In this video, we will discuss that Diagnostic cystoscopy is a fundamental urological and gynecological procedure that allows direct visualization of the urethra and urinary bladder. It plays a crucial role in the evaluation of various lower urinary tract conditions such as hematuria, recurrent urinary tract infections, urinary incontinence, bladder tumors, urethral strictures, and more. This video, titled "Diagnostic Cystoscopy: Step-by-Step Guide to Performing a Safe and Effective Procedure," provides a clear and concise demonstration of how to perform cystoscopy with proper technique, safety, and efficiency.

What is Cystoscopy?

Cystoscopy involves the insertion of a cystoscope—either rigid or flexible—through the urethra into the bladder to allow direct endoscopic inspection of the urinary tract lining. It is performed in both outpatient and operative settings, using local, regional, or general anesthesia depending on the indication and patient comfort.

Step-by-Step Procedure Demonstrated in the Video

Patient Preparation

Explain the procedure and obtain informed consent.
Position the patient in lithotomy or supine position.
Ensure sterile technique with appropriate draping and use of antiseptic solution for genital cleaning.

Anesthesia and Lubrication

For flexible cystoscopy, lidocaine jelly is used as a local anesthetic and lubricant.
General or spinal anesthesia may be used for rigid cystoscopy or operative interventions.

Insertion of the Cystoscope

Gently insert the cystoscope through the urethral meatus.
Navigate through the urethra, visualizing the mucosal lining, until entry into the urinary bladder is confirmed.

Bladder Examination

Irrigate the bladder using normal saline or sterile water to allow for optimal visualization.
Systematically examine key anatomical landmarks:

Bladder neck

Trigone
Ureteric orifices (look for efflux of urine)
Dome and lateral walls
Anterior bladder wall

Observation and Documentation

Look for abnormalities such as tumors, stones, inflammation, trabeculation, or diverticula.
Capture still images or video if needed for documentation or further review.

Scope Withdrawal and Post-Procedure Care

Slowly withdraw the scope while re-examining the urethra.
Clean the area and inform the patient about possible mild dysuria or hematuria, which usually resolves quickly.

Clinical Applications of Diagnostic Cystoscopy

Evaluation of gross or microscopic hematuria
Assessment of recurrent UTIs
Investigation of urinary incontinence or voiding dysfunction
Identification of bladder tumors, stones, or foreign bodies
Follow-up after bladder cancer resection

Conclusion

This step-by-step guide to diagnostic cystoscopy offers a comprehensive overview of how to safely and effectively perform this essential procedure. Mastery of cystoscopy not only aids in accurate diagnosis but also enhances clinical decision-making and patient outcomes in urological and gynecological practice.

Watch the full video to gain practical insights into instrument handling, anatomical orientation, and interpretation of findings during cystoscopy. Don’t forget to like, comment, and subscribe for more surgical training videos and endoscopic education.