Cystoscopy is a method of examining the internal part Bladder a special device. The device, an endoscope, is a thin flexible tube containing optical and lighting systems. It is administered through the urethra, which allows the doctor to examine its mucous part. In some cases, rigid cystoscopy is performed - in this case, a rigid cystoscope is used, which gives best review surgical field.
Cystoscopy is performed not only for diagnostic purposes. In addition to examining the walls of the bladder and taking material for a biopsy, during the procedure it is possible to administer drugs, excise tissue, and remove tumors.
Advantages of cystoscopy at the SM Clinic
Cystoscopy is a very delicate procedure, especially if it is performed on a child. Our doctors know how to perform examinations to ensure that each patient individual approach, comfortable conditions and minimum stress and painful sensations.
Doctors at the SM Clinic in Moscow and other cities constantly train in foreign partner clinics and keep their finger on the pulse modern medicine. Endoscopic techniques, used by us, meet all quality standards developed by advanced medicine.
Why do cystoscopy
Cystoscopy is often prescribed by doctors after an ultrasound, during which it is impossible to make a detailed examination of the mucous membrane. This procedure allows you to carefully examine every centimeter urinary tract and bladder from the inside and diagnose the following lesions:
- ulcer;
- polyps;
- papillomas;
- inflammatory processes;
- bladder tuberculosis;
- injuries;
- ureterocele (cystic defect of the ureter);
- stones, etc.
Who needs to undergo cystoscopy
Cystoscopy is a multifunctional procedure that allows, in addition to examination, various medical procedures, which affect its cost. For example, cystoscopy with biopsy allows you to take a small fragment of altered bladder tissue for further analysis. This allows our doctors to deliver the most accurate diagnosis and prescribe adequate treatment.
Small neoplasms on the walls of the bladder and urethra are also an indication for the procedure. The doctor will quickly remove them during the examination. Cystoscopy in men can be combined with resection of prostate adenoma with an electric knife.
The cystoscope also makes it possible to examine the orifices of the ureters and see the source purulent discharge and gross hematuria (large amounts of blood in the urine). Cytoscopy is used to examine the kidneys. If you need to remove one of them, you can check how fully the second one functions.
Contraindications to cystoscopy
There are some contraindications to the examination:
- acute period or exacerbation of chronic inflammation in the genitourinary system;
- urethral injuries;
- acute bleeding;
- urethral fever.
Preparation for cystoscopy
The main thing in preparing a patient for cystoscopy is to remember that the procedure is performed under anesthesia. Depending on the type of anesthesia, the patient may be asked not to eat for 6-8 hours before the procedure. General anesthesia is more often used in men, since their urethra is much longer than women's and the procedure can be more painful.
How is cystoscopy performed?
Before starting the procedure, the patient empties his bladder. He lies down on his back, and the doctor performs antiseptic treatment and anesthesia. During local anesthesia, the medicine is injected into the urethra. Then the cystoscope is treated with glycerin with a local anesthetic for better gliding and pain relief and inserted into the urethra. After the device enters the bladder, saline solution is injected through it, this improves the visibility of the surface for the specialist.
Cystoscopy is an examination of the bladder from the inside using a special cystoscope instrument. Some changes in the urethra and bladder - ulcers, polyps and other mucosal lesions - cannot be seen on ultrasound, so in some cases cystoscopy is prescribed as a more detailed examination. This is how tumors, stones, inflammations, and bladder injuries are detected.
Cystoscopy of the bladder can be called not only a diagnostic, but also a therapeutic procedure - with its help, the doctor can remove a tumor or papilloma, perform electrocoagulation (cauterization) of a simple ulcer on the bladder mucosa, dissect the mouth of the ureter, inject it into the bladder with an injection necessary medicine, perform bougienage or catheterization of the ureter, crush and remove stones from it, perform electrical resection of prostate cancer or adenoma (when performing cystoscopy in men).
How is cystoscopy of the bladder performed?
A cystoscope is a tubular device equipped with a lamp. It can be rigid (standard) or flexible.
To examine the bladder, a cystoscope must be inserted into the urethra. The procedure is somewhat painful, so local, spinal or general anesthesia is performed. If shown general anesthesia, which is more often prescribed to patients with unstable mental health, the patient should not eat for 8 hours before cystoscopy.
With local anesthesia, a solution of novocaine 2% - 10 ml or gel with lidocaine is injected into the urethra before cystoscopy. When performing cystoscopy in men, a special clamp is placed on the penis under the head for 5-10 minutes.
During cystoscopy, the patient should be in a supine position; after inserting the cystoscope, the bladder should be filled with water or sterile saline solution - no more than 200 ml to ensure better visibility. After this, the doctor examines the bladder. The examination itself lasts 2-10 minutes. In general, cystoscopy takes no more than 45 minutes and if used local anesthesia, the patient can go home immediately.
In some cases, cystoscopy in women and men is combined with another study - chromocystoscopy, for which the patient is injected intravenously with contrast - 1-3 ml of 0.4% indigo carmine solution. This is done in order to study from which ureter, at what interval and intensity, colored urine will appear. It is considered normal if the dye begins to release into the bubble 3-5 minutes after injection. If more than 10 minutes pass, this may indicate deterioration in kidney function.
Cystoscopy in children
Cystoscopy in children is carried out on the same principle as in adults, but special children's cystoscopes are used for examination; they are much smaller in diameter than adults. Cystoscopy is usually performed with the written consent of the parents; for emotionally excitable children, general anesthesia is offered.
Contraindications and consequences of cystoscopy
Cystoscopy in women, men and children is not performed in the presence of acute inflammation of the bladder, urinary tract, testicles and prostate, in the presence of bleeding, urethral fever.
After cystoscopy, the patient may experience a burning sensation during urination for some time, one or two days. In addition, there is a risk of developing infection (antibiotics are often prescribed after cystoscopy), bleeding, and disruption of the integrity of the bladder wall.
Due to the fact that men have a longer urethral canal than women, cystoscopy in men is a more complex and, in some sense, dangerous procedure. The degree of complications depends on the qualifications of the doctor and the cystoscope used - the thinner it is, the better. The device must pass through the prostate, seminal tubercle, bladder neck and after that enter the bladder. If the device is handled incorrectly, cystoscopy can cause prostatitis, cystitis, urethritis, inflammation of the seminal tubercle and vesicles, impaired potency, in particular morning erection, and lack of sexual desire. To eliminate complications, it is necessary to undergo treatment; the symptoms of erectile dysfunction are transient and can last for a week or several months.
Behind medical care You should contact us if you experience chills after cystoscopy, strong pain in the urethra, fever, if urine during urination becomes noticeably less than usual.
Examination of the bladder using a cystoscope is currently one of the most informative diagnostic procedures. This method is endoscopic - the instrument is inserted into the organ through the natural external opening of the urethra.
What is cystoscopy
Cystoscopy is an examination of the mucous membrane lining the inside of the bladder using an endoscopic cystoscope.
There are the following types of this manipulation:
- simple survey (diagnostic);
- chromocystoscopy, which combines endoscopic examination the inner surface of the bladder and study of kidney function using a dye (indigo carmine) injected into a vein;
- operating room - used for minor endoscopic interventions, for example, for the purpose of biopsy or removal of tumors and foreign objects from the bladder.
Cystoscopy is performed through the urethra
The so-called photocystoscopy involves photographing the pathologically changed lining of the bladder during the procedure, followed by the production and study of images.
Video: what the doctor sees inside the bladder during chromocystoscopy
How does a cystoscope work?
This device is designed in such a way that a source of electric light introduced into an organ filled with a special solution makes it possible to see the state of the latter using a magnifying lens. optical system. A cystoscope, or endoscope, has a hollow barrel (tube), a pavilion (outer handle) and a beak. On the outer part of the device there are devices that ensure the light is turned on and off, the influx and outflow of the washing solution, and also the fixation of the optical system. A light bulb is attached to the curved beak of the cystoscope, the electrical wire from which runs inside the tube.
The cystoscope consists of a beak (1), a tube (2) and a pavilion (3)
The device is inserted into the lumen of the bladder along with a mandrin - the so-called obturator. This device is a special wire rod that temporarily provides rigidity to a flexible cystoscope. After the beak of the instrument is inside the bladder, the mandrin is removed and a lighting system is placed in the tube instead.
The mandrin looks like a knitting needle or rod
There are cystoscopes designed separately for adults and for children. They differ from each other in diameter and length.
Advantages and disadvantages of the method
Due to its high information content and accuracy, cystoscopy has an undoubted advantage over other diagnostic studies. In many cases, it can be very useful for early detection and timely treatment of bladder diseases.
During cystoscopy, the region of the bladder triangle is of greatest interest.
However, cystoscopy is possible only under four conditions:
- Good bladder capacity (it should hold at least 100 ml of solution).
- Normal urethral patency.
- The clarity of the fluid that fills the bladder. That is, the patient should not have heavy bleeding (hematuria) or discharge of pus in the cavity of this organ.
- Calm behavior of the patient and absence of acute painful sensations during the procedure.
With severe discomfort in the bladder or uncontrollable frequent urges before urination, manipulation can be performed only after these phenomena have subsided.
The procedure is unpleasant and not indifferent to the patient, and this is its main drawback. In addition, cystoscopy is fraught with some complications:
- creation of a false passage in the lower urinary tract - this is associated with rough, forced insertion of an instrument in the presence of cicatricial narrowing of the urethra;
- blood poisoning (sepsis);
- cystitis;
- pyelonephritis;
- urethritis;
- epididymitis (inflammation of the epididymis in men);
- prostatitis;
- vesiculitis (inflammation of the seminal vesicle).
The procedure requires experience, accuracy and high qualifications of the doctor, since during its implementation it is easy to injure the mucous membrane of the urethra or bladder with the instrument.
Indications and contraindications for manipulation
Cystoscopy is offered to the patient in the following situations:
- bleeding from the urinary tract of unknown origin;
- suspicion of neoplasms, foreign objects or diverticula (bag-like protrusions of the wall) of the bladder;
- chronic inflammatory processes in the kidneys or ureters;
- suspicion of rupture or mechanical injury Bladder;
- urination disorders;
- need for differentiation renal colic with other diseases abdominal cavity(chromocystoscopy is performed);
- cancer of the uterus and appendages, direct or sigmoid colon to determine the extent of the tumor and the degree of compression of the ureter by it;
- severe kidney injury that does not allow excretory urography ( X-ray examination With intravenous administration contrast agent) to identify the side of the lesion;
- vesico-vaginal or vesico-rectal fistula - to establish the presence of such a defect and determine its location in relation to the neck of the bladder, the mouths of the ureters and other elements of the organ.
In the event of an alleged traumatic violation of the integrity of the bladder, this manipulation is carried out in a hospital setting directly on the operating table, so that it is possible to provide emergency assistance to the victim. surgical care when such a need arises.
A urologist prescribes a cystoscopy to a patient with extreme caution, since this diagnostic procedure has many contraindications. It is absolutely impossible under the following conditions:
- spicy inflammatory diseases external genitalia and urethra;
- cystitis;
- prostatitis;
- injury or stricture (narrowing) of the urethra and bladder neck.
If there is a urethral stricture, it will not be possible to insert a cystoscope into the patient.
Chromocystoscopy is contraindicated in cases of chronic renal failure, deep severe damage renal parenchyma, as well as in case of shock, collapse or uremic coma in a patient. In such conditions, the urinary organs will not secrete a coloring substance into the urine, so the study does not make sense.
Preparation for cystoscopy
Before the procedure, the patient is examined by a doctor to determine the diameter of the external opening of the urethra. Based on this, a cystoscope of a suitable caliber is selected. If the urethra is too narrow, and examination is extremely necessary, then it is dilated (dilated) using a special instrument.
Prevention of complications
For male patients if they have chronic infectious process V genitourinary organs Before cystoscopy, antibiotic therapy is prescribed wide range actions. Preventative treatment begins 3 days before the procedure and ends on the day of the procedure. It is necessary to prevent exacerbation of inflammation that is possible after endoscopic insertion of the instrument. Patients who have stagnation of urine in the bladder are especially in need of such prevention.
Sometimes it is enough to give the patient one on the day of the procedure. intramuscular injection an antibiotic, for example, a cephalosporin, an hour before cystoscopy, or intravenously immediately before it.
In addition, all men should undergo a digital examination of the rectum to detect benign growths. prostate gland or her other diseases. In such pathologies, the cystoscope will be inserted using a special method that differs from the classical one. Otherwise, not only damage to the urethral mucosa will become possible, but also more dangerous complications, such as the formation of a false tract.
Digital rectal examination. carried out on the eve of cystoscopy will help the doctor decide on the method of inserting the instrument
Patient position
To relieve anxiety and fear, the doctor tells the patient about the procedure. Then the patient is placed in a special chair, similar to a gynecological one. His body is located at an angle of 45°, and lower limbs bent in hip joints and in the knees. The crotch should be pushed towards the edge of the chair.
Cystoscopy is most conveniently performed with the patient lying on his back with his legs raised and bent.
The study is carried out under aseptic and antiseptic conditions, so the patient is covered with a sterile cape with a hole in which the external genitalia remain visible. The latter are disinfected by treating them with a disinfecting solution.
Anesthesia
Usually women special anesthesia when performing cystoscopy is not required. For elimination discomfort V urethra It is enough to lubricate the beak of the device with gel with Xylocaine.
Before the procedure, men undergo urethral anesthesia with a solution of Lidocaine or Novocaine. An anesthetic liquid is injected into the urethra with a syringe with a rubber nozzle for several minutes.
However, if long-term manipulations in the bladder are expected, its small volume, or with pathological growths in the lower urinary tract (for example, multiple papillomas), it is necessary to resort to short-term intravenous anesthesia.
General anesthesia is dangerous because a person in a state of narcotic sleep does not feel anything and cannot tell the doctor about his pain. As a result, there is a high probability of mechanical damage to the urinary tract.
Technique for performing diagnostic cystoscopy
Immediately before the procedure, the patient needs to empty the bladder independently. This, if necessary, will help determine the presence of residual urine in the organ.
Procedure:
If the tone of the bladder is reduced and residual urine is detected in the patient, the solution from the organ must be completely released at the end of the study. In the absence of these pathologies, the patient urinates naturally after the procedure.
Often during cystoscopy it is necessary to release part of the solution from the bladder, or, conversely, add liquid to it. This is done in order to get a clearer picture of the condition of the mucous membrane of the organ.
Sometimes, for the same purpose, the doctor presses his hand on the front abdominal wall in the suprapubic region. This technique helps to find the location of the fistula or an abscess breaking into the bladder, and also to better examine the neoplasm located on the front wall of the organ, which is difficult to view.
Cystoscopy in children
Most often it is necessary to resort to this procedure in children when there are suspicions of the presence of stones, tumors and foreign bodies in the bladder, as well as when identifying birth defects organ development. A special children's viewing cystoscope allows for examination of the mucous membrane and some intravesical manipulations even in newborns.
The conditions for examination are the same as for adults. The capacity of the bladder in infants should be at least 50 ml, and in older children - at least 100 ml.
Before the examination, the child must urinate on his own. In newborns and infants, the bladder is cleared of urine using a catheter or cystoscope.
Cystoscopy in children is performed in a supine position with legs slightly raised and bent. Children of preschool age and older are examined in a special urological or gynecological chair. A cystoscope is inserted, residual urine is released, the bladder is washed and examined in small patients according to the same procedure as in adults.
Cystoscopy in young children is done under intravenous anesthesia
Table: the amount of flushing liquid poured into the bladder and the age of the child
Decoding the results
The inner surface of a healthy bladder is painted a pale pinkish-yellowish color; it is smooth and glossy. The tree-like delicate network is clearly visible blood vessels. The edge of the sphincter of the organ is smooth and clearly defined, often having transverse folding. The area of the bladder triangle is colored more intensely and brightly, the vessels in this place are much larger than the others, and there are more of them.
The ureteral openings, located symmetrically on small mounds, can have a variety of shapes - slit-like, crescent-shaped, round or oval. In young children, the vesical triangle is not always clearly visible. In this regard, it can be difficult to find the orifices of the ureters.
The ureteric orifices are normally located symmetrically
While moving the beak of the cystoscope towards the neck of the bladder, if you ask the patient to strain, in male patients you can see the seminal tubercle.
Normally, when performing chromocystoscopy, the doctor can see the release of blue urine from the openings of both ureters within a few minutes after the injection of a dye (Indigo carmine) intravenously or intramuscularly. This indicates preserved renal function and good patency of the ureters.
Normally, soon after the administration of Indigo Carmine, blue urine begins to be released from the mouth of the ureter
If there are abnormalities in the bladder during cystoscopy:
- found on the mucous membrane of various inflammatory phenomena, ulcers, tumors, etc.;
- establish their prevalence and location;
- stones or foreign objects, pathological purulent or bloody discharge are found in the lumen of the organ;
- observe a delay or complete absence discharge of blue urine from the opening of one or two ureters when performing a test with Indigo Carmine;
- detect developmental anomalies, such as, for example, duplication of the ureters, or the entrance to the diverticulum.
Photo gallery: cystoscopic picture of some bladder diseases
Bladder polyp is dangerous due to the possibility of malignant degeneration 
A bladder diverticulum appears as a round hole on cystoscopy. 
Bladder stones: a - urates on a healthy mucous membrane, b - single oxalate with chronic inflammation Bladder 
Bladder tumors: a - papillomatosis, b - papillary cancer
Video: what chronic cystitis looks like during cystoscopy
Cystoscopy of the bladder in women is one of the main methods for examining its inner wall. After all, it is female representatives who are more susceptible to inflammatory processes in this body.
Bladder
Often, an accurate diagnosis of diseases of the lower urinary system cannot be made only on the basis of the results laboratory research and even ultrasound and computed tomography data.
Cystoscopy of the bladder in men also has considerable diagnostic value. However, due to anatomical features, urethral infections are more common in men.
In addition, it is worth noting that cystoscopy is also used in medicinal purposes.
Cystoscopy is one of endoscopic types research. The procedure is carried out using a special instrument - a cystoscope. Depending on the purpose of the examination, the following types of such devices are distinguished:
- observation;
- catheterization;
- operating.
Typically, the length of the cystoscope is standard and is suitable for examining both men and women. For pediatric cystoscopy, devices of smaller size and diameter are used.
Regardless of the type, it is a long flexible tube made of a special material.
This structure of the cystoscope ensures ease of insertion into the cavity of the urethra and bladder. prevents injury to their internal mucous membrane.
In addition, it is equipped with a special eyepiece and complex system optical fibers.
This allows you to transfer images to a computer and monitor, and record the progress of an operation or examination on removable media for further study.
A catheterization cystoscope has one or two channels for inserting catheters into the ureter. To guide the catheter to the mouth of the ureter, a so-called Albarran lift is provided.
The simultaneous use of the visual guidance system and elevators ensures accurate insertion of the catheter into one or both ureters.
The operating cystoscope has a special system for bringing in various instruments during surgery or treatment.
These may be biopsy forceps, electrodes for lithotripsy, resection of the organ wall or removal of tumors.
Reasons for the procedure
Frequent urination
For diagnostic purposes, this examination is carried out for both men and women with the following symptoms:
- urinary disturbance;
- pain and burning during urination;
- the appearance of pus or blood of unknown etiology in the urine;
- suspicion of oncological formations in the bladder, a biopsy is also performed at the same time;
- differential diagnosis of acute and chronic cystitis;
- determining the causes of urodynamic disturbances;
- disruption of neurogenic innervation of the bladder.
For therapeutic purposes, cystoscopy is most often performed for both women and men for urolithiasis.
Stones in the bladder are crushed using a special lithotripter; it is also possible to remove stones from the ureter during catheterization.
The use of an operating cystoscope makes it possible to perform operations on resection of the bladder, removal of various fibrous nodes and benign tumors small size.
Oncology
In addition, a so-called chromocystoscopy is performed.
In this case, a solution of a dye is injected into the cavity of the bladder.
This research method allows you to assess the patency of the ureters and the degree of functioning of each kidney separately.
The introduction of special fluorescent preparations during cystoscopy is decisive in the diagnosis of tumors, since cancer tissue has the property of accumulating this substance in a much larger volume than healthy tissue.
This study allows you to identify tumors that are not visible under normal lighting.
Preparation
Cystoscopy is preceded by a mandatory preliminary examination. During it, anamnesis is collected, general and biochemical tests blood and urine.
Bladder studies
For rate general condition and the structure of the organs of the urinary system are done by ultrasound, X-ray examination with contrast, CT or MRI.
Preparation for the study includes following a diet, and the manipulation itself is best done on an empty stomach. The drinking regimen is determined by the doctor depending on the goals of the procedure.
Cystoscopy of the bladder in women is less painful than in men. Therefore, for women, the use of anesthesia or local anesthesia is not mandatory and is carried out only if the patient wishes.
The exception is those cases when therapeutic or surgical procedures. For men, a local anesthetic is injected into the urethra immediately before cystoscopy.
Progress of the manipulation
For women, cystoscopy is performed in a supine position with legs apart and bent at the knees.
Cystoscope
To prevent infection, the area of the external opening of the urethra is wiped with an antibacterial solution.
The cystoscope tube is lubricated with sterile glycerin and inserted into the urethra.
Before starting a visual inspection of the inner wall of the bladder, it is necessary to clean its cavity from any remaining pus or blood clots. Therefore, it is washed with warm, sterile sodium chloride solution.
To improve the quality of the resulting image, the bladder is filled with carbon dioxide or oxygen (dry cystoscopy) or a clear, warm saline solution (irrigation cystoscopy).
Catheterization
Normally, the mucous membrane has a uniform structure, it Pink colour with bright red inclusions of blood vessels.
At the junction with the urethra, blood flow is more developed, so the bladder wall around the internal urethral sphincter is much brighter.
If catheterization of the ureter is necessary, a special catheter is installed in the cystoscope and its position is adjusted using the Albarran lift. Then, under constant visual control, it is injected into the ureter.
Contraindications
Cystoscopy is an invasive procedure, and sometimes special dyes or contrast agents are used to increase its effectiveness. Therefore, there are a number of contraindications to its implementation:
- violation of the patency of the urethra;
- diseases that are accompanied by blood clotting disorders;
- inflammatory processes of the bladder or urethra in the acute stage;
- in women - the period of menstruation;
- If the excretory function of the kidneys is impaired, or in a state of post-traumatic shock, the use of contrast is prohibited.
Despite the relative pain of the procedure and the rather complex technique, cystoscopy remains the only option for the doctor to visually assess the condition of the bladder.
After cystoscopy, blood may appear in the urine and a burning sensation during urination.
To prevent the development of bacterial inflammation, especially women are susceptible to this, it is usually prescribed short course antibiotics.
According to medical statistics, the number of bladder diseases in Russia increases annually by approximately 30%. The main character of these disappointing reports is a disease caused by inflammation of the mucous membrane of the bladder. However, doctors are increasingly diagnosing other diseases of this organ - urolithiasis, polyps, cysts, tuberculosis, ulcers, sclerosis, benign and malignant tumors.
Doctors are helped to detect the disease in a timely manner by examination using ultrasound and other studies, including cystoscopy of the bladder. About what cystoscopy is, for what symptoms it is indicated and how cystoscopy is performed, we'll talk In this article.
The bladder has two main functions: it receives urine from the kidneys and removes it from the body. Why is this important for our health. Together with urine, a person gets rid of toxins (waste), excess water, salts and toxins obtained as a result of diseases or from the external environment.
If all this remains inside the body, poisoning and other consequences cannot be avoided. Therefore, the role of the bladder is extremely important.
How healthy your bladder is can be judged by how often you go to the toilet, the color and smell of your urine, and whether you urinate or not. If a person feels discomfort in the pelvic area, observes urinary incontinence, urine has a dark yellow color and a pungent odor, or notices some other, non-standard situations, it’s time to consult a specialist.
In addition to tests, to avoid serious pathologies, the doctor may prescribe a cystoscopy. Today this is one of best methods bladder examination to make a diagnosis early stages development of the disease. In addition, this procedure allows not only to diagnose, but also to treat certain types of diseases.
Even in ancient times, doctors dreamed of observing their work with their own eyes. internal organs person. At the beginning of the 19th century, the Italian doctor Bozzini came up with a method by which it was possible to study the functioning of the urinary tract by introducing a light source into the body.
In the 70s of the same century, the German urologist Maximillian Nitze improved his colleague’s idea and created a device with optical device and a light bulb at the end. The structure was inserted into the bladder, filling it with a special liquid. Later, cystoscopy was improved, and the indications for it were expanded.
In practice, bladder cancer was diagnosed for the first time using cystoscopy.
What diseases are diagnosed and treated using cystoscopy?
Cystoscopy is prescribed when, despite the symptoms, it is not possible to detect neoplasms, stones and sand, modifications or injuries, as well as traces of inflammation in the bladder.
What symptoms may be a reason to undergo cystoscopy:
- Damage to the bladder mucosa due to weakening immune system(interstitial cystitis).
- Frequent urination.
- Difficult or intermittent flow of urine.
- The appearance of blood in urine.
- Involuntary urination.
- Chronic pain in the pelvic area.
- The presence of atypical cells in the urine, detected during laboratory tests.
The question often arises: is it possible to do cystoscopy for cystitis? Infectious cystitis and inflammation of the bladder mucosa in the active phase are contraindications to cystoscopy. However, this procedure is prescribed if relapses of this disease become frequent.
Modern medicine has great potential for solving problems of varying complexity.
So, when other methods for diagnosing organ diseases urinary system did not help establish an accurate diagnosis or develop an effective treatment regimen, cystoscopy is performed. It can help identify diseases such as:
- congenital anomalies and injuries of the genitourinary system;
- urolithiasis disease;
- benign tumors;
- leukoplakia (formation of plaques on the mucous membrane of the bladder);
- antonia (impaired control over the accumulation and excretion of urine);
- hematuria (blood in urine);
- polyps;
- tuberculosis;
- ulcer;
- blockage or narrowing of the ureters;
- bladder cancer.
Doctors of the American Urological Association concluded that bladder cancer is a disease of men and older people. The likelihood of developing this disease in the stronger sex is almost three times higher than in women, and average age patients are 73 years old.
In most cases, a tumor is diagnosed at the stage of damage to only internal tissues. In almost 35% of patients, the cancer does not spread beyond the organ, and in 65% of patients the disease affects the tissue adjacent to it. This type of cancer rarely affects other organs by metastases.
This diagnostic method is also used for medicinal purposes. It helps solve the following bladder problems:
- remove the tumor;
- stop internal bleeding;
- conduct electrocoagulation of a benign tumor;
- crush and remove stones;
- eliminate blockage and narrowing of the urinary tract;
- eliminate congenital anomalies.
And also for other medical procedures Using cystoscopy, you can install a catheter in the ureter and perform a biopsy of urinary tract tissue.
Cystoscopy as additional method often used in medical fields such as proctology and gynecology. Research in in this case the pelvic organs are subject to This procedure allows proctologists and gynecologists to diagnose:
- malignant tumor of the sigmoid and rectum;
- cancer of the uterus and appendages in women;
- prostate cancer, hypertrophy, hyperplasia and prostate adenoma in men.
There are also contraindications for cystoscopy:
- cystitis and urethritis in active stage diseases;
- renal failure;
- liver failure;
- post-infarction state;
- angina pectoris;
- heart defects;
- pregnancy.
How is a cystoscopic examination performed?
Since this procedure involves the introduction of a special device into the patient’s body, the patient has the right to ask how cystoscopy is performed.
For cystoscopy, one of the types is used endoscopic equipment- cystoscope. At one end there is an optical eyepiece (in a rigid cystoscope) or a small video camera with illumination (in a flexible cystoscope), and at the other there is a control system for the device.
How to perform cystoscopy of the bladder and other organs of the urinary system. The cystoscope is inserted through the urethra into the bladder. Using an optical eyepiece or a mini camera, the doctor can examine the condition of the internal membranes of the ureters or bladder, and also use additional tools to carry out therapeutic manipulations and surgical operations. The duration of diagnostic cystoscopy is 5–30 minutes, therapeutic – 1–2 hours.
As the cystoscope moves through the urinary tract, the patient may experience pain. Therefore, cystoscopy, like any similar procedure, is performed under anesthesia (general or local).
Epidural anesthesia is also used to relieve pain, and an anesthetic gel injected into the urethra through a catheter helps to numb a certain area. The anesthetic gel not only reduces pain, but also acts as a kind of lubricant that facilitates the advancement of the cystoscope.
Types of cystoscopic examination
Today, doctors have two types of cystoscopes at their disposal - rigid and flexible. Therefore, cystoscopy is divided into two types - rigid and mobile. Rigid cystoscopy is often indicated for women. Their wide and short urethra is physiologically more suitable for a static device. Cystoscopy with a flexible cystoscope is usually recommended for men whose urethra is elongated and has a smaller diameter, as well as for children.
Tough
What does rigid cystoscopy show? Typically, the procedure is used to study a specific “ pain point» of one or another organ, therefore does not require moving the cystoscope.
Using a rigid cystoscope, the doctor can examine the patient's organs through a special eyepiece. In this way, doctors conduct examinations of the urethra, examination and lavage of the bladder and ureters.
The set of instruments for rigid cystoscopy includes optical tubes with different viewing angles, lifting mechanisms, operating and diagnostic adapters, rigid biopsy forceps and other instruments depending on the set.
Movable
Mobile (flexible) cystoscopy is done for the purpose of a comprehensive examination of the organ for accurate diagnosis of the disease. It is also used to treat an already identified disease. This method of examining the organs of the urinary system allows you to evaluate the structure of the mucous membranes, detect bleeding, defects, injuries and neoplasms.
The peculiarity of mobile cystoscopy is the use of a cystoscope, on the flexible barrel of which a video camera and a lighting device are located. A metal cord, capable of changing position, is inserted through the urethra and allows you to display an image of the bladder cavity and ureters on the screen.
Before the procedure begins, a special solution is injected there, which improves the clarity of the image. Thus, the doctor can examine the diseased organ in detail, identify the problem area and more accurately make a diagnosis.
The set of instruments for flexible cystoscopy, in addition to flexible shafts with video cameras and lighting devices, includes telescopic bridges with a deflection mechanism and instrumental channels, high-frequency electrodes of various configurations, electrosurgical loops and knives, grasping and biopsy forceps, and other instruments.
Both types of cystoscopy also allow operations with biopsy, coagulation and removal of foreign bodies.
Consequences
Like any intervention in the human body using anesthetic medications, examination using a cystoscope requires subsequent medical supervision. What happens to the patient after cystoscopy, how does he feel and what consequences may there be for his health.
Standard post-procedure symptoms are a burning sensation in the urethra, minor pain in the lower abdomen and blood in the urine, which should disappear after 1-2 days. Drinking plenty of fluids and warm sitz baths can help relieve the condition. If your temperature rises after cystoscopy, you should inform your doctor.
Reason elevated temperature there may be a bladder puncture or infection. For prevention infectious infection genitourinary tract doctor prescribes antibacterial drugs. Doctors do not recommend taking painkillers during this period. On full recovery After cystoscopy it usually takes 2-3 days.
Patients often wonder whether there can be a complication after cystoscopy and what to do in this case?
Most dangerous complication– urethral injury as a result of inaccurate insertion of the cystoscope. It can lead to improper drainage of urine.
Other complications include:
- constant ;
- urinary tract infection;
- inflammation of the kidneys (pyelonephritis).
Fortunately, complications after cystoscopy are quite rare phenomena because this medical procedure has been successfully practiced by both Russian and foreign doctors for a long time.
