One of the most commonly used diagnostic procedures in urology is cystoscopy. During this procedure, the inner wall of the bladder is examined.
This manipulation allows you to diagnose such pathologies as cancer, stones, tumors, papillomas, ulcers, injuries. Bladder cystoscopy helps to assess the degree of mucosal change as a result of inflammation, to find out the cause of hematuria.
She from a diagnostic study can go into surgery if a pathology is detected. A study is performed using a cystoscope. It is lubricated with sterile glycerin.
The patient should urinate before the procedure. A mandatory requirement is the absence of acute inflammation in the bladder, genitals, urethra, as well as its patency.
Bladder cystoscopy is performed on a urological chair. Usually limited to local anesthesia, however, children and adults with high sensitivity to pain use general anesthesia. In the first case, the patient can immediately go home, and in the second - for some time he is in the ward.
After the introduction of the cystoscope, the remaining urine is removed from the bladder and washed. Then fill it up to the urge to urinate with a solution of furatsilina. In this case, the capacity of the bladder is determined.
First, examine the front wall, and then move on to the left side, back and right side. In this case, the cystoscope is rotated clockwise. The most careful examination requires the area of the Lietot triangle, since more often it is in it that pathological processes occur.
During the study, pay attention to the number, shape, location of the ureteral orifice, the color of the wall and the presence of pathological changes. The doctor checks for stones and foreign bodies in the bladder.
The mucous membrane should normally be smooth, pale pink, with a network of vessels. The shape of the mouths of the ureters can be point, round, sickle-shaped, oval, slit-like. Their location should be symmetrical. With various pathologies, blood and pus can be released from the mouth.
Bladder cystoscopy can be combined with chromocystoscopy. In this case, a solution of indigo carmine is injected into the patient's vein (this dye is blue). Then the doctor observes during cytoscopy after what time tinted urine will appear from the ureters.
Normally, this should happen after 4 minutes. If the time exceeds 12 minutes, then this may indicate impaired renal function or outflow of urine.
Usually, cystoscopy of the bladder, which is generally well reviewed by patients, lasts at least 45 minutes. However, the inspection of the wall takes no more than 10 minutes.
Complications of cystoscopy:
- exacerbation of inflammation, especially in the urethra;
However, under the condition of a highly qualified urologist-surgeon and modern equipment, the likelihood of complications is not high. The most terrible complication is the formation of a false move in case of an urethral injury. In this case, it is necessary to urgently urinate with a cystostomy. With the help of cystoscopy, the following surgical treatment of the bladder can be performed:
- TUR (transurethral electroresection) of cancer or prostate adenoma;
- crushing stones (cystolithotripsy);
- ureteral catheterization and bougienage, as well as dissection of its mouth during ureterocele and stone excretion using extractors;
- removal of tumors, papillomas;
- mucosal injection of drugs;
- endovesical electrocoagulation of an ulcer.
Thus, cystoscopy of the bladder helps to diagnose many of its pathologies, as well as conduct their treatment. It lasts 45 minutes, then the patient can go home. However, this study has several complications and contraindications.