Section 602.16 - Urinary System Treatments and Procedures(a) Partial nephrectomy (removal of part of the kidney). (1) Incomplete removal of stone(s) or tumor, if present.(3) Leakage of urine at surgical site.(4) Injury to or loss of the kidney.(5) Damage to organs next to kidney.(b) Radical nephrectomy (removal of kidney and adrenal gland for cancer).(1) Loss of the adrenal gland (gland on top of kidney that makes certain hormones/chemicals the body needs).(2) Incomplete removal of tumor.(3) Damage to organs next to kidney.(c) Nephrectomy (removal of kidney).(1) Incomplete removal of tumor if present.(2) Damage to organs next to kidney.(3) Injury to or loss of the kidney.(d) Nephrolithotomy and pyelolithotomy (removal of kidney stone(s)). (1) Incomplete removal of stone(s).(3) Leakage of urine at surgical site.(4) Injury or loss of the kidney.(5) Damage to organs next to kidney.(e) Pyeloureteroplasty (pyeloplasty or reconstruction of the kidney drainage system).(2) Leakage of urine at surgical site.(3) Injury to or loss of the kidney.(4) Damage to organs next to kidney.(f) Exploration of kidney or perinephric mass.(1) Incomplete removal of stone(s) or tumor, if present.(2) Leakage of urine at surgical site.(3) Injury to or loss of the kidney.(4) Damage to organs next to kidney.(g) Ureteroplasty (reconstruction of ureter (tube between kidney and bladder)). (1) Leakage of urine at surgical site.(2) Incomplete removal of the stone or tumor (when applicable).(4) Damage to organs next to ureter.(5) Damage to or loss of the ureter.(h) Ureterolithotomy (surgical removal of stone(s) from ureter (tube between kidney and bladder)). (1) Leakage of urine at surgical site.(2) Incomplete removal of stone.(4) Damage to organs next to ureter.(5) Damage to or loss of ureter.(i) Ureterectomy (partial/complete removal of ureter (tube between kidney and bladder)). (1) Leakage of urine at surgical site.(2) Incomplete removal of stone.(4) Damage to organs next to ureter.(j) Ureterolysis (partial/complete removal of ureter (tube between kidney and bladder from adjacent tissue)). (1) Leakage of urine at surgical site.(3) Damage to organs next to ureter.(4) Damage to or loss of ureter.(k) Ureteral reimplantation (reinserting ureter (tube between kidney and bladder) into the bladder). (1) Leakage of urine at surgical site.(3) Damage to or loss of ureter.(4) Backward flow of urine from bladder into ureter.(5) Damage to organs next to ureter.(l) Prostatectomy (partial or total removal of prostate).(1) Leakage of urine at surgical site.(3) Incontinence (difficulty with control of urine flow).(4) Semen passing backward into bladder.(5) Difficulty with penile erection (possible with partial and probable with total prostatectomy).(m) Total cystectomy (removal of bladder). (1) Probable loss of penile erection and ejaculation in the male.(2) Damage to organs next to bladder.(3) This procedure will require an alternate method of urinary drainage.(n) Radical cystectomy. (1) Probable loss of penile erection and ejaculation in the male.(2) Damage to organs next to bladder.(3) This procedure will require an alternate method of urinary drainage.(4) Chronic (continuing) swelling of thighs, legs and feet.(5) Recurrence or spread of cancer if present.(o) Partial cystectomy (partial removal of bladder). (1) Leakage of urine at surgical site.(2) Incontinence (difficulty with control of urine flow).(3) Backward flow of urine from bladder into ureter (tube between kidney and bladder).(5) Damage to organs next to bladder.(p) Urinary diversion (ileal conduit, colon conduit).(1) Blood chemistry abnormalities requiring medication.(2) Development of stones, strictures or infection in the kidneys, ureter or bowel (intestine).(3) Leakage of urine at surgical site.(4) This procedure will require an alternate method of urinary drainage.(q) Ureterosigmoidostomy (placement of kidney drainage tubes into the large bowel (intestine)). (1) Blood chemistry abnormalities requiring medication.(2) Development of stones, strictures or infection in the kidneys, ureter or bowel (intestine).(3) Leakage of urine at surgical site.(4) Difficulty in holding urine in the rectum.(r) Urethroplasty (construction/reconstruction of drainage tube from bladder). (1) Leakage of urine at surgical site.(2) Stricture formation (narrowing of urethra (tube from bladder to outside)).(3) Need for additional surgery.(s) Percutaneous nephrostomy/stenting/stone removal.(1) Pneumothorax or other pleural complications (collapsed lung or filling of the chest cavity on the same side with fluid).(2) Septic shock/bacteremia (infection of the blood stream with possible shock/severe lowering of blood pressure) when pyonephrosis (infected urine in the kidney) present.(3) Bowel (intestinal) injury.(4) Blood vessel injury with or without significant bleeding.(t) Dialysis (technique to replace functions of kidney and clean blood of toxins). (1) Hemodialysis. (A) Hypotension (low blood pressure).(B) Hypertension (high blood pressure).(C) Air embolism (air bubble in blood vessel) resulting in possible death or paralysis.(D) Cardiac arrhythmias (irregular heart rhythms).(E) Infections of blood stream, access site, or blood borne (for example: Hepatitis B, C, or HIV).(F) Hemorrhage (severe bleeding as a result of clotting problems or due to disconnection of the bloodline).(G) Nausea, vomiting, cramps, headaches, and mild confusion during and/or temporarily after dialysis.(I) Chemical imbalances and metabolic disorders (unintended change in blood minerals).(J) Pyrogenic reactions (fever).(K) Hemolysis (rupture of red blood cells).(L) Graft/fistula damage including bleeding, aneurysm, formation (ballooning of vessel), clotting (closure) of graft/fistula.(2) Peritoneal dialysis. (A) Infections, including peritonitis (inflammation or irritation of the tissue lining the inside wall of abdomen and covering organs), catheter infection and catheter exit site infection.(B) Development of hernias of umbilicus (weakening of abdominal wall or muscle).(C) Hypertension (high blood pressure).(D) Hypotension (low blood pressure).(E) Hydrothorax (fluid in chest cavity).(F) Arrhythmia (irregular heart rhythm).(G) Perforation of the bowel.(H) Sclerosis or scarring of the peritoneum.(I) Weight gain leading to obesity.(J) Abdominal discomfort/distension.(L) Increase in need for anti-diabetic medication.(N) Dehydration (extreme loss of body fluid).(O) Chemical imbalances and metabolic disorders (unintended change in blood minerals).(Q) Nausea, vomiting, cramps, headaches, and mild confusion during and/or temporarily after dialysis.25 Tex. Admin. Code § 602.16
Adopted by Texas Register, Volume 48, Number 51, December 22, 2023, TexReg 7985, eff. 12/26/2023