膀胱镜检查 - 膀胱内视镜检查

Cystoscopy - Endoscopic Examination of Urinary Bladder

                               
登录/注册后可看大图

Cystoscopy

Definition

Cystoscopy (cystourethroscopy) is really a diagnostic procedure that utilizes a cystoscope that is an endoscope particularly created for urological use to look at the bladder, lower urinary tract, and prostate. It is also accustomed to acquire urine samples, perform biopsies, and take away small stones.

Purpose

Cystoscopy is conducted by urologists to look at the whole bladder lining and take biopsies associated with doubtful areas. Cystoscopy might be prescribed for patients who show the next problems:

• urinary tract infection
• blood within the urine (hematuria)
• bladder or kidney stones
• signs of hereditary irregularities within the urinary tract
• suspected tumors within the bladder
• symptoms of interstitial cystitis
• inability to manage urination (incontinence)
• signs or the signs of an increased prostate
• pain or difficulty urinating (dysuria)
• disorders of or injuries towards the urinary tract
  

Blood and urine experiments, along with x-rays from the kidneys, ureters, and bladder, might be carried out before a cystoscopy to acquire just as much diagnostic information as you possibly can. Throughout the cystoscopy, a retrograde pyelogram can also be carried out to look at the kidneys and ureters.

Preparation

Patients might be questioned to provide a urine sample before cytoscopy to check on for infection and also to avoid urinating to have an hour before this the main procedure. They put on a hospital gown throughout the method and also the lower main is engrossed in a sterile drape. A sedative might be given about 1 hour before the operation to assist the individual relaxes. The location from the urethra is cleaned out along with a local anesthetic is applied. Spinal or general anesthesia could also be used for that procedure. Distension from the bladder with fluid is especially painful, and when it must be achieved, as with the situation of analyzing interstitial cystitis, common anesthesia is needed. A signed consent form is essential with this process.

Description

There are two kinds of cystoscopes accustomed to execute the process, a firm type along with a flexible type. Both types bring exactly the same purposes and vary only within their approach to insertion. The strict type mandates that the individual follow the lithotomy position, and therefore the individual depends on his / her back with knees up and apart. The versatile cystoscope doesn't need the lithotomy situation. A cystoscopy typically lasts from 10-40 minutes. The individual is questioned to urinate before surgery and suggested that relaxing pelvic muscles can help get this to the main procedure easier. A well-lubricated flexible or rigid cystoscope (urethroscope) is passed with the urethra to the bladder the place where a urine sample is taken. There might be some soreness since the device is placed. Fluid will be inserted to fill the bladder and permit the urologist to look at the whole bladder wall. The cystoscope runs on the lighted tip for guidance and makes it possible for biopsies to become taken or small stones to become taken out via a hollow channel within the cystoscope.

Throughout a cystoscopy, the urologist may eliminate bladder stones or kidney stones, collect tissue samples, and carry out x-ray studies. To get rid of stones, a guitar that appears just like a small basket or grasper is injected with the cystoscope to ensure that tiny stones could be taken out with the scope's channel. For any biopsy, Special Forces are injected with the cystoscope to pinch off a tissue sample. Alternatively, a little brush-like device might be injected to remove some tissue. To do x-ray studies like a retrograde pyelogram, a dye is inserted to the ureter using a catheter passed with the cystoscope. After completing all required tests, the cystoscope is taken away.

Risks

Just like any surgical treatment, there are several risks associated with a cystoscopy. Difficulties can sometimes include excessive bleeding, a damaged urethra, a perforated bladder, a urinary tract infection, or a hurt penis. Patients should contact their doctor when they encounter the following symptoms following the procedure, including pain, redness, swelling, drainage, or bleeding in the surgical site; signs of many times infection, which might include headache, muscle aches, dizziness, or a general ill feeling and fever; nausea / vomiting; or complicated or painful urination. Cystoscopy is really a commonly carried out procedure, but it's an invasive method which involves small yet substantial risk. If anesthesia is needed, there's additional risk, especially for those who are obese, smoke, or have been in illness. Those undergoing anesthesia must inform a doctor associated with a medicines they're taking.

Aftercare

After elimination of the cystoscope, the urethra is generally sore, and patients should be prepared to feel a burning experience while urinating for 2 days following a process. To ease soreness or pain, patients might be prescribed pain medicine, and antibiotics can also be necessary to stop infection. Minor pain can also be given over-the-counter, nonprescription drugs for example acetaminophen. To alleviate soreness, patients might be suggested to drink two 8-oz portions of water by the hour for 2 hours and also to have a warm bath to alleviate the burning sensation. Otherwise in a position to bathe, they might be suggested to keep a warm, damp washcloth within the urethral opening. Patients who've undergone a cystoscopy are directed to:

• Avoid strenuous exercise during recovery.
• Take warm baths to alleviate pain.
• Rest and avoid driving for a few days, particularly if general anesthesia was adopted.
• Postpone lovemaking before urologist can determine that healing is complete.
• Expect any blood within the urine to pay off up in a single to 2 days.
  

Who performs the process and where could it be carried out?

Cystoscopy is usually carried out with an outpatient basis, but as much as three times of recovery within the hospital may also be needed. The process can be carried out inside a hospital, doctor's office, cystoscopy suite, or urology office, with respect to the situation from the patient and also the anesthesia needed. If common anesthesia is needed, an anesthesiologist exists to manage the anesthesia and monitor the individual. The cystoscopy process is conducted with an urologist, urologic doctor, or urogynecologist, with the help of nurses experienced in urologic methods. If x-rays are taken throughout the process, an uroradiologist or radiologic technologist is needed to operate the x-ray equipment. Biopsy tissue samples are delivered to the clinical laboratory for evaluation with a pathologist.

Normal results

An effective cystoscopy features a detailed study of the bladder and assortment on urine samples for cultures. If no irregularities are noticed, the outcomes are pointed out as normal. In this instance, the bladder wall appears smooth and also the bladder sometimes appears to become of normal size, shape, and position, without interferences, growths, or stones. The treating doctor will easily notice the individual that which was seen within the bladder following the process. If your biopsy sample was taken, this can take a number of days to become analyzed and tested. Cystoscopy enables the urologist to identify inflammation from the bladder lining, prostatic enhancement, or tumors. If they are seen, further assessment or biopsies may be required. Cystoscopy with bladder distention may also assess interstitial cystitis. Bladder stones, urethral strictures, diverticula, or hereditary irregularities may also be recognized.

Alternatives

You will find methods that may offer some good info concerning the lining from the bladder, for instance, x-rays; however, none of those supply just as much information towards the physician like a cystoscopy. Questions patient should ask a doctor

• How long will the exam last?
• What may happen throughout the process?
• Will cystoscopy hurt?
• Are there any risks linked to the process?
• How will a patient get ready for cytoscopy?
• How many cytoscopies would you carry out every year?