CPT® Code 0596T

1. Indications

The inFlow™ intraurethral valve pump is indicated for use in females aged 18 years and older who experience permanent urinary retention due to neurologic impairment of the detrusor muscle. This condition is characterized by the inability to urinate independently, which can lead to serious urinary complications. The primary indications for this procedure include:

• Permanent Urinary Retention - A condition where the individual cannot urinate due to insufficient detrusor muscle contractility.
• Neurologic Impairment - Conditions such as spinal cord injury or disease that affect the normal functioning of the detrusor muscle.

2. Procedure

The procedure for the initial insertion of the inFlow™ intraurethral valve pump involves several critical steps to ensure proper placement and functionality of the device. The steps are as follows:

• Step 1: Urethral Measurement - The physician begins by using a plastic sizing device that features gradient markings to measure the urethral length. This sizing device is inserted into the urethra, and the adjustable tab is moved back until it touches the meatus, allowing for an accurate determination of the urethral length.
• Step 2: Device Insertion - Once the urethral length is established, the intraurethral device, which is 3-7 cm long and housed in a silicone casing, is prepared for insertion. The device is designed with flexible petal-like fins that open to secure it at the bladder neck and hold it in place within the urethra.
• Step 3: Activation Mechanism - Inside the housing of the device is a magnetically activated miniature valve-pump. The insertion process is similar to that of a urinary catheter, ensuring a smooth and effective placement.
• Step 4: Remote Control Setup - The system includes a handheld remote control activator, which is placed on a charger. This activator is used by the patient to operate the valve pump, allowing for bladder emptying by holding the remote over the pelvis and pressing the button to activate the pump.

3. Post-Procedure

After the initial insertion of the inFlow™ intraurethral valve pump, patients can expect to manage their urinary retention more effectively. The device is designed for replacement every 29 days or less, and the removal process is straightforward, involving grasping the external tab and pulling it out. Patients should be educated on the operation of the remote control activator and the importance of timely device replacement to maintain optimal function. Follow-up appointments may be necessary to monitor the patient's adaptation to the device and address any concerns regarding its use.