COAPTITE® INJECTABLE IMPLANT PROCEDURE
| The objective of the Coaptite Injectable Implant procedure is to obtain closure at the bladder neck to mid-urethra by injecting the Coaptite Implant until the tissue of the bladder neck and/or urethra coapts. | |
| Using standard procedure, prepare the patient for cystoscopy. Connect the coaptite Implant syringe to the needle by turning the needle hub 1-1/2 turns ensuring that one green dot on the syringe is visible through the window on the needle hub. Prime the needle. | |
| Insert the primed needle into the port of the scope. Insert the scope into the urethra. | |
| At the mid urethra, position the needle bevel towards the urethral lumen at a 4 o'clock position. Puncture the tissue at a 45 degree angle until the bevel of the needle is covered in tissue. Do not insert past the bevel. |
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| Re-angle the scope back parallel to the urethra. Using the circumferential markings on the needle as a guide, tunnel the needle tip towards the bladder neck 1-1/2 cm depending on the approximated length between the mid-urethra and bladder neck. After tunneling, the needle tip should lie at the proximal urethra. | |
| Begin injecting coaptite Implant using slow, consisten, and moderate thumb pressure n the syringe plunger. The submucosal lining should begin to rise at the site of injection and should flow unilaterally. Continue to inject Coaptite Implant into this sute until the bleb has crossed the midline of the urethra. | |
| Repeat steps 2-6 on the contralateral side at the eight o'clock position. | |
| Continue to inject coaptite Implant until the tissue of the bladder neck and/or urethra coapts. The bladder neck/urethra should be closed when viewed with cystoscopic irrigation on. The combination of Coaptite (CaHA) Implant and the carrier gel Sodium Caboxymethylcellulose (NaCMC) help to establsh an even distribution of particles with a degree of interstitial space that promotes collage infiltration. The carrier gel is gradually absorbed and replaced by the surrounding cells. |