Name of the Procedure:

Cystourethroscopy with Ureteral Meatotomy, Unilateral or Bilateral

Summary

Cystourethroscopy with ureteral meatotomy is a medical procedure that involves using a thin, flexible scope to visually inspect the interior of the bladder and urethra. During this procedure, the opening of one or both ureters (the tubes that carry urine from the kidneys to the bladder) is surgically widened to improve urine flow.

Purpose

This procedure addresses conditions like ureteral strictures or blockages that cause difficulty in urine flow from the kidneys to the bladder. The goal is to relieve obstruction, reduce symptoms such as pain and frequent urinary tract infections, and improve overall urinary function.

Indications

• Recurrent urinary tract infections (UTIs)
• Difficulty or pain with urination
• Diagnosed ureteral strictures or blockages
• Kidney stones that affect ureteral function

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments may be necessary, particularly blood thinners.
• A pre-procedure urine test may be conducted to check for infections.

Procedure Description

1. The patient is given anesthesia or sedation for comfort.
2. A cystoscope (a thin tube with a camera and light) is inserted through the urethra to the bladder.
3. The internal structures are inspected for any abnormalities.
4. If a ureteral stricture or blockage is found, a small incision is made at the ureteral opening to widen it (meatotomy).
5. The area is inspected again to ensure proper urine flow before concluding the procedure.
   • Tools include a cystoscope and precision surgical instruments for incisions.

Duration

Typically, the procedure takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Urologist or surgeon
• Nurse or surgical assistant
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Injury to the urethra or bladder
• Scar tissue formation at the surgical site
• Temporary difficulty with urination

Benefits

• Improvement in urine flow and reduction of symptoms
• Relief from pain and discomfort associated with blockages
• Decreased frequency of urinary tract infections
• Benefits are usually realized shortly after recovery

Recovery

• Patients may experience some discomfort or blood in the urine for a few days.
• Hydration and avoiding strenuous activity for a week are recommended.
• Follow-up appointments are essential to monitor healing and function.
• Complete recovery usually occurs within 1-2 weeks.

Alternatives

• Ureteral stenting
• Balloon dilation
• Medication to manage symptoms
• The choice of alternative depends on the specific condition and patient health.

Patient Experience

Patients may feel some pressure or mild discomfort during the procedure if under local anesthesia. Post-procedure, there may be mild pain managed by over-the-counter pain relievers. Overall, the procedure is well-tolerated with minimal post-operative discomfort.