LAC 48:I.2449. Urology

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. Nephrectomy (complete or partial removal of kidney) 1. bleeding; 2. infection; 3. injury to adjacent organs such as lung, spleen, liver, bowel, adrenal gland (if not removed); 4. incomplete removal of tumor, if present. B. Extracorporeal Shock Wave Lithotripsy (using shock waves to break up kidney or ureteral stones) 1. bleeding in or around kidney; 2. obstruction of kidney by stone particles; 3. failure to completely fragment stone requiring repeat treatment or other form of treatment; 4. high blood pressure (transient or permanent); 5. loss of kidney. C. Cystectomy with Urinary Diversion (removal of bladder with use of bowel to drain urine) 1. bleeding requiring blood transfusion; 2. infection; 3. injury to adjacent organs (bowel, blood vessels, nerves, etc.); 4. impotence (loss of erection functions); 5. ostomy problems (scarring, infection) which might necessitate re-operation. D. Transurethral Prostatectomy (use of lighted scope and cautery to internally remove portion of prostate causing blockage) 1. bleeding requiring transfusion or re-operation; 2. infection; 3. injury to bladder or urethra or rectum; 4. impotence; 5. retrograde ejaculation ("dry ejaculation"backward flow of ejaculate fluid into bladder) producing infertility; 6. bladder neck contractureformation of scar tissue causing bladder blockage requiring repeat surgery or treatment; 7. incontinence (urinary leakage). E. Radical Prostatectomy (total removal of prostate gland) 1. bleeding; 2. infection; 3. injury to adjacent organs (blood vessels, bowel, nerves); 4. blockage of ureters (kidney drainage tubes); 5. erectile dysfunction (impotence, i.e., loss of erection/ejaculation); 6. incontinence (urinary leakage). F. Bladder Suspension (MMK, PereryaProcedure, Cystocele Repair, etc.) 1. bleeding; 2. infection; 3. blockage of ureters (kidney drainage tubes); 4. persistent leakage; 5. urinary fistula (abnormal hole in connection between bladder, vagina, etc.); 6. inability to void. G. Vasectomy 1. bleeding; 2. infection; 3. testicular swelling or pain/possible loss of testicular function; 4. spermatic granuloma (nodule in cord at site of surgery); 5. recanalization ("re-connection" of vas tube resulting in becoming fertile again). H. Penile Implant 1. bleeding; 2. infection (with possible loss of implant); 3. penile pain or numbness; 4. injury to bladder or urethra; 5. problems with implantable prosthetic. I. Orchiectomy (removal of testicle) 1. bleeding; 2. infection; 3. loss of hormone (testosterone) resulting in erection problems, decreased energy, etc.; 4. loss of fertility (ability to have children). J. Varicocele Repair (ligation/tying of spermatic veins) 1. bleeding; 2. infection; 3. injury to spermatic cord (vas deferens), testicular artery, nerves; 4. testicular swelling or pain; 5. possible loss of testicle due to blood vessel injury or infection (rare). K. Transurethral Resection of Bladder Tumor 1. bleeding; 2. infection; 3. perforation of bladder; 4. obstruction of ureter (kidney drainage tube). L. Circumcision (removal of penile foreskin) 1. ulceration and scarring of urine hole at tip of penis (meatal stenosis); 2. bleeding; 3. infection (minor or serious); 4. removal of too much or too little skin; 5. skin bridge; 6. fistula (abnormal hole in urine tube); 7. buried penis. M. Hernia/Hydrocele (removal of fluid filled sac) 1. injury to sperm duct (vas deferens); 2. injury to blood vessels of testis; 3. atrophy (shriveling) of the testicle with loss of function; 4. reaccumulation of hernia or fluid in scrotum. N. Hypospadias Repair (Correction of Penile Curvature/Urethroplasty) (Construction/reconstruction of drainage tube from bladder) 1. leakage of urine at surgical site; 2. stricture formation; 3. residual curvature of penis; 4. disfiguring scars; 5. injury to glans (head of penis); 6. additional operations. O. Ureteral Reimplantation (Reinserting ureter, tube between kidney and bladder, into the bladder) 1. leakage of urine at surgical site; 2. obstruction to urine flow; 3. damage to or loss of ureter (kidney drainage tube); 4. backward flow of urine from bladder into ureter (kidney drainage tube); 5. damage to other adjacent organs; 6. damage to kidney. P. Pyeloplasty (pyeloureteroplastyreconstruction of kidney drainage system) 1. obstruction of urinary flow; 2. leakage of urine at surgical site; 3. injury to or loss of kidney; 4. damage to adjacent organs; 5. decrease in kidney functiontemporary/ permanent; 6. infection with resultant failure of surgery and/or loss of kidney function. Q. Orchiopexy (surgically placing an undescended testicle into the scrotum) 1. atrophy (shriveling) of the testicle with loss of function; 2. removal of the testicle; 3. injury to the vas deferens; 4. inability to completely bring the testicle into the scrotum in a single surgical procedure; 5. recurrent hernia formation; 6. infection with possible loss of testicle.