patient is placed under general anesthesia.
- A small incision is made to access the ureter.
- The narrowed or blocked section of the ureter is cut.
- The healthy ends of the ureter are reconnected, or a tissue graft is used if necessary.
- A stent is often placed to ensure the ureter remains open during healing.
- The incision is closed with sutures.
Tools and Equipment:
- Surgical instruments (scalpels, forceps)
- Endoscopic equipment
- Ureteral stent
- Sutures
Duration
Typically, the procedure takes 2-4 hours.
Setting
This procedure is usually performed in a hospital operating room.
Personnel
- Urologist surgeon
- Surgical nurses
- Anesthesiologist
- Operating room technicians
Risks and Complications
- Infection at the surgical site
- Bleeding
- Injury to nearby organs
- Urine leakage
- Stricture recurrence
- Anesthesia-related risks Management involves antibiotics, additional surgeries, or other interventions if complications arise.
Benefits
- Relief from pain and discomfort
- Lower risk of infections
- Improved kidney function
- Long-term solution to urinary obstruction Benefits are often seen within weeks to a few months post-surgery.
Recovery
- Patients usually stay in the hospital for a few days post-surgery.
- Pain management with prescribed medications.
- Avoid heavy lifting and strenuous activities for 4-6 weeks.
- Follow-up appointments for stent removal and monitoring.
- Hydration and a balanced diet are encouraged.
Alternatives
- Endoscopic balloon dilation: Less invasive but might be less durable.
- Ureteral stenting: Offers temporary relief, potentially requiring frequent changes.
- Observation: Managing symptoms with medications without addressing the underlying issue.
Patient Experience
During the procedure, the patient will be under general anesthesia and will feel no pain. Post-procedure, patients may experience some discomfort and require pain medications. Regular follow-ups and adherence to recovery guidelines ensure optimal healing and outcome.