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Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff
CPT4 code
Name of the Procedure:
Insertion of Inflatable Urethral/Bladder Neck Sphincter
Summary
This procedure involves surgically placing an artificial sphincter system to help control urine flow in individuals with urinary incontinence. The system includes a cuff around the urethra or bladder neck, a pump in the scrotum or labia, and a reservoir in the abdomen.
Purpose
The procedure addresses urinary incontinence, often due to a weakened or damaged urethral sphincter. The goal is to restore control over urine flow, improving the patient's quality of life.
Indications
- Severe urinary incontinence not responsive to other treatments.
- Patients with intrinsic sphincter deficiency.
- Prior unsuccessful surgical treatments for incontinence.
Preparation
- Patients may need to fast for a few hours before the procedure.
- Medication adjustments, especially blood thinners, will be necessary.
- Preoperative assessments, including urine tests and imaging, may be required.
Procedure Description
- Patients receive either general or regional anesthesia.
- A small incision is made in the perineal area to place the cuff around the urethra or bladder neck.
- Another incision is made in the scrotum or labia to position the pump.
- A third incision is made in the lower abdomen to place the reservoir.
- All components are connected and tested, then incisions are closed with sutures.
Duration
The procedure typically takes 1-2 hours.
Setting
It is usually performed in a hospital or surgical center.
Personnel
- Urologic surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Mechanical failure of the device
- Injury to surrounding tissues
- Urinary retention requiring catheterization
Benefits
- Improved control over urine flow
- Enhanced quality of life
- Potential for returning to normal activities
Recovery
- Patients may stay in the hospital overnight.
- Instructions include limited physical activity and avoiding heavy lifting for 4-6 weeks.
- Follow-up appointments to monitor device function and incision healing.
Alternatives
- Behavioral therapies and pelvic floor exercises
- Medications
- Other surgical options like sling procedures
- Use of absorbent pads or catheters
Patient Experience
- Mild to moderate discomfort at the incision sites.
- Swelling and bruising initially.
- Pain management will be provided, and symptoms typically improve within a couple of weeks.