Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique
CPT4 code
Name of the Procedure:
Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique
Common Names: Complex CMG with voiding pressure studies, Bladder function test with voiding pressure
Summary
A complex cystometrogram with voiding pressure studies is a diagnostic test used to measure the pressure in the bladder during filling and voiding. This helps evaluate how well the bladder and urethra are storing and releasing urine.
Purpose
Medical Condition: Overactive bladder, urinary incontinence, neurogenic bladder, urinary retention
Goals: To diagnose issues with bladder storage and release function, to determine the cause of abnormal urinary symptoms, and to guide appropriate treatment plans.
Indications
Symptoms: Frequent urination, urgency, incontinence, painful urination, incomplete emptying of the bladder
Patient Criteria: Patients with unexplained urinary symptoms, patients with suspected neurological conditions affecting bladder function, and those not responding to initial treatments.
Preparation
- Pre-procedure Instructions: Follow specific dietary restrictions if advised, arrive with a comfortably full bladder if requested, review and adjust medications as directed by your healthcare provider.
- Diagnostic Tests: A urinalysis may be required to rule out infection.
Procedure Description
- Catheter Insertion: A thin catheter is inserted into the bladder via the urethra to fill it with a sterile fluid.
- Pressure Measurement: Another catheter is placed in the rectum to measure abdominal pressure. Electronic equipment calibrates and records the pressure in the bladder.
- Filling Phase: The bladder is filled slowly while pressures are recorded.
Voiding Phase: The patient is asked to urinate while pressures are recorded to gauge voiding function.
Tools/Equipment: Catheters, calibrated electronic pressure measurement apparatus, sterile fluid.
Anesthesia/Sedation: Typically, no anesthesia; may use local anesthesia for catheter insertion if needed.
Duration
The entire procedure typically takes about 45-60 minutes.
Setting
Performed in a specialized outpatient clinic, urology practice, or hospital setting.
Personnel
Urologist or trained urodynamic specialist, nurse or medical assistant.
Risks and Complications
Common Risks: Discomfort or mild pain during catheter insertion, slight risk of urinary tract infection
Rare Risks: Bladder or urethral injury, significant bleeding
Benefits
Expected Benefits: Accurate diagnosis of underlying bladder problems, more tailored and effective treatment plans
Realization Time: Immediate insights from pressure measurements; customized treatment plan usually discussed after analysis.
Recovery
- Post-procedure Care: Drink plenty of fluids to flush out any remaining sterile fluid, mild hydration recommended.
- Recovery Time: Most patients can resume normal activities immediately.
- Follow-up: Any follow-up appointments will be scheduled to discuss results and treatment options.
Alternatives
Other Options: Non-invasive bladder scans, conservative management (lifestyle changes, medications).
Pros and Cons: Alternatives may be less invasive but potentially less informative regarding detailed bladder function.
Patient Experience
During Procedure: Expect sensations of bladder fullness, mild discomfort during catheter insertion and removal.
After Procedure: Possible mild discomfort or a burning sensation when urinating, generally temporary; pain management with over-the-counter medications if necessary.