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Cystorrhaphy, suture of bladder wound, injury or rupture; complicated

CPT4 code

Name of the Procedure:

Cystorrhaphy, Suture of Bladder Wound, Injury, or Rupture (Complicated)

Summary

Cystorrhaphy is a surgical procedure performed to repair a wound, injury, or rupture of the bladder. This operation involves suturing the damaged area to restore the bladder's integrity, particularly in complicated cases where the injury may be extensive or involve surrounding tissues.

Purpose

The purpose of cystorrhaphy is to address significant bladder injuries or ruptures to prevent urine leakage into the abdominal cavity, which can cause infection and other serious complications. The procedure aims to restore bladder function and structural integrity.

Indications

  • Bladder trauma due to accidents or surgery
  • Ruptured bladder due to severe pelvic fractures
  • Complicated bladder tears with extensive tissue involvement
  • Persistent urine leakage from the bladder

Preparation

  • Patients may need to fast for several hours before the procedure.
  • Medications may be adjusted as advised by the healthcare provider.
  • Diagnostic tests such as imaging studies (CT scan, MRI) may be conducted to assess the extent of the bladder injury.
  • A complete medical evaluation including blood tests and assessment of overall health.

Procedure Description

  1. Anesthesia: General anesthesia is typically administered to ensure the patient is unconscious and free of pain during the surgery.
  2. Incision: An incision is made in the lower abdomen to access the bladder.
  3. Assessment: The bladder is inspected to assess the injury's extent.
  4. Suturing: The surgeon sutures the bladder wound or rupture using specialized surgical threads.
  5. Additional Repairs: If the injury involves surrounding tissues, additional repairs may be made.
  6. Closure: The abdominal incision is closed with sutures or staples.
  7. Drainage: A catheter or drainage tube may be placed to allow urine to drain and reduce pressure on the repaired bladder.

Duration

The procedure typically takes between 1 to 3 hours, depending on the complexity of the injury.

Setting

Cystorrhaphy is performed in a hospital's surgical department or operating room.

Personnel

  • Surgeon
  • Anesthesiologist
  • Surgical nurses
  • Operating room technicians

Risks and Complications

  • Infection
  • Bleeding
  • Urinary retention or difficulty urinating
  • Injury to surrounding organs
  • Anesthesia-related risks

Benefits

  • Effective repair of bladder injuries
  • Prevention of urine leakage and infection
  • Restoration of normal bladder function
  • Immediate reduction of symptoms such as pain and urinary leakage

Recovery

  • Hospital stay for a few days post-surgery
  • Pain management with prescribed medications
  • Restricted physical activity for several weeks
  • Follow-up appointments to monitor healing
  • Instructions for catheter care, if applicable

Alternatives

  • Non-surgical management for minor bladder injuries
  • Endoscopic approaches for less severe cases
  • Pros: Less invasive options may have shorter recovery times.
  • Cons: Non-surgical alternatives may not be effective for complicated injuries.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-surgery, patients may experience discomfort and will receive pain management medications. A catheter may be in place temporarily, and patients should follow postoperative care instructions closely to ensure proper healing.

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