Cystoscopy ( cystourethroscopy ) : indications, risks course of the procedure
Urology / / May 08, 2016
Cystoscopy - a diagnostic procedure that allows the physician to directly examine the urinary tract - the bladder, urethra and openings in the ureters.Cystoscopy may help identify such problems with the urinary tract, as the early signs of cancer, infections, strictures (narrowing), and bleeding.
long, flexible tube equipped with electric light, called a cystoscope, is inserted into the urethra (the tube that allows urine to pass through the body and out to the outside) and moving into the bladder.In addition to the visualization of the inside of the urethra and bladder, cystoscopy allows the doctor to do irrigation, suction and allows access to these structures for surgical instruments.
Also, using a cystoscope urologist can enter into the bladder necessary substances.During cystoscopy physician may remove tissue for further examination (biopsy) and possibly the treatment of any problems that may be detected.Cystoscope may also be used to enter the bladder with saline or distilled water.
Interior, healthy urinary tract - pink and smooth, with a moist mucous membrane.Some medical conditions can change the appearance of the lower urinary tract and they cause bleeding.Other conditions can cause narrowing of the urethra, obstructing the movement of urine and cleansing from her bladder.Furthermore, some diseases of the bladder can cause a change in its size, shape, position and stability.Cystoscopy allows the doctor to examine the structure in detail, photograph them and then get a biopsy.Cystoscope, if necessary, can be used to perform therapeutic procedures - such as for example removal of stones.
Other related cystoscopy procedures that can be used to diagnose a urinary tract problems include: X-rays of the kidneys, ureters, and bladder (in other words, "the cube"), computed tomography (CT) scan of the kidneys, cystometry, cystography, retrograde tsistografiiyu andpyelogram (serial radiographs of the urinary tract that is done after injection into a vein of iodine-containing substance, impervious to X-rays. pyelogram allows you to monitor the functioning of the kidneys, ureters and bladder. With se can be used to assess whether a person has a well-functioning kidneys, to detect the presence of stones in themor in the ureters, and to identify any other urinary tract anomalies) - antegrade, intravenous or retrograde.
How does the urinary system?
body takes nutrients from food and converts them to energy.After the body has taken the necessary his food in the intestines and blood are waste.Urinary
retains chemicals - such as potassium and sodium and water balance in the body stores by waste - urea - from the blood.Urea is produced in the body when foods containing proteins (meat, poultry, vegetables and certain legumes), cleaved.Urea moves through the bloodstream to the kidneys.
Functions parts of the urinary system:
- Kidney. This pair of purple-brown organs located below the ribs on both sides of the spine.Their function is to remove liquid waste from the blood in the urine, maintaining a stable balance of salts and other substances in the blood, and in the production of erythropoietin - hormone involved in the formation of red blood cells.The kidneys remove urea from the blood through tiny filtering elements, called "nephrons."Each nephron consists of a ball formed from a coil of small blood capillaries, the small tubes and renal tubules.Urea, together with water and other waste substances forming urine, passing through the nephrons down the renal tubules, and the outside;
- Two ureter. ureters - narrow tubes that carry urine from the kidneys to the bladder.ureter walls continually Muscles contract and relax, causing the urine to move from the kidneys.If urine backs up, or does not pass, a long time is, then a kidney infection can develop.Every 10-15 seconds, a small amount of urine is emptied from the ureters into the bladder;
- Bladder. It is triangular, hollow organ located in the lower abdomen.He shrouded bundles, which are attached to other organs and the bones of the pelvis.The bladder's walls relax and expand, keeping the urine, and then cut and sealed, forcing urine out through the urethra.Healthy adult bladder can store up to two cups of urine for several hours;
- Two sphincter muscles. These circular muscles prevent uninterrupted outflow of urine (incontinence), closing like a rubber band around the opening of the bladder;
- nerves in the bladder. nerves signal the person when it is time to urinate (empty your bladder);
- urethra. This tube through which urine is excreted from the body.
Indications for cystoscopy
- Cystoscopy may be recommended in cases where suspected urinary tract disorders.Urinary tract may have structural problems which can lead to blockage of the flow of urine, or its backflow.If untreated, structural problems may lead to potentially serious complications.
- Cystoscopy may also be performed after surgical gynecological procedures bladder around - in order to verify the location of the seams and supporting devices.
Some medical conditions in the urinary tract include:
- cancer (malignant tumor) of the prostate (prostate), or bladder;
- polyps.This overgrowth of normal tissue or new formation (usually benign) that extend from the mucosa or diverticula - packages that are formed when the mucous membrane pushes the muscle membrane;
- bladder stones.This calcium crystals, which can lead to infection, bleeding and inflammation of the urinary tract, or other blockages urinary tract;
- benign prostatic hypertrophy (increase in size), or hyperplasia, or prostate adenoma.It usually occurs in men over 50 years.Prostate enlargement interferes with normal passage of urine from the bladder.If left untreated, enlarged prostate can interfere with bladder completely emptied;
- frequent urinary tract infections (UTI);
- blood in the urine;
- urinary incontinence, involuntary release of urine from the bladder;
- painful urination;
- congenital anomalies of the urinary tract.Abnormalities of the urinary tract caused at birth a person can lead to backflow of urine or kidney problems;
- traumatic injury of the urinary tract;
- there may be other reasons for the recommendation of a doctor patient cystoscopy.
risks and complications associated with cystoscopy
As with any invasive procedure, complications can occur and at cystoscopy.These complications include:
- urinary retention;
- perforation (breakthrough beyond the normal limits) of the bladder.
There may be other risks depending on the patient's health.The patient (ke) is necessary to discuss any problems with your doctor before the procedure.
Urinary tract infection may interfere with a cystoscopy.
- The physician should explain the procedure to the patient and offer him the opportunity to ask any questions about the procedure.
- Patient (CU) will be asked to sign a consent form that gives permission to the doctor to test.Patient (ka) should read the form carefully and ask questions if something is not clear.
- starvation type which require up procedure will depend on the type of anesthesia to be used.The doctor should give the patient (ke) specific instructions on how to behave during the procedure.
- If the patient is pregnant or suspected pregnancy, she should report it to your doctor.
- Patient (ka) should inform your doctor if it is sensitive to allergies to any medications, and latex, iodine, tape, and anesthetic agents (local and general).
- Patient (ka) should inform the doctor about all medications (prescribed and non-prescription) and herbal supplements that he takes in this period.
- Patient (ka) should (at) tell your doctor, if he has a history of bleeding disorders or if he receives anticoagulant blood thinners - aspirin or other medications that affect blood clotting.For the patient, it may be necessary to stop taking these medications before the procedure.
- If you use a local anesthesia, the patient during the procedure (ka) is awake, but the procedure it may be given a sedative.
- If the patient (ka) suspects that he has a urinary tract infection (s) he should be (on) notify your doctor, as this may be a contraindication for cystoscopy.The physician may require that before treatment urine samples were tested for infection.
- Depending on the health of the patient (s) may be required and other special preparation for the procedure.
Cystoscopy may be performed on an outpatient basis or as part of the patient's stay (s) in the hospital.
Generally, a cystoscopy follows this process:
- patient (ke) is proposed to remove clothing, jewelry or other objects that may interfere with the procedure.For treatments typically provide a gown.
- intravenous catheter can be inserted into the patient's arm.
- Patient (ka) may receive sedation or anesthesia, depending on the particular situation and the survey site.If the patient is given a sedative medication or anesthetic, during the procedures will be constantly monitored his condition - heart rate, blood pressure, breathing, and blood oxygen levels.
- In some cases, a special blue dye may be given to the patient (ke) for 10-15 minutes before the procedure.The dye is in the kidneys, where it is mixed with urine.Painted blue urine helps the doctor to check bladder for clogging.
- Patient (ku) is placed on the examination table on your back, knees apart.The feet are placed in stirrups.
- Gel anesthetic is inserted into the urethra using a special catheter.It can be slightly uncomfortable until the area is not numb.
- When the urethra is numb and anesthesia has been operating at full strength, the doctor inserts a cystoscope into the urethra.During the introduction of the cystoscope patient (ka) may experience some discomfort.
- While cystoscope is passed through the urethra, the physician checks the mucosa for urinary tract obstructions or abnormalities.Cystoscope will move up until it reaches the bladder.
- Once introduced cystoscope into the bladder to the physician can infuse a sterile water or saline, to expand the bladder for better visualization.While the bladder is filled, the patient (s) may be the urge to urinate or feel mild discomfort.
- The doctor will examine the entire bladder for any abnormalities.A small device can be passed through the cystoscope to collect a sample of tissue for biopsy.Urine from the bladder can be obtained.
- After the cystoscope procedure carefully removed from the urinary tract.
- Cystoscopy and the possibility of its application
- Bladder tumors
- Tumors of the urethra
- Incontinence: Causes, treatment, prevention
- After the procedure, the patient (ka) can be taken to the recovery room for observation if cystoscopy were used anesthesia or sedation (modern anesthesia technique makes it comfortable to move the majority of unpleasant medical procedures previously performed without anesthesia This dream-like state of calm, tranquility.and equanimity, which is caused by drugs, usually used for general anesthesia. Sedation helps the patient to relax physically and emotionally during medical examinations and procedures that can be unpleasant or painful).The recovery process will vary depending on the type of applied sedation.As soon as the blood pressure, pulse and breathing become stable patient, the patient (more) enters the hospital room or his (her) discharged home.Cystoscopy is usually done on an outpatient basis.
- Patient (ka) can resume their usual diet and activities, if the doctor allows it.
- Patient (ka) should (in) to drink plenty of fluids, which dilutes the urine and reduces urinary discomfort.Some burning during urination in the first days after the procedure is normal, but it should decrease over time.warm sitz baths may be recommended to help relieve urinary discomfort.
- After a certain period of time after the procedure, you may notice blood in the urine.The amount of blood is gradually decreased within one to two days.
- In the case of pain or discomfort, it is recommended to take an analgesic in accordance with the doctor's recommendations (and, keep in mind that Aspirin and some other pain medications may increase the chance of bleeding).
physician may provide further guidance to the patient after the procedure, depending on the particular situation.