Indications for urethrocystoscopy

Urethral cystoscopy is a relatively common endoscope. It is a method of examination. Cystoscopy can be used to observe some conditions inside the bladder. It is very effective in treating bleeding spots or papilloma in the bladder. It can be treated with an electrocautery device. When performing this treatment, you should also understand some contraindications and make adequate preoperative preparations.

Indications for urethrocystoscopy

1. For diagnosis, the situation inside the bladder can be observed through the examination endoscope; a thin ureteral catheter can be inserted into the ureter to the renal pelvis through the ureteral catheter endoscope, and urine can be collected for routine examination and culture; indigo carmine solution can be injected intravenously to observe the blue discharge time of the ureters on both sides, and the renal function of both sides can be estimated separately (normally blue discharge occurs 5 to 10 minutes after injection); 12.5% ​​sodium iodide contrast agent is injected into the renal pelvis or ureter through the catheter, and retrograde pyelography is performed to understand the situation of the kidney, renal pelvis and ureter. 2. For treatment purposes, if there are bleeding spots or papilloma in the bladder, it can be treated with an electrocautery device through a cystoscope; stones in the bladder can be crushed with a lithotripter and then flushed out; small foreign bodies and diseased tissues in the bladder can be removed with foreign body forceps or biopsy forceps; if the ureteral orifice is narrow, it can be cut open with a scissors through a cystoscope (or dilated with a dilator).

Contraindications

1. The urethra and bladder should not be examined when they are in the acute inflammatory stage, as this may cause the inflammation to spread. In addition, acute inflammation of the bladder may cause congestion and make it difficult to distinguish the lesions. 2. If the bladder capacity is too small, below 60ml, it means the disease is serious and most patients cannot tolerate this examination, which can also easily lead to bladder rupture. 3. Patients with phimosis, urethral stenosis, urethral calculi, etc., who cannot insert a cystoscope. 4. Those with bone and joint deformities who cannot adopt lithotomy position. 5. Women who are menstruating or pregnant for more than 3 months. 6. Those with severely impaired renal function, signs of uremia, hypertension and poor heart function.

Preoperative preparation

1. The cystoscope can be disinfected by steaming with 40% formalin (formaldehyde) solution for 20 minutes or soaking in 10% formalin solution for 20 minutes. The cystoscope should not be disinfected by boiling, alcohol, or 0.1% chlorhexidine immersion method to avoid damaging the cystoscope. 2. The operator should wash his hands, wear sterilized clothes and sterilized gloves. The principle of aseptic operation should be emphasized to avoid complications such as nosocomial urinary tract infection. 3. Prepare the patient Let the patient empty his bladder and assume the lithotomy position. Disinfect the vulva with soapy water, sterile saline and chlorhexidine solution. Lay a sterile towel to expose the urethral opening.