Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service
CPT4 code
Name of the Procedure:
Cystourethroscopy with Ureteral Catheterization (Common Names: Bladder Scope with Ureter Catheterization, Cystoscopy with Ureteral Catheterization)
Summary
Cystourethroscopy with ureteral catheterization is a diagnostic and therapeutic procedure where a cystoscope (a thin tube with a camera and light) is inserted through the urethra to view the bladder and ureters. It may involve irrigation (fluid flushing), instillation (medication delivery), or ureteropyelography (imaging of the ureters and kidneys). The procedure does not include radiologic services.
Purpose
This procedure is used to diagnose and sometimes treat conditions affecting the bladder, urethra, and ureters. It helps in identifying issues like blockages, stones, tumors, or structural abnormalities in these areas.
Indications
- Blood in urine (hematuria)
- Frequent urinary tract infections
- Painful urination (dysuria)
- Urinary incontinence
- Kidney stones or blockage
- Unexplained lower urinary tract symptoms
Preparation
- Follow fasting instructions, typically no food or drink a few hours before.
- Adjust or stop certain medications as advised by your healthcare provider.
- Undergo prior diagnostic tests like urine tests or imaging studies (e.g., ultrasound, CT scan).
Procedure Description
- Anesthesia: Local, spinal, or general anesthesia may be used.
- Insertion: A cystoscope is gently inserted through the urethra into the bladder.
- Inspection: The bladder and ureters are examined for any abnormalities.
- Catheterization: Ureteral catheters may be introduced through the cystoscope into one or both ureters for additional procedures like flushing, medication delivery, or imaging.
- Completion: Once the inspection and necessary interventions are done, the cystoscope is removed.
Duration
The procedure typically takes 15-30 minutes.
Setting
Performed in a hospital, outpatient clinic, or surgical center.
Personnel
- Urologist (surgeon)
- Nurses
- Anesthesiologist or anesthesia provider
Risks and Complications
- Urinary tract infection (UTI)
- Bleeding or blood in urine
- Discomfort or pain during urination
- Rare risk of injury to the urethra or bladder
Benefits
- Accurate diagnosis of urinary tract issues
- Immediate treatment of some conditions during the same procedure
- Quick recovery, often within a few days
Recovery
- Drink plenty of fluids post-procedure.
- Expect mild discomfort or blood-tinged urine for a day or two.
- Avoid strenuous activities for 24-48 hours.
- Follow-up appointment if needed.
Alternatives
- Non-invasive imaging (e.g., ultrasound, CT scan)
- Intravenous pyelogram (IVP) for ureter and kidney imaging
- Ongoing medical management for urinary symptoms
Patient Experience
Patients may feel slight pressure or discomfort during the procedure. Post-procedure, mild burning during urination or a small amount of blood in the urine is common. Pain relief options include over-the-counter analgesics.