Transurethral drainage of bladder wall abscess


Local Chapter Officer
Parks, AZ
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Any Uro coders out there that can help me with this procedure

Patient was taken operating room and was placed on the OR table. She was already intubated. A timeout was performed. She was started on aggressive antibiotic coverage. Foley catheter was removed. She was prepped and draped in usual sterile manner. A 26 French continuous flow resectoscope was inserted with Collins knife. Inspection of bladder revealed some erythematous changes posteriorly consistent with a recent Foley. There was a large bullous abnormality noted in the right aspect of the bladder was purplish in color and consistent with the abscess is noted on CT. The Collins knife was used to incise the lower aspect of this area. Initially some old bloody fluid was noted to drain. The incision was carried down to the lower aspect and then slightly carried proximally. It was opened well enough to allow insertion of the scope into the cavity. Large amount of clot was noted that was scraped free of this area using a resectoscope loop. Further inspection revealed no other lesions. There was no real bleeding to be noted. It was felt that point myself and Dr. Kurzweil that at this point this had been adequately drained. Feel the complete resection of the entire wall was needed as there was concern about how thick the posterior wall would be reiterated good drainage of been performed. No other clot was noted within the cavity. All clot was removed from the bladder with irrigation. The scope was removed. 24 three-way catheter was inserted although does not appear that irrigation will be needed at this time and the irrigation port was plugged. She transported back to the ICU in stable condition