Complex cystometrogram (ie, calibrated electronic equipment)
CPT4 code
Name of the Procedure:
Complex Cystometrogram (CMG)
- Also known as Urodynamic Testing or Bladder Function Test
Summary
A Complex Cystometrogram (CMG) is a diagnostic test that examines how well your bladder is functioning. It measures how much your bladder can hold, how smoothly urine flows out, and how the bladder muscles work. This procedure uses calibrated electronic equipment to provide accurate measurements.
Purpose
The CMG is used to diagnose and evaluate disorders of the bladder and urethra. It helps identify issues like urinary incontinence, frequent urination, or difficulty emptying the bladder. The goal is to pinpoint the exact nature of bladder problems, guiding appropriate treatment plans.
Indications
- Symptoms of urinary incontinence
- Frequent urination (overactive bladder)
- Difficulty urinating or incomplete bladder emptying
- Painful urination without infections
- Neurogenic bladder conditions
- Follow-up for conditions like spinal cord injuries
Preparation
- You may be asked to arrive with a comfortably full bladder.
- Inform your doctor of any medications you're taking; some may need to be adjusted.
- A urinary tract infection (UTI) should be ruled out before the test, so a urine sample may be required.
Procedure Description
- Initial Assessment: You may be asked to empty your bladder to measure residual urine.
- Catheter Insertion: A small catheter is inserted into the bladder through the urethra and another into the rectum to measure pressure.
- Bladder Filling: The bladder is slowly filled with sterile water or saline. You'll be asked to report sensations of filling and urgency.
- Pressure Measurement: As the bladder fills, pressures within the bladder and abdomen are recorded. You may be asked to cough or bear down at intervals.
- Voiding Phase: You will be asked to void, and the measurements taken during emptying will be recorded.
- Tools: Catheters, calibrated electronic measurement equipment.
- Anesthesia: Local anesthetic gel may be used for comfort.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The CMG is usually performed in a hospital's urology department or an outpatient clinic specialized in urodynamic testing.
Personnel
- Urologist or a specially-trained healthcare provider
- Nurses or medical assistants to help with equipment and patient care
Risks and Complications
- Mild discomfort or pain during catheter insertion
- Urinary tract infection (UTI)
- Rarely, bladder or urethral injury
- Blood in urine (usually temporary)
Benefits
- Accurate diagnosis of urinary problems
- Helps tailor effective treatment plans
- Immediate insights about bladder and urethral function
Recovery
- You may feel a mild burning sensation during urination for a few hours.
- Drink plenty of fluids to flush out your system.
- Avoid strenuous activities for the rest of the day.
- Follow-up appointment may be scheduled to discuss results and next steps.
Alternatives
- Bladder diary and observation over time
- Non-invasive tests like ultrasound
- Empirical treatment based on symptoms without detailed urodynamic information
Pros and Cons of Alternatives: While alternatives might offer initial insights with less discomfort, they may not provide as comprehensive an evaluation as the CMG, potentially leading to less targeted treatment.
Patient Experience
During the procedure, you may experience pressure and mild discomfort from the catheters and bladder filling. Most patients report it as tolerable. Pain management measures, including local anesthesia, are used for comfort. Afterward, you might feel tired but should be able to resume normal activities within a day.