Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
HCPCS code
Name of the Procedure:
Ostomy Pouch, Urinary, with Extended Wear Barrier Attached, with Built-In Convexity, with Faucet-Type Tap with Valve (1 piece)
Common name(s): Urinary ostomy pouch, urostomy pouch with convexity and faucet-type tap
Technical/medical term: A4430
Summary
This procedure involves the use of a specialized urinary ostomy pouch designed to manage urine output for patients with urostomies. The pouch has an extended wear barrier, built-in convexity to ensure a proper fit, and a faucet-type tap with a valve for easier draining.
Purpose
Medical Conditions/Problems Addressed
- Urostomies due to bladder cancer, trauma, bladder dysfunction, or severe urinary incontinence.
Goals/Expected Outcomes
- Secure and leak-proof urine collection.
- Minimized skin irritation and infection.
- Convenient and easy urine drainage management.
Indications
Specific Symptoms/Conditions
- Patients with a urostomy needing a secure and durable urine collection system.
- Frequent leakage or skin irritation with other types of pouches.
Patient Criteria
- Individuals with a stoma requiring a convex fitting due to retracted or flush stoma.
- Patients seeking an extended wear option due to high urine output or activity level.
Preparation
Pre-Procedure Instructions
- Clean and dry the stoma area thoroughly.
- Ensure the skin is free from oils, soaps, or lotions that may affect the adhesive barrier.
- Review the usage instructions provided by healthcare professionals or product manual.
Diagnostic Tests/Assessments
- Occasional assessment by a stoma care nurse to ensure proper use and fit.
Procedure Description
Step-by-Step Explanation
- Clean the stoma area: Use water and mild soap, then dry completely.
- Prepare the pouch: Cut the opening of the pouch to fit the stoma size.
- Apply the pouch: Center the opening over the stoma and press the barrier onto the skin.
- Secure the convexity: Make sure the convex barrier fits snugly around the stoma.
- Drain urine: Use the faucet-type tap with valve for easy and hygienic urine drainage.
Tools/Equipment Used
- One-piece urinary ostomy pouch with extended wear barrier and built-in convexity.
- Faucet-type tap with valve for drainage.
Anesthesia/Sedation Details
Not required.
Duration
The procedure for applying and managing the ostomy pouch typically takes a few minutes.
Setting
This procedure is usually performed at the patient's home or in an outpatient clinic.
Personnel
- Ostomy Care Nurse or Specialist (for initial training and periodic assessment).
Risks and Complications
Common Risks
- Skin irritation or breakdown around the stoma.
- Leakage and odor issues.
Rare Risks
- Urinary tract infections.
- Allergic reactions to the adhesive barrier.
Benefits
Expected Benefits
- Enhanced security and confidence with a leak-proof system.
- Reduced skin irritation due to the extended wear barrier.
- Ease of draining urine with the faucet-type tap.
Realization Timeline
Benefits are immediate upon proper application of the pouch.
Recovery
Post-Procedure Care
- Regular cleaning and maintenance of the stoma and surrounding skin.
- Monitor for any signs of infection or irritation.
- Routine assessment by a healthcare provider.
Recovery Time
- Continuous use with periodic replacement as advised (usually every few days to a week).
Restrictions/Follow-Up Appointments
- No specific restrictions, but regular follow-ups with an ostomy nurse or healthcare provider may be necessary.
Alternatives
Other Treatment Options
- Two-piece systems where the barrier and pouch are separate.
- Flat barriers without convexity for those who do not require convex fittings.
Pros and Cons of Alternatives
- Two-piece systems: Easier pouch changes but may require more frequent barrier changes.
- Flat barriers: Suitable for patients without retracted stomas but may not provide the same secure fit.
Patient Experience
During the Procedure
- Minimal discomfort during pouch application.
- Adjustments may require patience and practice.
After the Procedure
- Improved confidence in daily activities due to leak security.
- Occasional skin care and monitoring.
Pain Management and Comfort Measures
- Use of stoma powder or barrier rings to enhance comfort and fit.
- Regular consultation with a stoma care nurse for personalized advice.