Urethrocystoscopy: indications, preparation, conduct and results
Urethrocystoscopy is an endoscopic examination of the bladder and the urethra throughout its length. Today it is the most informative method of research, and is indispensable in the diagnosis of cancer – bladder cancer and its recurrences. Other survey methods are not able to give the doctor as much information as urethrocystoscopy, in addition, the study might pick up on cytological analysis of a piece of suspicious tissue. There are other possible manipulations during the procedure.
In this case indicated that such a study?
Common indications for carrying out of urethrocystoscopy men and women are:
Particularly relevant to this examination of women with suspected malignant processes. In addition to the diagnostic, the procedure is often carried out solely for therapeutic purposes. It is effective for:
- excision/removal of small tumours – benign and malignant;
- the destruction of stones located in the bladder or in the urethra;
- removal of coarse cicatricial formations in the mucosa of the bladder or urethra;
- hemostatic therapy.
Do not be afraid of conducting such a study – doctor will do everything possible to ensure that it went smoothly and quickly. Excessive emotional stress during urethrocystoscopy undesirable, and may require additional application of sedatives.
In preparation for the examination
At the preliminary examination, determines the size of the external opening of the urethra – it allows you to choose the most suitable diameter of the tube. If the size is too small, it is probing. In the presence of men of the inflammatory process in the urinary tract or genital organs it is advisable prescription of antibacterial therapy lasting 2-3 days. This treatment can be prescribed immediately before manupulating using intramuscular administration of the drug.
Depending on the purpose of such a survey is chosen method of pain relief. Can be used spinal anesthesia, intravenous anesthesia, or sedation. The patient definitely explains the upcoming procedure that helps to reduce possible fears. The research is conducted in the special endoscope Cabinet with strict adherence to aseptic technique.
The course of urethrocystoscopy
The patient undresses from the waist down, laid on a special table/chair, and covered with a sterile sheet with an opening. The head of the penis or prepucialna space in women treated with antiseptic solutions. The male urethra is anesthetized with a warm solution of 2% novocaine introduced through a syringe. Some clinics use the gels with anesthetic, which smeared the tube of the instrument. Anesthetic is filled the urethra in hanging and bulbous parts.
If necessary, prolonged examination, pronounced the pathological process with multiple papillomas, the small volume of the bladder, most often used General anesthesia. Just before urethrocystoscopy in women and men is required to fully empty the bladder, and before the inspection, he is filled with sterile saline solution – it allows you to straighten all the folds and details to examine the entire mucosa.
Possible complications of urethrocystoscopy
With proper training and sufficient skills of the doctor, the complications of such studies are rare. This is due to the sufficient simplicity of diagnostic procedures and modern equipment. The most frequent complications be expressed in trauma of the mucous membranes of the urethra and bladder.
Minor injuries do not require special treatment and heal quickly on their own. Other complications include:
- resorptive or urethral fever;
- the symptoms of acute epididymitis or prostatitis;
- the occurrence of false turn – the complication accompanied by profuse bleeding, and forces to stop further procedure.
Very rare cases of lightning resorptive fever with the emergence of a septic state of the patient. Thanks to advanced equipment the number of complications has been steadily decreasing.