Name of the Procedure:

• Cystorrhaphy
• Common name: Suture of bladder wound, injury, or rupture
• Medical term: Cystorrhaphy (simple)

Summary

Cystorrhaphy is a surgical procedure to repair a wound, injury, or rupture of the bladder by stitching it closed. It is classified as a simple procedure for less complex injuries.

Purpose

Cystorrhaphy addresses bladder injuries or ruptures, aiming to restore the bladder's integrity and normal function by closing the wound or repair the tear.

Indications

• Bladder trauma from accidents or surgical complications
• Injuries causing a tear or rupture of the bladder
• Symptoms such as blood in urine, difficulty urinating, or leakage of urine into the abdomen

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Preoperative diagnostic tests such as a CT scan, ultrasound, or cystoscopy may be required.
• Discussion with the healthcare team regarding current medications, which might need adjustment.

Procedure Description

1. Anesthesia: Administered general or regional anesthesia.
2. Incision: Small incisions made to access the bladder.
3. Closure: The surgeon stitches the bladder wound or tear using absorbable sutures.
4. Irrigation: The bladder may be irrigated and checked for leaks.
5. Closing Incision: The external incision is closed with sutures or staples.

Tools and equipment used include surgical sutures, scalpels, scissors, and possibly laparoscopic instruments if a minimally invasive approach is taken.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the injury.

Setting

Cystorrhaphy is performed in a hospital operating room or a surgical center.

Personnel

The team usually includes:

• A urologic surgeon or a general surgeon
• An anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgery site
• Bleeding or blood clots
• Injury to surrounding organs
• Urinary retention or incontinence
• Potential need for a repeat surgery if the bladder repair fails

Benefits

• Restores bladder function
• Prevents further leakage of urine and associated complications
• Typically, benefits are realized almost immediately, with progressive improvement as healing occurs.

Recovery

• Hospital stay for 1-3 days post-procedure for monitoring
• Catheter may be left in place for several days to allow healing
• Pain management will be provided
• Avoid heavy lifting and strenuous activities for several weeks
• Follow-up appointments for monitoring recovery and removing the catheter

Alternatives

• Conservative management with catheterization for small, non-severe injuries.
• More complex surgical approaches for severe or multiple bladder injuries.
• Pros and cons vary based on injury severity and individual patient conditions.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-procedure, there might be discomfort or pain at the incision site managed with medication. Gradual improvement is expected as the bladder heals.