CPT® Code 0597T

1. Indications

The inFlow™ intraurethral valve pump is indicated for use in females aged 18 years and older who suffer from permanent urinary retention due to neurologic impairment of the detrusor muscle. This condition may arise from various underlying causes, including:

• Spinal Cord Injury - Damage to the spinal cord that affects nerve signals to the bladder.
• Neurologic Conditions - Disorders that impair the function of the nervous system, impacting bladder control.
• Detrusor Muscle Dysfunction - Insufficient contractility of the detrusor muscle, leading to an inability to urinate independently.

2. Procedure

The procedure for replacing the inFlow™ intraurethral valve pump involves several key steps to ensure proper placement and functionality of the device. The initial step is to perform device sizing, which is crucial for determining the appropriate length of the urethra. This is accomplished by inserting a plastic sizing device that features gradient markings corresponding to urethral length. The adjustable tab on the sizing device is moved back until it touches the meatus, allowing the physician to accurately measure the urethral length.

• Step 1: Device Sizing - The physician inserts the plastic sizing device into the urethra and adjusts the tab to measure the length accurately.
• Step 2: Insertion of the Intraurethral Device - Once sizing is complete, the intraurethral device, which is 3-7 cm long and housed in silicone, is inserted. The device features flexible petal-like fins that open to secure it at the bladder neck and hold it in place within the urethra.
• Step 3: Activation of the Valve-Pump - The internal miniature valve-pump, which is magnetically activated, is now positioned within the housing tube of the device. The user will utilize a handheld remote control activator to operate the valve pump.
• Step 4: Bladder Emptying - To empty the bladder, the user holds the remote control activator over her pelvis and presses the button to activate the pump. Releasing the button stops the urine flow.
• Step 5: Device Replacement - When it is time for replacement, the device can be removed by grasping the external tab and pulling it out, making the process straightforward and manageable.

3. Post-Procedure

After the replacement of the inFlow™ intraurethral valve pump, patients can expect to resume normal activities with minimal downtime. It is important to monitor for any signs of complications, such as discomfort or leakage, and to follow up with healthcare providers as necessary. The device is designed for ease of use, allowing for self-management or assistance from a trained caregiver at home. Regular replacement of the device every 29 days or less is essential to maintain optimal function and prevent urinary complications.