lcole7465
Expert
I have a provider that performed a biopsy on the bladder dome, trigone and prostatic urethra. I'm going back and forth between 52214 and 52224-52240. Any help???
A 22-French cystoscope was then used to evaluate the patient. The anterior urethra was normal in appearance without any evidence of stricture or diverticulum. His prostatic urethra had bilobar hypertrophy as well as hypertrophy of the bladder neck. Upon entering the bladder, his left ureteral orifice appeared to be in orthotopic position with clear efflux urine. His right ureteral orifice had been removed following his right nephroureterectomy. There was a scar at the right trigone. Systematic evaluation of bladder was notable for 2 bladder tumors including 1 just posterior the trigone 1.2 cm as well as 1 up at the dome of 1.5 cm. There was some mild bladder trabeculation. However, no other gross ntravesical pathology.
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Given the dome lesion, we had to place pressure on the dome as well as to reduce fluid within the bladder in order to remove this lesion. A biopsy forceps was then used to remove the superficial aspect in the deep aspect of this tumor. This was sent for histologic analysis. This area was then cauterized using a Bugbee cautery device.
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The trigone lesion was able to be removed using the biopsy forceps. Initially, the superficial, then the deep portion of the tumor was removed. A Bugbee cautery device was then used to obtain adequate hemostasis. Lastly, biopsy of the prostatic urethra was performed given his positive FISH. This was then cauterized using a Bugbee cautery device. Adequate hemostasis was achieved. At this point, then the cystoscope was withdrawn. An 18-French Foley catheter was placed in the bladder.
A 22-French cystoscope was then used to evaluate the patient. The anterior urethra was normal in appearance without any evidence of stricture or diverticulum. His prostatic urethra had bilobar hypertrophy as well as hypertrophy of the bladder neck. Upon entering the bladder, his left ureteral orifice appeared to be in orthotopic position with clear efflux urine. His right ureteral orifice had been removed following his right nephroureterectomy. There was a scar at the right trigone. Systematic evaluation of bladder was notable for 2 bladder tumors including 1 just posterior the trigone 1.2 cm as well as 1 up at the dome of 1.5 cm. There was some mild bladder trabeculation. However, no other gross ntravesical pathology.
*
Given the dome lesion, we had to place pressure on the dome as well as to reduce fluid within the bladder in order to remove this lesion. A biopsy forceps was then used to remove the superficial aspect in the deep aspect of this tumor. This was sent for histologic analysis. This area was then cauterized using a Bugbee cautery device.
*
The trigone lesion was able to be removed using the biopsy forceps. Initially, the superficial, then the deep portion of the tumor was removed. A Bugbee cautery device was then used to obtain adequate hemostasis. Lastly, biopsy of the prostatic urethra was performed given his positive FISH. This was then cauterized using a Bugbee cautery device. Adequate hemostasis was achieved. At this point, then the cystoscope was withdrawn. An 18-French Foley catheter was placed in the bladder.