Cystoscopy renal tests in the patients.pptx

renal tests

1. Cystoscopy

2. Cystourethroscopy is one of the most common procedures performed by a urologic surgeon. It allows for direct visualization of the urethra, urethral sphincter, prostate, bladder, and ureteral orifices.

3.   It can be performed as a simple office procedure or as a procedure in the operating room with the patient under general anesthesia . There are both flexible and rigid cystoscopes and a variety of tools that can be incorporated during cystoscopy, depending on the situation. 

4. Anatomy and Physiology The first structure encountered during cystourethroscopy is the urethra.

5. Indications Presence of hematuria , gross or microscopic. Gross hematuria is defined as blood in the urine that can be seen with the naked eye. Microscopic hematuria is defined as 3 or greater red blood cells per high-powered field . Another common indication for regular cystoscopy is any history of malignancy, including urethral, bladder .

6. Lower urinary tract symptoms (LUTS) are another indication of cystourethroscopy . These symptoms can include obstructive voiding symptoms, irritative voiding symptoms, urinary incontinence, chronic pelvic pain syndrome, or recurrent UTIs. Any trauma in which there is a concern for injury to the lower urinary tract necessitates cystourethroscopy , as well as any bladder abnormalities discovered during imaging studies . Removal of foreign bodies, for example, if a patient has an indwelling urinary stent that requires removal, hematospermia , azoospermia , or concern for a bladder or lower urinary tract fistula are also reasons for cystourethroscopy . 

7. Contraindications  any evidence of acute urinary infection it is recommended to obtain a urinalysis 5 to 7 days before any scheduled cystoscopy procedure. If a UTI is identified, the patient should be treated appropriately before the procedure. A contraindication for flexible cystoscopy in the office would be any intolerance to pain or discomfort with the procedure. This may necessitate a trip to the operating room (OR) for cystoscopy under anesthesia . A urethral stricture can sometimes make cystoscopy impossible, as the scope will not be able to pass.

8. Procedure Prior to the procedure, the skin should be prepared with an antiseptic agent. Both chlorhexidine gluconate and alcohol-based solutions can be damaging to mucous membranes and are therefore not recommended for use on the genitalia. Betadine are safe on all skin surfaces and are most commonly used for preparation. After application of the antiseptic agent, a lubricating gel is injected into the urethra. A plain or lidocaine gel may be used.

9. Complications of cystoscopy are generally minor and may include urinary tract infection, hematuria , dysuria, and injury to the bladder or urethra. The development of an iatrogenic urethral stricture is a known possible complication of instrumentation