Name of the Procedure:

Cystourethroscopy with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure).

Summary

Cystourethroscopy with insertion of a permanent adjustable transprostatic implant is a minimally invasive procedure that involves using a scope to examine the bladder and urethra, and then placing an implant to help relieve urinary symptoms caused by an enlarged prostate.

Purpose

This procedure is designed to address lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH), or an enlarged prostate. The goal is to improve urine flow and alleviate symptoms such as difficulty starting urination, a weak urine stream, and frequent urination.

Indications

• Symptoms of BPH such as frequent urination, urgency, weak urine stream, or difficulty starting urination.
• Patients for whom medication has not been effective or causes significant side effects.
• Patients seeking a minimally invasive alternative to more extensive surgical options.

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or stopped.
• Pre-procedure diagnostic tests may include urine tests, PSA levels, and ultrasounds of the prostate.

Procedure Description

1. The patient is given local anesthesia, sedation, or general anesthesia.
2. A cystoscope, a thin tube with a camera, is inserted through the urethra to view the bladder and urethra.
3. The surgeon inserts the transprostatic implant through the cystoscope and positions it within the prostate to lift and hold the enlarged prostate tissue, preventing it from blocking the urethra.
4. The procedure may involve placing multiple implants, with each additional one listed separately.
5. The cystoscope is then removed, and the procedure is completed.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the number of implants inserted.

Setting

The procedure is usually performed in an outpatient clinic, surgical center, or hospital.

Personnel

• Urologist or specialized surgeon.
• Nursing staff.
• Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is used).

Risks and Complications

• Common risks include bleeding, infection, and temporary discomfort.
• Rare complications may include injury to the urethra or bladder, severe urinary retention, or persistent symptoms requiring additional treatment.

Benefits

• Improved urine flow and relief from urinary symptoms.
• Minimally invasive with a shorter recovery time compared to traditional surgery.
• Quick return to normal activities.

Recovery

• Patients may go home the same day.
• Mild discomfort or blood in the urine may occur and typically resolves within a few days.
• Avoid strenuous activities for about a week.
• Follow-up appointments to monitor recovery and implant effectiveness.

Alternatives

• Medication (alpha blockers, 5-alpha-reductase inhibitors).
• Thermotherapy or laser therapy.
• Traditional surgical approaches such as transurethral resection of the prostate (TURP).
• Each alternative has its own set of benefits and risks which should be discussed with a healthcare provider.

Patient Experience

• Patients may feel mild discomfort during the procedure if under local anesthesia.
• Post-procedure pain is generally mild and manageable with over-the-counter pain medications.
• Temporary urinary symptoms, such as frequent urination or a burning sensation, may occur but usually subside within a few days.