What Is the Typical Cystoscopy Procedure?

Cystoscopy is the earliest method to observe internal organs. Cystoscopy is a method in which a cystoscope is inserted directly from the urethra into the bladder to observe its internal lesions or perform a retrograde ureteral intubation angiography to achieve diagnostic and therapeutic purposes. It is suitable for diagnosis of unknown bladder, ureter, kidney or posterior urethral disorders; treatment of bladder tumors, stones, foreign bodies and other diseases and prostatectomy or ureteral intubation

Basic Information

Chinese name: Cystoscopy
Anesthesia: Local infiltration anesthesia

Indication: Examination and treatment of urinary diseases
complication: Fever, hematuria, urethral injury, bladder injury

Cystoscopy anesthesia

Local infiltration anesthesia.

Preparation before cystoscopy

1. Do a good job of explaining the operation to the patient and get the patient's cooperation.
2. Comprehensive inspection, pay attention to whether the urethra and urethral stricture, bone joints are deformed or diseased.

3. Prepare the skin one day before surgery and wash the vulva with soap and water (males include the penis, foreskin, and scrotum, and females include the labia majora, labia minora, and folds around the urethral orifice).

4. Intestinal preparation: clean enema 1 night before surgery, and 1 morning if necessary.

5. Fasting in the morning and instructing the patient to urinate.

Cystoscopy indications

1. Unexplained hematuria, especially gross hematuria, need further clarification of the cause and location of hematuria.

2. Confirmation of bladder diseases such as tumors, foreign bodies and stones.

3. To clarify the cause of urinary tract obstruction. For patients with hydronephrosis caused by ureteral stone obstruction, it is necessary to leave the ureteral stent tube to relieve hydronephrosis.

4. A ureteral intubation is needed to prepare for retrograde pyelography or to collect special pelvic urine on both sides for special examinations, or silver nitrate pyelography for chyluria.

5. Need to be treated by urethral cystoscope, such as taking foreign body, biopsy, electrocautery, resection

6. There are lesions around the bladder, such as tumors of the posterior wall of the abdomen, pelvic tumors, rectal tumors, etc., to help understand the extent of invasion of the bladder through microscopy.

Cystoscopy contraindications

1. Urethral stricture.

2. Bladder volume is less than 50ml.

3. Patients with acute urethritis and cystitis.

4. Patients with systemic bleeding disorders.

Cystoscopy procedure

1. Take the lithotomy position and thoroughly clean the vulva.

2. Introduce a cystoscope, withdraw the obturator, estimate the residual amount, and observe the urine properties.

3. Insert the speculum, check while filling the water, and check the interior of the bladder in order.

4. For ureteral intubation, pull out the observation speculum and change the intubator, find the ureteral orifice, and insert the ureteral catheter. The depth depends on the gender and height, and generally needs to be more than 25cm.

5. After the operation, discharge the fluid in the bladder, insert the obturator, and exit the cystoscope.

Cystoscopy complications

Fever

It is more common in those who have a urinary system infection before the test and the test is not smooth, and those with difficulty in urinary tract insertion occasionally have fever.

Hematuria

Hematuria is generally not heavy and heals itself after drinking more water.

3. Urethral injury

It is more common in urethral strictures and prostate hyperplasia. In order to avoid urethral damage, the purpose of the examination should be clear before the examination. When there is resistance, it cannot be inserted violently blindly.

4. Bladder injury

Occurs in those with significantly reduced bladder capacity.

Cystoscopy considerations

1. Operate carefully and gently. If disinfected with Xinjieer, it should be rinsed with clean water first, and should not be washed with soapy water.

2. Before injection of iodine for angiography, iodine allergy test should be done first, and pay attention to observe whether there is allergic reaction.

3. When filling the water, pay attention to the temperature of the water, and do not overcool or overheat it.

4. Rest in bed for half a day or one day after surgery, and encourage more water.

5. Pay attention to observe the condition, such as fever, severe pain or massive urethral bleeding, should be treated immediately, if necessary, indwelling catheter, and given antibiotics to control infection.

6. Pay attention to the patient's warmth and psychological comfort.