Miko24
Guru
A 22-French, 30 degrees cystoscope was passed through the urethra into the bladder. Bulbous, pendulous, membranous urethra
were within normal limits. prostatic urethra had significant left-sided prostatic regrowth pushing into the bladder. there was
some bladder stones free floating and these were irrigated out and passed off as a specimen. It appeared as if there was more
stone material capping enlarged prostate. Rigid cystoscope was removed and the flexible cystoscope 15 French was placed. On
retroflex you could see indeed calcification capping an enlarged area of prostate pushing into the bladder. There was no bladder
tumor identified. The flexible cystoscope was removed.
Rigid cystoscope 20 French was replaced. A 550 micron laser fiber was readied. One setting was placed on prostate
vaporization in the other was placed on settings for breaking up stone. In order to get at the stone material I need to vaporize
through some of the prostate tissue. This was done along what appeared to be middle lobe and part of the left lateral lobe.
Concentration of this work was done at the area of the bladder neck. Once I was through vaporizing some of the tissue I did
come upon stone. The stone settings were then used with the laser to break the stone up. This was flushed out and passed off as
a specimen. I felt like I was able to get a large portion of the stone material out. In order to do this I vaporize some tissue right
at the bladder neck opening up the prostatic channel. I felt that doing anything more at this point would be too much for a same
day surgery Center case so I elected to stop any further vaporization of the prostate at this point. There was good hemostasis.
The cystoscope was removed and an 18 French Foley catheter was placed.
52318
or
52318 - 22 mod
or
52318 and 52648 with possibly a 52?
Or is integral to the procedure the vaporization and just charge the 52318
Thank you!!
were within normal limits. prostatic urethra had significant left-sided prostatic regrowth pushing into the bladder. there was
some bladder stones free floating and these were irrigated out and passed off as a specimen. It appeared as if there was more
stone material capping enlarged prostate. Rigid cystoscope was removed and the flexible cystoscope 15 French was placed. On
retroflex you could see indeed calcification capping an enlarged area of prostate pushing into the bladder. There was no bladder
tumor identified. The flexible cystoscope was removed.
Rigid cystoscope 20 French was replaced. A 550 micron laser fiber was readied. One setting was placed on prostate
vaporization in the other was placed on settings for breaking up stone. In order to get at the stone material I need to vaporize
through some of the prostate tissue. This was done along what appeared to be middle lobe and part of the left lateral lobe.
Concentration of this work was done at the area of the bladder neck. Once I was through vaporizing some of the tissue I did
come upon stone. The stone settings were then used with the laser to break the stone up. This was flushed out and passed off as
a specimen. I felt like I was able to get a large portion of the stone material out. In order to do this I vaporize some tissue right
at the bladder neck opening up the prostatic channel. I felt that doing anything more at this point would be too much for a same
day surgery Center case so I elected to stop any further vaporization of the prostate at this point. There was good hemostasis.
The cystoscope was removed and an 18 French Foley catheter was placed.
52318
or
52318 - 22 mod
or
52318 and 52648 with possibly a 52?
Or is integral to the procedure the vaporization and just charge the 52318
Thank you!!
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