Content:
1. What is cystoscopy.
2. Types of cystoscopes.
3. Indications and contraindications for cystoscopy.
4. Preparation for cystoscopy.
5. Carrying out cystoscopy in men.

6. Possible complications after cystoscopy.
7. Chromocystoscopy.

The use of cystoscopy in the treatment of diseases of the urinary system.

If there is a suspicion of bladder disease, the doctor prescribes. Other research methods do not reveal pathological changes in the mucous membrane (the appearance of polyps, ulcers).

Cystoscopy is a special invasive test to diagnose the condition of the bladder. Using this procedure, sources of bleeding and inflammation of the organ are identified, tuberculosis of the urinary system, abnormalities of the urinary tract and kidneys, as well as polyps, tumors, foreign bodies and stones in the bladder are detected.

Cystoscopy has not only a diagnostic, but also a therapeutic purpose. Cystoscope- a device for carrying out this procedure. They can bougen and cut the mouth of the ureter, crush and remove stones, cauterize ulcers, remove growths and papillomas of the mucous membrane, inject a drug, and take tissue for a biopsy.

Types of cystoscope

The cystoscope can be rigid or flexible. This long and thin instrument is hollow inside. It has an optical mirror system. It transmits the image to the monitor. The cystoscope is also equipped with lighting lamps that improve visibility.

If necessary, the inner tube of the cystoscope is used to deliver medication directly to the bladder mucosa, inject saline into the organ to increase visibility, and remove excess urine. Also, using this device and a cutting loop, you can cauterize tumors and ulcers and take tissue samples for analysis.

Depending on the purpose cystoscopes There are operating rooms, catheterization rooms, examination rooms, universal rooms and special rooms.

Operating cystoscopes are used during medical procedures in combination with semi-rigid surgical instruments.

By using catheterization cystoscopes Catheters are installed on the ureters.

Designed for rinsing and examining the bladder viewing cystoscope.

TO special cystoscopes include pediatric cystoscopes, cystoresectoscopes and cystolithotriptors.

Children's cystoscope They have a small diameter and are used for examining and treating children.

Cystoresectoscope The following medical procedures are performed: resection of the prostate gland, if it is affected by cancer or adenoma; resection of tumors and papillomas of the bladder using high-frequency current under visual control; transurethral electroresection of the bladder neck affected by sclerosis.

By using cystolithotriptor Mechanical crushing of stones in the bladder is carried out.

Indications for cystoscopy

• Bladder cystoscopy is performed in the following cases:
• frequent or painful urination (for example, urinary incontinence in men);
• presence of pus or blood in the urine;
• pain in the pelvic organs of unknown etiology;
• frequent cystitis;
• suspicion of infectious diseases of the urinary system;
• suspicion of prostate tumors;
• suspicion of stone formation in the urinary tract.

Contraindications for cystoscopy

Cystoscopy is strictly prohibited if there is inflammation in the bladder, urinary tract, prostate or testicles, if bleeding is suspected, if there is urethral fever, or if there are problems with the urethra (damage, obstruction).

Preparation for cystoscopy

There is no need to follow a diet before cystoscopy. There is only one prohibition: do not eat on the day of the procedure. It is also recommended to refrain from urinating for an hour before the examination. Men should undergo a cleansing enema 1-2 hours in advance. The physician should notify the patient of the risk of complications. The patient must sign consent for the procedure. Cystoscopy is carried out only under the following conditions: the absence of inflammation in the urethra that may interfere with the passage of the cystoscope; content of at least 80-100 ml of fluid in the bladder; absence of pus and blood, the patient’s urine is transparent. Bladder cystoscopy in men is associated with greater risk than in women. The reason is that the urethral canal in women is much shorter. This procedure also gives men more painful sensations. Therefore, cystoscopy in men is performed under local anesthesia.

Cystoscopy of the bladder in men

Stages of cystoscopy of the bladder in men:

The doctor lifts the patient's penis and inserts the edge of the cystoscope into the opening of the urethra.

Under its own weight, the device lowers to the sphincter of the urethra.

The doctor lowers the penis down, holding the device in an inclined position. This moves the tube toward the back of the urethra.

If adenomas are present, the doctor tilts the cystoscope down and moves it forward. It is forbidden to make additional efforts to advance the device along the urethra, as this may lead to the appearance of a false passage or rupture of the urethra. A cystoscope for examining the urinary system in men is a long way: bypasses the prostate, moves past the seminal tubercle and the neck of the bladder.

Before cystoscopy, a man must undergo certain preparation. This will help minimize the risk of complications.

Conduct a general and biochemical urine analysis. This will give a more complete clinical picture.

Examine blood clotting.

Take an x-ray of the urethra.

The last meal before cystoscopy under general anesthesia should be 8 hours before the start of the examination. To prevent possible hairs from getting into the urethra along with the cystoscope, a man should shave the hair from the groin area and external genitalia. Also, before the procedure, hygiene procedures must be carried out to prevent infection outside the genitourinary tract.

Complications after cystoscopy

After cystoscopy, certain complications may occur.

Presence of blood in the urine. They usually go away within a couple of days.

Feeling of pain and burning when urinating. They disappear on their own within a few days.

Development of cystitis. This is caused by infection during cystoscopy. Quite often this complication occurs due to insufficient hygiene of the external genitalia.

Perforation (puncture) of the bladder. This happens with inexperienced doctors. For example, the doctor collected histological material with a needle that was too long. Symptoms of this are prolonged severe pain, blood in the urine, a decrease in its amount, chills, and fever.

Damage to the urethra. This complication is one of the most serious. It leads to the formation of a false move. For treatment, they resort to installing a cystostomy. According to this system, urine is discharged into a special attached container. It is removed after normal urination has been restored.

If the patient is not bothered by negative symptoms after the cystoscopy procedure, he can return to his normal rhythm of life as soon as possible.

Chromocystoscopy

To diagnose kidney function, doctors resort to a separate type of cystoscopy - chromocystoscopy. The patient is first given an intravenous contrast agent. After this, the doctor determines the rate and time of release of colored urine from each ureter separately. Normally, this result is 3-5 minutes. If the discharge is delayed for up to 10 minutes, we should talk about disturbances in the functioning of the kidneys.

The use of cystoscopy in the treatment of diseases of the urinary system

Cystoscopy allows you to perform the following: healing procedures:

• stop bleeding;
• remove benign and malignant neoplasms in the bladder;

Hello! I visited a paid urologist in Chelyabinsk. At the first appointment, they took prostate juice for analysis. I am concerned possible consequences procedures. Because I was only worried about the issue of premature ejaculation and very rarely had pain after orgasm in the lower abdomen. And after visiting a urologist, I am worried about the frequent urge to urinate and pain when sitting on a chair and sometimes tingling in the pubic area. The first two days after the tests there was even pain during orgasm. I thought that the doctor performed the prostate massage too roughly and was in a hurry all the time. Ultrasound shows isolated calcifications in the prostate. Question: Could the doctor have damaged the tissue of the prostate gland itself when taking prostate secretions?

Vadim Railevich Shakurov, Chelyabinsk

ANSWERED: 09/08/2016

Hello, don’t worry. It is impossible to damage the prostate gland during this procedure. Judging by your complaints, you need to treat chronic prostatitis.

Clarification question

QUESTION FOR CLARIFICATION 08.09.2016 Vadim, Chelyabinsk

What could be the reason for the increase in symptoms after palpation of the gland? This is the fourth day I've been worried. Before the procedure there were no such complaints on my part. And now there is.

ANSWERED: 09/08/2016

Hello, it is quite possible to cause harm through inept actions. Be sure to perform an examination of the prostate gland, PCR scraping for all groups of infections

Clarification question

ANSWERED: 09/08/2016

Hello, I answered you, it is quite possible that the inept actions of the urologist, strong pressure (which is categorically unacceptable), led to your complaints

Clarification question

QUESTION FOR CLARIFICATION 09.09.2016 Vadim, Chelyabinsk

Immediately after the procedure it was almost impossible to urinate, as if everything had shrunk. Considering that before the massage I very rarely had pain after sexual intercourse, but now it’s uncomfortable to sit on a chair and I constantly run around for a small need. Tell me, judging by the symptoms that arose, could it cause irreversible damage to the prostate gland? And will this affect men's health? Should I worry about the consequences of the procedure, or are the symptoms temporary?

ANSWERED: 09/09/2016

Hello, perform truzi glands. Visit the doctor again (better than another). Based on the results, we can guess the essence of the problem

Clarification question

QUESTION FOR CLARIFICATION 09.09.2016 Vadim, Chelyabinsk

According to the truth, there are isolated calcifications in the gland and paraurethral area. It turns out that inflammation was caused after the massage? The urologist massaged me in the presence of stones and in a rough way.

ANSWERED: 09/09/2016

Hello, the presence of calculous prostatitis is a contraindication for digital examination, the doctor could not have known this

Clarification question

QUESTION FOR CLARIFICATION 12.09.2016 Vadim, Chelyabinsk

Tell me, since after the procedure my gland became inflamed (a constant urge to urinate and pain and the inability to pass urine after the procedure, the secretion began to flow poorly) - could this have irreparable consequences for my men's health? Just 5 days after taking it, the symptoms began to subside.

QUESTION FOR CLARIFICATION 12.09.2016 Vadim, Chelyabinsk

Tell me, since after the procedure my gland became inflamed (a constant urge to urinate and pain and the inability to pass urine after the procedure, the secretion began to flow poorly) - could this have irreparable consequences for my men’s health? Just 5 days after taking it, the symptoms began to subside. And what kind of injection was given to me in the groin area 20 minutes before the prostate massage, with an insulin needle?

ANSWERED: 09/12/2016

Hello, you have been answered. Repeat the research. About the injection, find out from your doctor, he should explain everything to you

Clarification question

ANSWERED: 09/12/2016

Hello, please do not duplicate questions. You won't get more information, but it will cause a lot of inconvenience

Clarification question

ANSWERED: 09/12/2016

Hello, please remove duplicate questions. They hang in the unanswered category and interfere with your work.

Clarification question

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The prostate, protected by the bony walls of the pelvic ring and the muscular aponeurotic layers of the perineum, is rarely subject to isolated damage, which is more often combined with damage to the rectum, bladder, and seminal vesicles. Damage to the prostate is facilitated by its pathological conditions: chronic inflammatory processes, plethora, fragility of tissue changes and reduced mobility of the gland due to infiltration and swelling of the ligamentous apparatus. Prostate injuries can be closed or open.

Closed injuries from the urethra usually occur as a result of incorrect, forced instrumental examination of the bladder during the insertion of a catheter, bougie, cystoscope, or lithotripter. More often, such damage is observed with strictures or inflammatory changes in the walls of the urethra and prostate. Forcible insertion of instruments may lead to the formation of a false passage in the prostate tissue, going towards the bladder or periprostatic tissue.

Damage to the prostate is accompanied by pain, hematuria, excretion of blood with clots in the urine, dysuria, and fever. In mild cases, these phenomena disappear after 2-3 days. IN severe cases hematuria and dysuria last much longer; An infection is often associated, which leads to the occurrence of parenchymal or the formation of a prostate abscess.

With simultaneous damage to the periprostatic tissue, urinary infiltration may occur, spreading to the pelvic tissue, followed by the formation of urinary phlegmon, which requires immediate surgical treatment.

The diagnosis is made on the basis of palpation of the prostate through the rectum. Palpation is painful; the prostate is unevenly enlarged and dense; Foci of softening are identified in places. All of these phenomena can concern any one lobe or spread to the entire prostate gland. If there is an abscess, then upon palpation a swell is noted.

Open prostate injuries occur with gunshot wounds, a fall with the perineum on the edge of any object, or a stabbing or cutting weapons and are found much less frequently than closed ones. Gunshot wounds to the prostate are usually combined with damage to the bladder, rectum, and urethra. Isolated prostate injuries are extremely rare.

With a combined injury, symptoms of prostate damage do not appear immediately; signs of damage to neighboring organs come to the fore: urinary leaks, urine and feces coming out of the wound, gases passing in the urine. After some time, symptoms of injury to the prostate gland appear: pain in the anus, dysuria, hematuria. Urinary leaks with subsequent urosepsis usually lead to the death of the wounded. In milder cases, urethrorectal or urethro-perineal fistulas are formed with cicatricial changes and prostate atrophy, which can lead to impaired sexual function.

The diagnosis of prostate damage is made on the basis of palpation examination through the rectum (which makes it possible to identify deformation or wound of the prostate gland), as well as urethrography. First aid for a wounded prostate consists of primary treatment of the wound. If the prostate gland and bladder are damaged, a suprapubic fistula is necessary. In case of urinary leakage, drainage is performed through the obturator foramen or through the rectosciatic fossa (see Drainage in urology). If the rectum is simultaneously injured, anus praeternaturalis (see) is applied. In case of extensive injury to the prostate with a foreign body, perineal prostatotomy is indicated.