| Transurethral cystoscopy is a method of direct visualization of the bladder and urethra. It is performed using a lighted fiberoptic tube called a cystoscope.
The cystoscope has a self-contained optical lens system that provides a magnified, illuminated view of the urethra, the section of the urethra surrounded by the prostate gland (prostatic urethra), the bladder, and the openings of the ureters into the bladder (ureteral orifices). Small scopes can be passed through the cystoscope, allowing assessment of the tube that carries urine from the kidney to the bladder (ureter) and the inner area (pelvis) of the kidney. Contrast material can be injected into the ureter allowing visualization of both the ureter and renal pelvis (retrograde pyelogram). Cystoscopes are either rigid or flexible. Rigid cystoscopes are long, straight, and stiff instruments. Flexible cystoscopes are also long, but they can be gently bent and curved. Flexible cystoscopes cause less discomfort to the individual and can be used at the bedside, in an office setting, or in an operating room. Flexible cystoscopes are also used when the individual cannot be positioned with the legs up in stirrups (lithotomy position), is positioned flat on the back (supine).
A variety of procedures may be performed through the cystoscope. The cystoscope permits the urologist to obtain a urine specimen from each kidney to evaluate its function. Cup forceps can be inserted through the cystoscope in order to remove a small sample of the tissue for microscopic analysis (biopsy), or for removal of kidney stones (renal calculi). Flushing (irrigation) and suction are also performed through the cystoscope. Cystoscopes may be attached to video camera equipment for recording and to allow the individual the opportunity to view abnormalities. |
Source: Medical Disability Advisor
| Cystoscopy is a diagnostic procedure performed for diagnosis of a number of abnormalities of the urinary tract including blood of unknown origin in the urine (hematuria), urinary incontinence, abnormal urine collection in the bladder (urinary retention), abnormal urine collection in the kidney due to an obstruction (hydronephrosis), an enlarged prostate gland (benign prostatic hypertrophy), suspected cancer (urethra, prostate, ureter or renal pelvis), urinary tract stones, abnormal narrowing or constriction (strictures), obstruction at the point where the ureter joins the kidney (ureteropelvic junction), bladder inflammation with abnormal bleeding (hemorrhagic cystitis), infection, abnormal tracts between the urethra and nearby structures (fistula), or chronic inflammation within the walls of the bladder (interstitial cystitis).
While cystoscopy is generally a diagnostic procedure, it may also be performed for therapeutic purposes. Using additional instruments that are passed through the cystoscope, stones (calculi) in the bladder, ureter, or urethra may be removed, bleeding sites may be controlled through electrocauterization, strictures may be opened (dilated), and small tumors in the bladder may be removed (tumor resection). |
Source: Medical Disability Advisor
| Transurethral cystoscopy is most often performed under sedation. Alternatively, spinal or general anesthesia may be used. The opening of the urethra (meatus) is cleansed with a surgical scrub solution. If therapeutic procedures are planned, the perineal area may be also cleansed. A local topical anesthetic is instilled into the urethra by the urologist before the cystoscope (also called a cystourethroscope) is inserted. An irrigation system is attached to the cystoscope, and the scope is passed up through the urethra to the bladder. If the ureters are to be examined, ureteral catheters are passed through the cystoscope. Examination includes visualization of the interior of the urethra, the bladder, and the ureteral openings. In males, the prostate, bladder neck, and the area containing the ejaculatory duct (verumontanum) are also examined. In females, the urethra, bladder neck and bladder are examined.
Urine may be obtained for culture or to be sent to the pathologist to identify abnormal or cancerous cells (cytology). |
Source: Medical Disability Advisor
| The predicted outcome is accurate diagnosis of conditions affecting the urinary tract. The immediate outcome of therapeutic procedures performed with cystoscopy (removal of stones, electrocauterization of bleeding sites, opening of strictures, and removal of small tumors) is generally good. |
Source: Medical Disability Advisor
| Complications may include injury or perforation to the urethra or bladder, and infection. Bleeding may occur from sites that are biopsied. |
Source: Medical Disability Advisor
| Work restrictions or accommodations are not usually associated with this procedure. |
Source: Medical Disability Advisor
| Gilbert, Scott M. "Cystoscopy." MedlinePlus. 27 Oct. 2004. National Library of Medicine. 20 May 2005 <http://www.nlm.nih.gov/medlineplus/ency/article/003903.htm>. |
Source: Medical Disability Advisor