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Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)

CPT4 code

Name of the Procedure:

Sling Operation for Correction of Male Urinary Incontinence (e.g., Fascia or Synthetic Sling)

Summary

A sling operation is a surgical procedure designed to treat male urinary incontinence. This condition typically involves involuntary leakage of urine. During the surgery, a sling made of either synthetic material or the patient’s own tissue (fascia) is placed to support the urethra and help restore normal urinary function.

Purpose

  • Condition Addressed: Male urinary incontinence, especially post-prostate surgery incontinence.
  • Goals: To significantly reduce or eliminate urine leakage, improve urinary control, and enhance the patient’s quality of life.

Indications

  • Persistent urinary leakage following prostate surgery (e.g., prostatectomy).
  • Incontinence not sufficiently managed by conservative measures like pelvic floor exercises or medication.
  • Men in good overall health who are suitable candidates for surgery.

Preparation

  • Preoperative evaluation including a thorough medical history and physical examination.
  • Diagnostic tests such as urodynamics or cystoscopy to assess bladder function.
  • Instructions may include fasting for a certain period before surgery and adjusting current medications under medical guidance.

Procedure Description

  1. Anesthesia: General anesthesia or spinal anesthesia is typically administered.
  2. Incision: A small incision is made in the perineum (the area between the scrotum and rectum).
  3. Placement of Sling: The sling, made from synthetic material or the patient’s own fascia, is positioned under the bulbous urethra to provide support.
  4. Securing the Sling: The ends of the sling are secured to either side of the pelvic bone.
  5. Closure: The incision is closed with sutures.

Duration

The procedure generally takes between 1 to 1.5 hours.

Setting

Typically performed in a hospital surgical suite or an outpatient surgical center.

Personnel

  • Surgeon (urologist specialized in male incontinence)
  • Anesthesiologist
  • Surgical nurses and assisting staff

Risks and Complications

  • Common Risks: Infection, bleeding, and pain at the surgical site.
  • Rare Risks: Sling erosion, urinary retention, recurrent incontinence, or injury to surrounding structures such as the bladder or urethra.

Benefits

  • Improved urine control usually noticeable within weeks post-surgery.
  • Enhanced quality of life with reduced need for incontinence pads or urinary catheters.

Recovery

  • Patients often return home the same day or after an overnight stay.
  • Recovery typically involves rest and limited physical activity for a few weeks.
  • Pain management with prescribed medications.
  • Follow-up appointments to monitor recovery and assess the success of the procedure.

Alternatives

  • Non-surgical Options: Pelvic floor muscle exercises, urethral bulking agents, medications.
  • Other Surgical Options: Artificial urinary sphincter implantation.
  • Pros and cons of each alternative should be discussed with a healthcare provider based on the patient’s specific condition and health status.

Patient Experience

  • Mild to moderate discomfort immediately after the procedure, managed with pain medications.
  • Gradual improvement in urinary control as healing progresses.
  • Instructions to avoid heavy lifting or strenuous activity for a few weeks to ensure proper recovery and sling integration.

By understanding the details and implications of a sling operation for male urinary incontinence, patients can make informed decisions alongside their healthcare providers about the best treatment approach for their specific condition.

Medical Policies and Guidelines for Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)

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