Cystoscopy: Difference between revisions

During cystoscopy the bladder is continously irrigated with fluids. During cauterization bleeding and thermal burns occur, which is washed out with fluid. In some cases, a monopolar resectoscope is used because it is cheaper than a bipolar one. To prevent burns, the fluid used to irrigate must be non-conductive, usually distilled ion-free water or glycine-based solutions. Some of this water can be absorbed, causing hypotonicity and potentiallly haemolysis. Absorbed glycine can also cause CNS problem. This usually only occurs after prolonged irrigation, and so TUR is usually kept shorter than 1 hour to reduce the risk.

Nowadays one can use bipolar resectoscope with physiological saline solution (which is also conductive and is isotonic) to prevent TUR syndrome, but this fluid is more expensive. One can also use bipolar cautery, as this eliminates the need for non-conductive fluids.