Name of the Procedure:

Cystotomy or Cystostomy; with Fulguration and/or Insertion of Radioactive Material

Summary

A cystotomy, or cystostomy, involves creating an opening in the bladder. This procedure may include using fulguration (a technique to destroy tissue with electric current) and/or inserting radioactive material to treat specific conditions.

Purpose

This procedure addresses urinary bladder conditions such as tumors, severe infections, and obstructions. The goal is to correct or manage these issues to restore normal bladder function or to administer targeted treatment.

Indications

• Bladder cancer that requires direct treatment.
• Severe bladder infections not responsive to medication.
• Urinary obstruction causing significant symptoms.

• Requirement for long-term bladder drainage when other methods are unsuitable.

  Preparation

• Fasting several hours before the procedure.
• Discontinuation of certain medications as directed by the healthcare provider.

• Pre-procedure diagnostics such as blood tests, urinalysis, and imaging studies (e.g., ultrasound, CT scan).

  Procedure Description

  1. The patient is given anesthesia to ensure comfort.
  2. The surgeon makes an incision in the abdominal wall to access the bladder.
  3. An opening is created in the bladder.
  4. Fulguration may be used to destroy abnormal tissue within the bladder.
  5. Radioactive material may be inserted directly into the bladder or bladder wall for targeted therapy.
  6. In some cases, a tube (catheter) is placed to allow urine drainage during healing.
  7. The incision is closed, and the patient is taken to recovery.

Tools used include a scalpel, fulguration equipment, and possibly radioactive material delivery systems. General or regional anesthesia is typically administered.

Duration

The procedure usually takes about 1 to 2 hours, depending on complexity.

Setting

Performed in a hospital or specialized surgical center.

Personnel

• Urologist or surgeon
• Surgical nurses
• Anesthesiologist
• Radiologist (if radioactive materials are involved)

Risks and Complications

• Infection at the surgical site
• Bleeding
• Injury to surrounding organs or tissues
• Adverse reaction to anesthesia
• Potential need for repeat procedures or additional interventions

Benefits

• Effective treatment of bladder cancer or other severe bladder conditions.
• Relief from urinary obstruction or severe infection.
• Improved bladder function and quality of life.

Expected benefits can often be realized within a few days to a few weeks, depending on the specific treatment and healing process.

Recovery

• Hospital stay for 1-2 days post-procedure.
• Instructions to keep the incision site clean and dry.
• Pain management with prescribed medications.
• Avoid heavy lifting and strenuous activities for several weeks.
• Follow-up appointments to monitor healing and effectiveness of the treatment.

Alternatives

• Medications for less severe conditions.
• Minimally invasive procedures such as transurethral resection of the bladder (TURB).
• Use of external catheters for urinary drainage.

Pros of alternatives may include less invasive options and shorter recovery times, while cons may be less effective in severe cases requiring direct treatment.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there might be mild to moderate pain managed by medications. The presence of a catheter for several days or weeks may cause discomfort. Following recovery instructions can enhance comfort and support faster healing.