Cystoscopy and Ureteroscopy Surgery

Cystoscopy and Ureteroscopy Surgery

Urologoscopic operation is a diagnostic method widely used in urinary surgery and can easily diagnose many urinary tract diseases with use by a urologist. It literally means a bladder scan with a camera.

It is applied by entering the external urinary tract (urethra) with a camera for both men and women and it is introduced through the external urinary tract and is examined and diagnosed.

A bladder endoscopy or urethoscopy is a procedure that allows a urologist to view the inside of the bladder and urethra in detail.

In this procedure a flexible optical fiber tube is inserted through the urethra and the bladder and lower urinary tract organs are visually examined..

The advantages of treatment through the operation of the genitourinary system are:

  • Urinary tract tightness
  • Urinary tract tumors (urethra tumors)
  • Bladder tumors
  • Cystolith
  • It is used extensively in the diagnosis of bladder wounds and in the measurement of bladder capacity in chronic painful bladder disease, which we call interstitial cystitis.
  • It is a frequently used method for treating chronic cystitis that does not disappear for long periods, especially in middle-aged women.
  • In men who have difficulty urinating, diagnosis can be made by observing that the prostate enlarges and closes the bladder opening.

A uroploscope is a diagnostic procedure in which a urologist is allowed to view a patient’s urinary tract, bladder, and urethra.

The urologist examines the patient’s urinary tract and detects negative conditions there by applying a cystoscopy.

Urinary endoscopy provides early diagnosis of bladder cancer, detection of urinary tract infections, and detection of ureteral obstruction and stenosis.

For urinary endoscopy, a long medical device called a cystoscope is used where the cystoscope is pushed through the urethra to reach the bladder.

By using the illuminated tube at the end of the device, a urologist can easily examine the inside of the bladder.

During cystoscopy, if the patient suspects bladder cancer, the doctor may take these tissue fragments if necessary. This procedure is called a biopsy.

Cystoscopy and Ureteroscopy Surgery
Cystoscopy and Ureteroscopy Surgery

Operation of Cystoscopy and Ureteroscopy Surgery

  • There are two types of endoscopic instruments: rigid (flat and not bendable) and flexible (bendable).
  • Both systems have advantages and disadvantages.
  • In general, the cystoscope is used from 6 to 12 branches in pediatric patients (children) and 16-20 branches in adult patients.
  • The preferred endoscope size during the endoscopy procedure should be the smallest size that we can use during the procedure.
  • Cystoscopy 16-17 F is sufficient for diagnostic endoscopy.

Importance of Cystoscopy and Ureteroscopy Surgery

  • The role and importance of cystoscopy in the follow-up of bladder cancer (bladder tumor)
  • Urinary incontinence for young people and its treatment
  • Recurrent urethral tumor (external urinary tract) at 5 years after artificial bladder surgery
  • Cystoscopy should not be neglected in the follow-up of low-grade bladder tumors
  • In the video below, follow-up cystoscopy for 6-9 months was neglected and as a result of this, a newly formed tumor in the bladder was seen that could not be detected by ultrasound
  • It is important to detect and eliminate these tumors at an early stage.
  • Scanning the areas of leukoplakia in the bladder due to chronic cystitis
  • Surgery for bladder cancer – early removal of cystoma
  • Weakness of bladder structure due to enlarged prostate (BPH)
  • Excision of urethra tumor
  • Surgery to correct urethral stenosis (urinary canal stenosis)
  • Closed bladder stone surgery

In which cases is the Cystoscopy and Ureteroscopy Surgery performed

  • Lower urinary tract narrowing, infections, benign and malignant tumours
  • Size of the prostate and its tumors
  • Bladder stones, tumors, and infections
  • Inner urinary tract obstruction
  • It is used to diagnose and treat urinary incontinence.

The purpose of Cystoscopy and Ureteroscopy Operation

  • A cystoscopy is usually performed to detect causes of bleeding or obstruction and to find abnormalities in the bladder.
  • Bladder endoscopy may be recommended even if the urologist believes there is a problem with the patient’s urinary tract. For example, if a problem is suspected causing an obstruction of urine flow.

Conditions that may be diagnosed by applying cystoscopy include

  • Bladder Cancer
  • Benign tumors in the tissues or abnormal growth
  • Urinary tract infections
  • Bladder stones
  • Wounds that cause inflammation of the urinary tract

  Indicators of Cystoscopy and Ureteroscopy Surgery

  • Microscopic hematuria (blood in urine)
  • Symptoms of obstructive or irritating urination (urinary complaints such as excessive urination and burning)
  • Upper urinary tract width using retro-pH (cavity and renal canal imaging)
  • To put a catheter or stent in your ureter (to insert a stent into your kidney canal)

To whom and in which cases is a Cystoscopy and Ureteroscopy Surgery

 A cystoscopy is performed for diagnostic and therapeutic purposes. A cystoscopy is also recommended to investigate the cause of bleeding that can be seen during urination or detected in a urine test

It is also used to detect infections in the urinary tract and  it is also preferred for periodic monitoring of bladder cancer patients.

On the other side, in therapeutic use, it is used to shave the prostate, alleviate stenosis of the urinary canal, lithotripsy , and insert a temporary catheter into the upper urinary tract.

Cystoscopy and Ureteroscopy Surgery is often performed in diagnosing the following conditions:

  • Blood in the urine.
  • Urinary incontinence and overactive bladder syndrome
  • Alginuresis
  • Biopsy of the bladder.
  • Diagnosis of diseases such as cystoliths and bladder cancer
  • Suspected cystoma
  • Detection of tiny bladder tumors
  • To relieve gravel congestion or stenosis that may occur in the ureter
  • Imaging the Upper Urinary Syste
  • Elimination of Prostate Obstructive Disorder

Operation of Cystoscopy and Ureteroscopy Surgery (Cases under which diagnosis is made)

  • In evaluating patients with urination problems
  • Ocular or microscopic hematuria (hematuria)
  • Evaluation of urinary fistulas
  • In congenital malformations of children
  • For a biopsy
  • Imaging during urethra, bladder and ureteral surgery and in incontinence or bladder surgery

How does the operation of Cystoscopy and Ureteroscopy Surgery perfurmed

  • Cystoscopy is most often performed as a procedure for general patients (that is, for ambulatory patient ). Usually the patient is given antibiotics before the cystoscopy. The patient must empty the bladder completely. If necessary, a liquid local anesthetic or gel may be used on the urethra.
  • The patient lying on his or her back and is asked to bend and open his or her legs. The cystoscope extends from the urethra and allows it to reach the bladder.
  • Water or saline is injected into the patient’s bladder with the help of a cystoscope. The filled bladder is stretched so that the physician begins to examine the wall of the bladder properly. If necessary, a urine sample may be taken from the bladder. At the end of the procedure, the cystoscope is slowly pulled out.
  • The cystoscopy usually takes 5 to 10 minutes.

Diseases visable in the operation of Cystoscopy and Ureteroscopy Surgery

  • PUV
  • BPH
  • Constriction of cervix vesicae
  • Leukoplakia
  • Ureterocele
  • Retrograde ureteral orifice
  • Hematuria
  • Trabeculum
  • Diverticulum
  • Cystitis
  • Calculus

Tumor and so forth. Signs and diseases should be checked carefully

Stages after the operation of Cystoscopy and Ureteroscopy Surgery

  • After removal of the cystoscope, the patient may experience pain in the urethra and there may be a burning sensation in the first 48 hours. There may also be blood in the urine in the first hours, but this must pass within 12 to 24 hours. Physician should be consulted about persistent pain and bleeding.
  • If reversal is not recommended after the procedure, normal eating habits and physical activities can be resumed. You may be advised to consume additional fluids for a diuretic after cystoscopy.
  • Antibiotics can be given to prevent infection.

If the following conditions occur after the cystoscopy, report to a physician

  • Fever and shivering
  • Insistency to urinate
  • Difficulty urinating
  • Back pain
  • Persistent blood in the urine

Causes of the operation of Cystoscopy and Ureteroscopy Surgery for women

  • Suspicion of surgery-related urinary tract injury (about 1% urinary tract injury that occurs during pelvic surgery for women). Uterine removal (hysterectomy), urinary incontinence operations are the most common operations associated with urinary tract injuries
  • Excessive urination without urinary tract infection
  • In the case of suspected infection of the urinary tract with gynecological cancers and endometriosis
  • If urine comes out of the vagina
  • In the case of infection of the urinary tract as a result of injuries of the vagina
  • Urinary drip after urination
  • In the case of recurrent urinary tract infection in those with a previous history of gynecological surgery
  • Incontinence treatment by injection
  • Women’s cystoscopy is performed in suprapubic catheter applications.

Things to be aware of after the operation of Cystoscopy and Ureteroscopy Surgery

 What should be considered after the cystoscopy must be taken into consideration by patients. If the patient has undergone anesthesia or general anesthesia, he must wait a period of time after the operation to fully recover.

  • Put a warm, damp cloth on the genital area to relieve pain. Repeat this process as necessary Take a hot shower. However, you will need to get information from your doctor for these instructions.
  • Due to the possibility of urinary tract infection and bleeding in the urine after the bladder oscopy, drinking plenty of water is enough to prevent both. Contact your doctor if you are unable to urinate after the cystoscopy or if you have bleeding and urine pain that lasts more than 2-3 days.

How does the operation of Cystoscopy and Ureteroscopy Surgery – Request form step by step:

How is the cystoscopy performed and the request form for this procedure, one of the most common questions .. Briefly, it is as follow:

  • Since anesthesia will be performed before the cystoscopy, it is recommended that the patient remain fasting.
  • General or local anesthesia is performed prior to a cystoscopy.
  • The patient should wear a special gown.
  • The patient is placed on a table on his or her back with his or her legs open on both sides and the bladder and urethra are examined by entering the urethra with an instrument called a cystoscope and ends with a camera.
  • In this procedure the area is cleaned with a disinfectant liquid.
  • A gel like substance is injected into the urinary tract with the help of a plastic syringe so that the patient does not feel uncomfortable.
  • The bladder is filled with fluid by entering the bladder with a pen-sized cystoscope whose expansion is ensured.
  • During the procedure, the duration of the procedure may vary depending on the purpose of the application. Simple cystoscopy procedures typically take 10 to 30 minutes.
  • After cystoscopy, it is recommended that a lot of water be used to clean the urinary tract and prevent the risk of infection.
  • No worries from seeing blood in the urine after the operation. This situation will disappear within 24 hours. It is also normal for the patient to feel a burning sensation during urination for a day or two, and to urinate frequently. However, if an unusual situation occurs, he should contact his doctor without delay.

How does the results of the cystoscopy be evaluated

  • The method or plan of treatment is created in light of data obtained from the results of the cystoscopy.
  • To remove the patient’s complaint, the method of treatment is applied depending on the patient’s general health status and the size of the disease.
  • It is a short – term procedure, which usually takes 5 to 15 minutes, for those who have had their bladder endoscopy, but with additional interventions the time may be longer.

We usually do a cystoscopy under general anesthesia. It is performed with local anesthesia in the follow-up of low-grade bladder cancers for 3 months, but general anesthesia is preferred because sampling may be necessary in the follow-up of high-risk bladder cancers.

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