Name of the Procedure:

Cystourethroscopy with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral.

Summary

Cystourethroscopy with resection or fulguration of ectopic ureterocele(s) is a surgical procedure where a camera (cystoscope) is inserted into the urinary bladder through the urethra. The surgeon uses this tool to either remove (resect) or burn away (fulgurate) an abnormal swelling (ureterocele) in the ureter, which can occur on one side (unilateral) or both sides (bilateral) of the bladder.

Purpose

This procedure addresses the presence of an ectopic ureterocele, which is an abnormal ballooning of the lower part of the ureter. The goals are to alleviate any blockage or obstruction in the urinary system, prevent recurrent urinary tract infections, improve kidney function, and alleviate symptoms like pain or difficulty urinating.

Indications

• Recurrent urinary tract infections.
• Abdominal or flank pain.
• Difficulty urinating or urinary incontinence.
• Obstruction in the urinary tract visible on imaging studies.
• Hydronephrosis (swelling of a kidney due to urine build-up).

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustments to current medications may be necessary, particularly anticoagulants.
• Pre-procedure imaging studies like ultrasounds or CT scans may be conducted.

Procedure Description

1. The patient is typically placed under general anesthesia.
2. A cystoscope is inserted through the urethra into the bladder.
3. The surgeon locates the ureterocele using the camera.
4. Depending on the condition, the ureterocele is either resected (cut out) or fulgurated (burned away) using specialized instruments.
5. The area is inspected to ensure the obstruction is resolved.
6. The cystoscope is removed.

Duration

The procedure typically lasts between 30 minutes to 1 hour.

Setting

The procedure is performed in a hospital, usually in an operating room or a specialized urology surgical suite.

Personnel

• Urologist or specialized surgeon.
• Anesthesiologist.
• Nursing staff and surgical technicians.

Risks and Complications

• Infection.
• Bleeding.
• Injury to the bladder or urethra.
• Postoperative pain or discomfort.
• Scarring or strictures in the ureter or bladder.
• Rare risk of anesthesia-related complications.

Benefits

• Relief from urinary obstruction and reduction in infection risk.
• Improved kidney function.
• Alleviation of pain and urinary symptoms.
• Benefits can often be noticed soon after recovery from the procedure.

Recovery

• Patients may need to stay in the hospital for a day or two for observation.
• Pain management with prescribed medications.
• Instructions on fluid intake and activity restrictions.
• Follow-up appointment for imaging and assessment of kidney function.

Alternatives

• Observation and periodic monitoring if the ureterocele is not causing significant symptoms.
• Antibiotic therapy for managing infections.
• Open surgical repair may be considered in complicated cases.

Patient Experience

• Patients may experience some discomfort or pain during the initial recovery period.
• A catheter may temporarily remain in place to help with urination.
• Pain management strategies, including medications, will be used to ensure comfort.
• Full recovery is expected within a few weeks, with instructions provided on activity levels and follow-up care.