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BackTable / Urology / Topic / Procedure
Cystoscopy
The goal of a cystoscopy, or cystourethroscopy, is to obtain a direct view of the urethra, urethral sphincter, prostate, bladder, and ureteral orifices. Rigid cystoscopes have large channels and can be used along with a wide variety of instruments. Additionally, rigid cystoscopes provide greater optical clarity. Flexible cystoscopes are smaller and can be easily passed when the patient is in the supine position. Flexible scopes also allow for easier navigation around the bladder neck and median lobe of the prostate.
Learn more on the BackTable Urology Podcast
BackTable is a knowledge resource for physicians by physicians. Get practical advice on Cystoscopy and how to build your practice by listening to the BackTable Urology Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.
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Cystoscopy Approach
Once it is inserted using a sheath obturator, the cystoscope is directed anteriorly as it moves towards the bladder. While advancing the cystoscope, the operator evaluates the lower urinary tract, penile urethra, and bulbar urethra for signs of structure. The verumontanum and utricle can be identified when the scope reaches the prostatic urethra. The bladder, excluding the floor and trigone, are inspected for bladder stones, bladder lesions, erythematous patches, and other abnormalities. The bladder is drained through a catheter before the cystoscope is removed. Complications of a cystourethroscopy include urinary tract infection, hematuria, and dysuria.
Cystoscopy Podcasts
Listen to leading physicians discuss cystoscopy on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.
Episode #57
In this episode of BackTable Urology, Dr. Aditya Bagrodia speaks with urologist Dr. Anne Schuckman from the University of Southern California about advantages and advice for blue light cystoscopy, a procedure performed to identify bladder tumors during transurethral resection of bladder tumor (TURBT).
Episode #12
We talk with Dr. Yahir Santiago-Lastra, director of the Women's Pelvic Medicine Center at UC San Diego Health about the management of cystitis and pelvic pain syndromes. She shares her insights on genitourinary syndrome of menopause, pain evaluation and treatment, and procedural options including botox and sacral neuromodulation.
Episode #11
Dr. Aditya Bagrodia interviews urologist Dr. Steve Hudak from UT Southwestern Medical Center about post-prostatectomy incontinence. They cover an array of topics including, incontinence evaluation, managing patient expectations, kegel exercises and pelvic floor therapy, and slings vs. artificial urinary sphincters.
Cystoscopy Indications
Cystoscopy is utilized when patients experience gross or microscopic hematuria, malignancy, lower urinary tract symptoms (LUTS), or trauma to the lower urinary tract. Patients with a history of malignancy are evaluated for urethral, bladder, or upper tract UCC malignancy on a surveillance basis. Lower urinary tract symptoms include obstructive voiding symptoms, irritative voiding symptoms, chronic pelvic pain syndrome, recurrent urinary tract infections, and urinary incontinence. Bladder abnormalities discovered in prior imaging may indicate the need for a cystoscopy and can lead to the removal of a foreign body, such as a stent, if necessary. In order to prevent the risk of sepsis, a cystoscopy should not be performed if the patient has a urinary tract infection.
Cystoscopy Articles
Read our exclusive BackTable Urology Articles for quick insights on cystoscopy, provided by physicians for physicians.
Many BPH patients experience severe late-stage bladder complications, including urinary retention and bladder failure, even when their immediate symptoms are managed according to BPH guidelines. These cases highlight a gap in care where timely surgical deobstruction could have preserved bladder health.
References
[1] Engelsgjerd, J. S., & Deibert, C. M. (2021, April 20). Cystoscopy. StatPearls [Internet]. Retrieved September 19, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK493180/
Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
Podcasts
Articles
BPH Patient Education: Focus on Shared Treatment Decisions
Bladder vs Prostate: How to Prevent Bladder Complications of BPH
Blue Light vs White Light Cystoscopy in Bladder Cancer
Contributors
Dr. Aditya Bagrodia
Dr. Sam Chang
Dr. Timothy Clinton
Dr. Steve Hudak
Dr. Ashish Kamat
Dr. Suzanne Merril