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Cystoscopy: Difference between revisions
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<section begin="urology" /><section begin="urology2" />'''Cystoscopy''', also called '''cysturethroscopy''', is a procedure where a cystoscope (an endoscope) is inserted into the urethra to examine the urethra, urethral sphincter, prostate, urinary bladder, and uretral orifices. The endoscope can visualise the organs, take biopsy samples, and perform a limited number of therapeutic interventions like cauterisation. It's one of the most common procedures performed in urology. | <section begin="urology" /><section begin="urology2" />'''Cystoscopy''', also called '''cysturethroscopy''', is a procedure where a cystoscope (an endoscope) is inserted into the urethra to examine the urethra, urethral sphincter, prostate, urinary bladder, and uretral orifices. Fluid is continously irrigated into the bladder to prevent it from collapsing and reducing view. The endoscope can visualise the organs, take biopsy samples, and perform a limited number of therapeutic interventions like cauterisation. It's one of the most common procedures performed in urology. | ||
<section end="urology2" /> | <section end="urology2" /> | ||
== Indications == | == Indications == | ||
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== Transurethral resection == | == Transurethral resection == | ||
<section begin="TUR" /> | |||
An instrument called a resectoscope is similar to a cystoscope and can be used to perform transurethral resection of the bladder (TUR-B) or prostate (TUR-P). This is done under [[Spinal anaesthesia|spinal]] or [[general anaesthesia]]. The resectoscope has a camera like a cystoscope but is thicker, and has a metallic loop on the end. The metallic loop is a monopolar cautery, which is used to resect the bladder, or the prostate from the inside of the urethra. During TUR one obtains histological samples for pathological examination. | |||
TUR-B is indicated for as a procedure which is both diagnostic and therapeutic for all stages of bladder cancer. TUR-P is indicated for severe benign prostatic hyperplasia instead of prostatectomy. It is not used for prostate cancer. | |||
TUR- | During TUR-P, the prostate capsule is not removed. The remaining cavity will be epithelialized after a few months. | ||
=== TUR syndrome === | |||
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. Some of this water can be absorbed, causing hypotonicity and potentiallly haemolysis. 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 glycine solution (which is also non-conductive but 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. | |||
<section end="TUR" /> | |||
<section end="urology2" /> | <section end="urology2" /> | ||
[[Category:Urology]] | [[Category:Urology]] | ||