Cystoscopy
Cystoscopy | |
---|---|
Pronunciation | sis-ˈtäs-kə-pē |
ICD-9-CM | 57.31-57.33 |
MeSH | D003558 |
MedlinePlus | 003903 |
Cystoscopy is
The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a
There are two main types of cystoscopy—flexible and rigid—differing in the flexibility of the cystoscope. Flexible cystoscopy is carried out with local anaesthesia on both sexes. Typically, a topical anesthetic, most often xylocaine gel (common brand names are Anestacon and Instillagel) is employed. The medication is instilled into the urethra via the urinary meatus five to ten minutes prior to the beginning of the procedure. Rigid cystoscopy can be performed under the same conditions, but is generally carried out under general anesthesia, particularly in male subjects, due to the pain caused by the probe. The sizes of the sheath of the rigid cystoscope are 17 French gauge (5.7 mm diameter), 19 Fr gauge (6.3 mm diameter), and 22 Fr gauge (7.3 mm diameter).
Medical uses
Cystoscopy may be recommended for any of the following conditions:[1]
- urinary tract infections;
- blood in the urine (hematuria);
- loss of bladder control (incontinence) or overactive bladder; (Although, the American Urogynecologic Society does not recommend that cystoscopy, urodynamics, or diagnostic renal and bladder ultrasound are part of initial diagnosis for uncomplicated overactive bladder.)[2][3]
- unusual cells found in urine sample;
- need for a bladder catheter;
- painful urination, chronic pelvic pain, or interstitial cystitis;
- urinary blockage such as from prostate enlargement, stricture, or narrowing of the urinary tract;
- stonein the urinary tract; and
- unusual growth, tumor, or cancer.
Male and female urinary tracts
If a patient has a stone lodged higher in the urinary tract, the physician may use a much finer calibre scope called a
Test procedures
Physicians may have special instructions, but in most cases, patients are able to eat normally and return to normal activities after the test. Patients are sometimes asked to give a urine sample before the test to check for infection. These patients should ensure that they do not urinate for a sufficient period of time, such that they are able to urinate prior to this part of the test.
Patients will have to remove their clothing covering the lower part of the body, although some physicians may prefer if the patient wears a
Patients receiving a ureteroscopy may receive a spinal or general anaesthetic.
The physician will gently insert the tip of the cystoscope into the urethra and slowly glide it up into the bladder. The procedure is more painful for men than for women due to the length and narrow diameter of the
solution) will flow through the cystoscope to slowly fill the bladder and stretch it so that the physician has a better view of the bladder wall.As the bladder reaches capacity, patients typically feel some mild discomfort and the urge to urinate.[citation needed]
The time from insertion of the cystoscope to removal may be only a few minutes, or it may be longer if the physician finds a stone and decides to remove it, or in cases where a biopsy is required. Taking a biopsy (a small tissue sample for examination under a microscope) will also make the procedure last longer. In most cases, the entire examination, including preparation, will take about 15 to 20 minutes.[citation needed]
Blue light
In blue light cystoscopy
Indications before and after the procedure
Before the procedure
Prior to the early 1990s, it was common practice for the physician performing the procedure to prescribe an antibiotic to take for a few days to prevent an infection. Since that time, many urologists will order a "urine C & S" (urinalysis with bacterial/fungal cultures and testing for sensitivities to anti-infective medications) prior to the performance of the cystoscopy, and as part of the pre-operative workup. Depending on the results of the testing and other circumstances, he or she may elect to prescribe a 10- to 14-day course of antibiotic or other anti-infective treatment, commencing 3 days before the cystoscopy is to be performed, as this may alleviate some inflammation of the urethra prior to the procedure.[citation needed]
This practice may provide an additional benefit by preventing an accidental infection from occurring during the procedure. When antibiotics are given for UTI prevention in adults undergoing a cystoscopy, they may reduce the risk of infections that go into the bloodstream and infections limited to the bladder.[8] However, antibiotics may have little to no effect on only the risk of serious infections that go in the bloodstream. From review data, antibiotics do not appear to cause serious unwanted side effects or affect the occurrence of minor side effects, but more research is needed to confirm these findings.[8] The full-course of antibiotic treatment also lessens the possibility of the bacteria becoming resistant to the antibiotic/anti-infective agent prescribed.
Physicians may also prescribe an oral urinary
After the procedure
Patients often experience a burning sensation during urination and often see small amounts of blood in their urine. Procedures using rigid instrumentation more frequently result in short-term
Common (non-invasive) prescriptions to relieve discomfort after the test may include:
- drinking 32 fluid ounces (1 L) of water over 2 hours;
- taking a warm bath to relieve the burning feeling; and
- holding a warm, damp washcloth over the urethral opening.
Other animals
Cystoscopy has similar indications in animals, including visualisation and biopsy of mucosa, retrieval or destruction of urinary bladder stones and diagnosis of ectopic ureters.[9][10][11]
In
References
- ^ "Cystoscopy and Ureteroscopy". The Doctors Lounge. Archived from the original on 2011-07-10. Retrieved 2008-01-29.
- ABIM Foundation. American Urogynecologic Society. Retrieved June 1, 2015.
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- ^ "Pharmaceutical Information – Hibitane". RxMed. Archived from the original on 2014-02-03. Retrieved 2013-06-09.
- S2CID 195192577.
- ^ "Photodynamic Diagnostic D-Light C (PDD) System – P050027". FDA. Archived from the original on 18 January 2017.
- PMID 22512972.
- ^ PMID 30789676.
- PMID 26002795.
- PMID 21801049.
- PMID 20632793.
- PMID 26336001.
- PMID 23725439.
- An earlier version of this article was adapted from the public domain NIH Publication No. 01-4800, which says, "This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired."