52224 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy

Name of the Procedure:

Cystourethroscopy with Fulguration or Treatment of Minor Lesions
Also known as: Bladder Endoscopy with Fulguration, Cryosurgery, or Laser Surgery

Summary

Cystourethroscopy is a medical procedure where a thin, flexible tube with a camera (cystoscope) is inserted into the urethra to visually inspect the bladder. This procedure may involve the removal or treatment of small lesions in the bladder or urethra using electric current (fulguration), freezing (cryosurgery), or a laser.

Purpose

Medical Condition: Used to diagnose and treat bladder or urethral issues like small lesions, growths, or abnormalities.
Goals: Remove or treat lesions less than 0.5 cm, alleviate symptoms, and provide tissue for biopsy if necessary.

Indications

• Blood in urine (hematuria)
• Recurrent urinary tract infections
• Painful urination or chronic pelvic pain
• Abnormal findings from imaging studies (e.g., ultrasound or CT scan)
• Suspected bladder cancer or polyps

Preparation

• Fasting may be required a few hours before the procedure.
• Adjustments to current medications as directed by a healthcare provider.
• Urine tests or imaging may be done beforehand.

Procedure Description

1. Preparation: Patient lies on an exam table, and the genital area is cleaned.
2. Anesthesia: Local, regional, or general anesthesia may be administered.
3. Insertion: The cystoscope is gently inserted into the urethra and advanced into the bladder.
4. Inspection: The bladder and urethra are visually examined.
5. Treatment: Minor lesions are treated using fulguration, cryosurgery, or laser, and biopsies may be taken if needed.
6. Completion: The cystoscope is slowly withdrawn.

Tools Used: Cystoscope, fulguration equipment, cryotherapy tools, laser device.

Duration

Typically takes 15-45 minutes.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Urologist or specialized surgeon
• Nurses
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

Common Risks:

• Mild discomfort or bleeding during urination
• Urinary tract infection

Rare Risks:

• Bladder or urethral injury
• Prolonged bleeding
• Anesthesia-related complications

Benefits

• Accurate diagnosis of bladder/urethral issues
• Effective treatment of minor lesions
• Improved urinary symptoms
• Early detection of potential malignancies

Recovery

• Expect mild burning or blood in the urine for a few days.
• Drink plenty of fluids to help flush out the bladder.
• Avoid heavy lifting or straining for a few days.
• Follow-up may be required to monitor recovery or discuss biopsy results.

Alternatives

• Watchful waiting for small, asymptomatic lesions.
• Imaging studies (e.g., ultrasound, CT scan) for a non-invasive assessment.
• More significant surgical procedures for larger lesions or extensive disease.

Pros and Cons:

• Cystourethroscopy is minimally invasive and effective for small lesions but may cause temporary discomfort.
• Imaging is non-invasive but less accurate for small lesions.

Patient Experience

During the Procedure: Mild discomfort during cystoscope insertion and bladder inspection, especially with local anesthesia.

After the Procedure:

• Mild pain or burning during urination.
• Blood in urine that typically resolves in a few days.
• Pain management through over-the-counter pain relievers and increased fluid intake.
• Follow-up care if symptoms persist or worsen.