CYSTOSCOPY

WHAT IS CYSTOSCOPY? 

cystoscopy is a endoscopic procedure to diagnose or inspect the bladder and urethra, investigate specific urological conditions or treat  including enlargement of prostate gland and other abnormal finding in the urethra and bladder. 

Cystoscopy is a usually simple outpatient procedure with local anesthesia in normal patient but in some cases this procedure done under the short general anesthesia and full general anesthesia,  spinal anesthesia. 

Cystoscopy is done for diagnosis:

-Blood in the urine

-Urinary retention, Inability or difficulty to pass urine (emptying bladder )

-Pain with urination

-Repeated infection 

-Abnormal findings on x-ray, CT-scan, MRI or other imaging test. 

Cystoscopy is done for the treatment and diagnose the problem  of bladder conditions like tumour, inflammation prostate and urethra condition like enlarged prostate, scar tissue and urethral strictures. 

In this procedure if done under the local anesthesia than no need to Start intravenously fluid but if  it has done under the general anesthesia and spinal anesthesia then need to start intravenous fluid or antibiotics for prevent infection and also don't eat and drinks before the surgery and fluids allowed to run until administration of the prescribed dose is completed.(as per doctors advised )

Anesthesist continue watching monitor and watch vital signs including pulse, spo2(saturation ), E.C.G,  body temperature and blood until the  patient  will not shifted from operation theatre to recovery room.

Mostly cystoscopy procedure done when patient have suddenly urinary retention or patient not able to pass urine or emptying bladder due to stone stuck in the urethra (urethral stone) or also due to urethral strictures this is emergency conditions to see inside the urethra and bladder by the cystoscopy. And some time also need to performe cystoscopy after the  post of TURP due to blood clots are present  in urethra which is causes urinary retention (inability to pass urine).

After lithotomy position patient painted by antiseptic solution and drap by sterile towel than  a topical anesthetic, 2% xylocaine jelly this  viscous lidocaine like jelly  is introduced  into the urethra, and  hold the tip of the penile atleast for  five minutes.  

After this cystoscope (4mm telescope attach with video camera and cold light source) introduce into urethra and start irrigation with sterile water for distension of the cavity for And urologist examine the cause of urinary retention or diagnose the problem and assess the urethra and urinary bladder.All this diagnostic procedure can be recorded for further treatment or video documentation. 

During the cystoscopy urologist may be find urethral strictures and urethral stone and also see blood clots are found after the post of TURP.

Cystoscopy may be done alone with or another procedure like pelvic or rectal examination and also for the biopsy test.

Biopsy of bladder :In this small instruments introduced through the working channel and grasp the tissue and remove small piece of bladder lining area may be cauterized. Pinching sensation blood in urine and biopsy tissue send to be laboratory for pathological. 

Retrograde pyleogram performed very rarely with cystoscopy to assess urinary track above bladder 

Urinary stent or DJ stent is long narrow  like tube from kidney to bladder this is help to maintain drainage of kidney. 

Placement of stent with guidance of fluoroscope. 

And removal of stent insert cystoscope and pull the stent with the help of stent forcep. 

After the diagnosis of the cystoscopy urologist planned further treatment or surgery if patient have urethral strictures than urologist can performe DVIU with the cystoscopy procedure and if stone are present in urethra than also URS can done with same time and stone remove from the inside. 

After the procedure patient may need to urgent urinate, burning sensation during the urination and frequent urination, blood in urine.

After the discharge from the hospital :

-Drink plenty of water 

-Normal diet

-Warm bath can help

-Medication if prescribed will take right   time.

-Take antibiotics 

After the cystoscopy risk are very minimal, blood in urine, infection, difficulty in urination. After the cystoscopy if patient feel sudden cold and cough, high fever, foul or bed smelling in urine and new severe pain, burning sensation lasting more than 2 days, blood in urine lasting more than 2-3 days and significant difficulty emptying bladder than contact your doctor. 

For know more details & appointment contact us : 

+91 7692976910

DR. VIMAL KESWANI

MBBS, MS, DNB Urologist & andrologist, Mumbai

Former consultant at R.G. stone hospital, mumbai