53855 Insertion of a temporary prostatic urethral stent, including urethral measurement

Name of the Procedure:

Insertion of a Temporary Prostatic Urethral Stent, also known as Prostatic Urethral Stent Placement or Temporary Urethral Stenting.

Summary

This procedure involves placing a small, temporary stent in the prostatic urethra to help maintain urine flow in men with urinary retention or obstruction due to prostate enlargement. Urethral measurement is also done to ensure an appropriate fit for the stent.

Purpose

The procedure is used to address urinary retention or obstruction often caused by an enlarged prostate (benign prostatic hyperplasia, BPH). The goal is to improve urine flow and relieve symptoms such as difficulty urinating, frequent urination, and incomplete bladder emptying.

Indications

• Persistent urinary retention not responsive to medications.
• Symptomatic benign prostatic hyperplasia.
• Patients awaiting more definitive surgical treatment.
• Contraindications for surgical intervention due to other health issues.

Preparation

• The patient may be asked to fast for several hours before the procedure.
• Medication adjustments might be required, particularly blood thinners.
• Pre-procedure assessments may include urinalysis, kidney function tests, and an ultrasound of the bladder and prostate.

Procedure Description

1. Anesthesia/Sedation: Local anesthesia or mild sedation may be given to ensure comfort.
2. Urethral Measurement: A catheter or special measuring device is inserted into the urethra to measure the length and diameter.
3. Stent Placement: The stent is inserted using a cystoscope (a thin tube with a camera) to guide placement.
4. The stent is positioned within the prostatic urethra and expanded to maintain patency.
5. Post-placement assessment to ensure proper stent function and position.

Duration

The procedure typically takes around 30 minutes to 1 hour.

Setting

It is usually performed in an outpatient clinic, ambulatory surgical center, or hospital.

Personnel

• Urologist or specialized surgeon
• Nurse or medical assistant
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Common Risks: Discomfort, blood in urine, urinary tract infection, stent displacement.
• Rare Risks: Severe bleeding, bladder injury, stent migration requiring additional procedures.

Benefits

• Expected Benefits: Relief from urinary symptoms, improved urine flow.
• Realization Time: Benefits can typically be observed immediately after the procedure.

Recovery

• Patient may be monitored for a few hours post-procedure for any immediate complications.
• Instructions include drinking plenty of fluids, avoiding heavy lifting, and taking prescribed medications.
• Follow-up appointments may be scheduled to assess the stent’s position and function.
• Most patients recover fully within 1-2 days with minor restrictions.

Alternatives

• Medication: Alpha-blockers or 5-alpha-reductase inhibitors.
• Other Procedures: TURP (Transurethral Resection of the Prostate), laser therapy, or permanent stent placement.
• Each alternative has its own risk-benefit profile, and choice depends on patient-specific factors and preferences.

Patient Experience

• During the procedure: You might feel mild discomfort or pressure.
• After the procedure: Expect some urinary frequency, mild pain, and possibly blood in the urine, which should resolve in a few days.
• Pain management: Over-the-counter pain relievers can be taken as needed; report persistent pain to your doctor.