This video demonstrates how to perform diagnostic hysteroscopy. Cystoscopy is a Minimally invasive procedure that allows surgeons, gynecologists, or urologists to examine the lining of your bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a lens attached to high definition camera is inserted into your urethra and slowly advanced into the bladder.

Cystoscopy may be done in a testing room, using a local anesthetic jelly to numb your urethra. Or it may be done as an outpatient procedure, with sedation. Another option is to have a cystoscopy in the hospital during general anesthesia.

Diagnostic cystoscopy is a minimally invasive procedure used to examine the inside of the bladder and urethra. It helps in diagnosing conditions such as bladder tumors, infections, stones, and structural abnormalities. The procedure is performed using a cystoscope, a thin, flexible or rigid tube with a camera and light at the tip. This guide provides a step-by-step approach to performing diagnostic cystoscopy safely and effectively.
 
Indications for Diagnostic Cystoscopy
 
- Hematuria (blood in urine)
- Recurrent urinary tract infections (UTIs)
- Bladder pain or irritation
- Suspected bladder cancer
- Urinary incontinence or retention
- Evaluation of abnormal imaging findings
 
Pre-Procedural Preparation
 
1. Patient Assessment:
 
- Obtain a detailed medical history, including allergies and past urological issues.
- Perform a physical examination and review relevant imaging studies.
- Discuss potential risks and obtain informed consent.
 
2. Preparation and Positioning:
 
- Ensure the patient has an empty bladder.
- Position the patient in the lithotomy position (legs elevated and supported).
- Clean the urethral opening with an antiseptic solution.
- Administer a local anesthetic gel into the urethra for comfort.
 
Steps for Performing Diagnostic Cystoscopy
 
1. Insertion of the Cystoscope:
 
- Choose the appropriate cystoscope (flexible for office procedures, rigid for operating room use).
- Lubricate the cystoscope and gently insert it into the urethra.
- Advance the scope carefully while observing the urethral walls.
 
2. Bladder Examination:
 
- Once inside the bladder, instill sterile saline or water to expand it for better visualization.
- Inspect the bladder mucosa systematically, covering all areas including the bladder neck, lateral walls, dome, and trigone.
 
3. Identification of Abnormalities:
 
- Look for signs of tumors, inflammation, stones, or structural defects.
- Take biopsy samples if necessary for histological examination.
- Record findings with images or video documentation.
 
4. Completion of the Procedure:
 
- Slowly withdraw the cystoscope, inspecting the urethra on the way out.
- Ensure there is no significant bleeding or complications.
- Clean the area and provide post-procedure care instructions.
 
Post-Procedural Care
 
- Encourage hydration to flush out the bladder.
- Advise the patient to report symptoms like persistent pain, fever, or blood in urine.
- Prescribe pain relief medication if needed.
- Schedule follow-up appointments if further investigation is required.
 
Conclusion
 
Diagnostic cystoscopy is a crucial tool in urology, enabling direct visualization of the bladder and urethra to diagnose various conditions. With proper technique and patient care, it is a safe and effective procedure that enhances diagnostic accuracy and guides appropriate treatment planning.