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Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia

CPT4 code

Name of the Procedure:

Cystourethroscopy with Dilation of Bladder for Interstitial Cystitis (IC)

Summary

Cystourethroscopy with dilation of the bladder is a minimally invasive procedure used to diagnose and treat interstitial cystitis, a chronic condition causing bladder pain and frequent urination. The procedure involves using a cystoscope to visually inspect the bladder and urethra and then stretching the bladder to alleviate symptoms. It is performed under general or spinal anesthesia.

Purpose

The procedure is aimed at diagnosing and providing symptomatic relief for interstitial cystitis. The goals include reducing bladder pain, decreasing urinary frequency, and improving the patient's quality of life.

Indications

  • Persistent bladder pain or pelvic discomfort
  • Frequent urination, including nocturia (frequent nighttime urination)
  • Patients diagnosed with interstitial cystitis

Preparation

  • Patients are typically instructed to fast for 6-8 hours prior to the procedure.
  • Discontinue certain medications as advised by the healthcare provider.
  • Blood tests or imaging studies may be required beforehand to assess overall health.

Procedure Description

  1. Anesthesia: General or spinal anesthesia is administered to ensure the patient is pain-free and comfortable.
  2. Insertion of Cystoscope: A cystoscope, which is a thin, tube-like instrument with a camera and light, is gently inserted through the urethra into the bladder.
  3. Bladder Inspection: The bladder's lining is inspected for inflammation, ulcers, or other abnormalities.
  4. Bladder Dilation: A saline solution is used to fill and stretch the bladder. This may help reduce bladder wall sensitivity.
  5. Completion: Once the inspection and dilation are complete, the cystoscope is removed.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

Cystourethroscopy with bladder dilation is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

  • Urologist or surgeon
  • Anesthesiologist
  • Nursing staff

Risks and Complications

  • Urinary tract infection (UTI)
  • Bleeding or hematuria (blood in urine)
  • Bladder perforation (rare)
  • Discomfort or pain post-procedure

Benefits

  • Relief from bladder pain and discomfort
  • Reduced frequency of urination
  • Diagnostic clarity for further treatment
  • Improvement in the quality of life, often noted within weeks

Recovery

  • Patients are monitored post-procedure for a few hours.
  • Urine may appear slightly bloody for a few days.
  • Drink plenty of fluids to flush out the bladder.
  • Avoid strenuous activities for a few days.
  • Follow-up appointments may be scheduled to monitor symptoms and healing.

Alternatives

  • Oral medications (e.g., pain relievers, antihistamines)
  • Physical therapy
  • Dietary changes
  • Bladder instillations (direct medication into the bladder)
  • Surgical options (for severe cases)

Patient Experience

During the procedure, patients are under anesthesia and will not feel pain. Afterward, they might experience mild discomfort, urgency to urinate, and light bleeding. Pain management includes prescribed medications and advice to rest and stay hydrated.

Medical Policies and Guidelines for Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia

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