Name of the Procedure:

Cystostomy, cystotomy with drainage

Summary

Cystostomy, or cystotomy with drainage, is a surgical procedure where a small incision is made into the bladder to allow urine to be drained. A tube is inserted during the procedure to facilitate continuous drainage.

Purpose

The procedure aims to address urinary obstruction, bladder injury, or other conditions preventing normal urination. It helps in relieving pain, preventing bladder infections, and avoiding further kidney damage.

Indications

• Urinary retention
• Bladder obstruction due to tumors or enlarged prostate
• Traumatic bladder injury
• Neurological conditions affecting bladder control
• A need to divert urine temporarily after complex surgeries

Preparation

• Patients are usually advised to fast for 6-8 hours before the procedure.
• Blood and urine tests may be conducted to assess overall health.
• Imaging studies like ultrasound or CT scan may be performed to pinpoint the obstruction.

Procedure Description

1. The patient is administered anesthesia (usually general or regional).
2. An incision is made in the lower abdomen.
3. A small cut is made in the bladder.
4. A tube (catheter) is inserted into the bladder through the incision to drain urine.
5. The tube is secured, and the incision is closed around the tube to ensure it stays in place.
6. The tube can then drain urine into a collection bag.

Duration

Approximately 1 to 2 hours.

Setting

The procedure is typically performed in a hospital or surgical center.

Personnel

• Urologist or general surgeon
• Surgical nurse
• Anesthesiologist
• Operating room staff

Risks and Complications

• Infection at the incision site or within the bladder
• Bleeding
• Injury to nearby organs
• Clot formation in the bladder
• Dislodgement or obstruction of the catheter

Benefits

• Immediate relief from urinary obstruction
• Prevention of urinary tract infections
• Protection against kidney damage
• Improved comfort and quality of life

Recovery

• Hospital stay of a few days for monitoring
• Instructions for catheter care and hygiene
• Restricted physical activity for a few weeks
• Follow-up appointments to assess healing and catheter function

Alternatives

• Indwelling urinary catheter inserted via the urethra
• Intermittent self-catheterization
• Medications to relieve symptoms
• Prostate surgery or tumor removal if applicable

Patient Experience

• Mild discomfort or pain, managed with medications
• Sensation and awareness of the catheter
• Instructions on how to manage and care for the catheter at home