Cystoscopy & Retrograde Pyelogram +/- Insertion of ...

The State of Queensland (Queensland Health), 2018. Permission to reproduce should be sought from (Affix identification label here). URN: Family name: Cystoscopy & Retrograde Pyelogram +/- Insertion of Given name(s): Ureteric stent Address: Date of birth: Sex: M F I. Facility: A. Interpreter / cultural needs Rarely damage to the urethra. A false passage may be produced causing leakage of urine or in the long term, a An Interpreter Service is required? Yes No narrowing that may affect flow of urine. If Yes, is a qualified Interpreter present? Yes No Damage to the bladder by puncturing the bladder wall. A Cultural Support Person is required? Yes No This may need further surgery. If Yes, is a Cultural Support Person present? Yes No Swelling at the exit of the bladder which may stop passage of urine.

Ureteric Stent Facility: Page 1 of 2 Continues over page V 5 – 2018 • 2018 u SW 9289 including additional treatment if the doctor finds N A. Interpreter / cultural needs An Interpreter Service is required? narrowing that may affect flow of urine.Yes No …

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  Insertion, Retrograde, Erecruit, Stent, Cystoscopy, Cystoscopy amp retrograde pyelogram insertion of, Pyelogram, Ureteric stent

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