Name of the Procedure:

Cystourethroscopy with insertion of permanent urethral stent

• Common Name: Bladder and urethra camera exam with stent placement
• Technical Term: Cystourethroscopy with permanent urethral stent insertion

Summary

Cystourethroscopy with insertion of a permanent urethral stent is a procedure where a doctor uses a specialized scope to view the inside of the bladder and urethra and then places a stent to keep the urethra open.

Purpose

This procedure is done to treat conditions like urethral strictures, which are narrowings of the urethra that can cause problems with urination. The goal is to relieve urinary obstruction and improve the flow of urine, providing long-term relief from symptoms.

Indications

• Recurrent urethral strictures
• Difficulty urinating or weak urine stream
• Frequent urinary tract infections due to blockages
• Patients who have not responded to other treatments such as dilation or temporary stents

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted.
• Pre-procedure tests like urine analysis or imaging studies may be required.

Procedure Description

1. Anesthesia: The patient is given either general or local anesthesia for comfort.
2. Cystourethroscopy: A cystoscope, a thin tube with a camera, is inserted through the urethra into the bladder to visualize the area.
3. Stent Placement: A specially designed stent is inserted through the cystoscope and positioned within the urethra to hold it open.
4. Completion: After verifying the stent's proper placement, the cystoscope is removed.

Technology/Tools: Cystoscope, stent, guidewires, and possibly fluoroscopy for guidance.

Duration

The procedure typically takes about 30 to 60 minutes but may vary depending on individual circumstances.

Setting

This procedure is generally performed in a hospital's operating room or an outpatient surgical center.

Personnel

• Urologist (Surgeon)
• Anesthesiologist
• Surgical Nurse or Technician

Risks and Complications

• Common: Mild discomfort, urinary frequency or urgency, blood in the urine.
• Rare: Infection, stent migration, urethral injury, or urinary incontinence.

Benefits

• Improved urine flow
• Reduced urinary symptoms
• Decreased risk of urinary tract infections
• Long-term relief from urethral strictures

Recovery

• Post-procedure: May experience mild discomfort or urinary symptoms.
• Care: Drink plenty of fluids, avoid strenuous activities for a few days.
• Follow-up: Regular check-ups may be needed to monitor the stent.
• Recovery Time: Most patients return to normal activities within a few days, but complete recovery might take a couple of weeks.

Alternatives

• Urethral dilation: Temporarily widens the urethra but may not be lasting.
• Urethroplasty: Surgical reconstruction of the urethra.
• Periodic self-catheterization: To maintain urethral patency.

Patient Experience

During the procedure, patients will be under anesthesia, so they won't feel any pain. After the procedure, they might experience some mild discomfort or urinary symptoms, which can be managed with medications and rest. Patients usually see improvement in their urinary symptoms within a few days to weeks.