Cystoscopy of the bladder
One of the most commonly used diagnostic manipulations in urology is cystoscopy. During this procedure, the inner wall of the bladder is examined.
This manipulation makes it possible to diagnose suchhis pathology, like cancer, stones, tumors, papillomas, ulcers, trauma. Cystoscopy of the bladder helps to assess the degree of mucosal changes due to inflammation, to find out the cause of hematuria.
She can go from a diagnostic study to a surgical operation if a pathology is found. The study is performed with a cystoscope. It is smeared with sterile glycerin.
The patient must urinate before the procedure. A mandatory requirement is the absence of acute inflammation in the bladder, genitals, urethra, as well as its patency.
Cystoscopy of the bladder is performed onurological chair. Usually limited to local anesthesia, however, in children and adults with a high sensitivity to pain, general anesthesia is used. In the first case, the patient can immediately go home, and in the second - he is in the ward for some time.
After the introduction of the cystoscope, the remains of urine are removed from the bladder and washed. Then fill it up to urge to urinate with a solution of furacilin. This determines the capacity of the bladder.
First, examine the front wall, and thenpass to the left lateral, back and right lateral. The cystoscope is rotated clockwise. The most careful examination requires the area of the Ljeto triangle, since more often it is where pathological processes arise.
During the study, attention is drawn tonumber, shape, location of the ureter's mouth, color of the wall and the presence of pathological changes. The doctor checks to see if there are stones and foreign bodies in the bladder.
Mucous in the norm should be smooth,pale pink, with a network of blood vessels. The shape of the ureteral anus can be dotted, rounded, sickle-shaped, oval, slit-shaped. Their location must be symmetrical. With various pathologies from the mouths, blood and pus can be secreted.
Cystoscopy of the bladder can be combined withchromocystoscopy. In this case, a solution of indigo carmine is injected into the vein of the patient (this colorant has a blue color). Then the doctor observes during cytoscopy through what time the tinted urine appears from the ureters.
Normally this should happen in 4 minutes. If the time exceeds 12 minutes, this may indicate a violation of kidney function or outflow of urine.
Usually cystoscopy of the bladder, patients' reviews of which are generally good, last at least 45 minutes. However, the examination of the wall takes no more than 10 minutes.
Complications of cystoscopy:
- urethral fever;
- exacerbation of inflammation, especially in the urethra;
- damage to the urethra;
- bleeding.
However, on condition of high qualificationurologist-surgeon and modern equipment the probability of complications is not high. The most terrible complication is the formation of a false path in urethral trauma. In this case it is necessary to urinate urgently with the help of cystostomy. With the help of cystoscopy, the following surgical treatment of the bladder can be performed:
- TUR (transurethral electroresection) of prostate cancer or adenoma;
- crushing stones (cystolithotripsy);
- catheterization and bougeling of the ureter, as well as dissection of its mouth with a ureterocele and excretion of the stone with the help of extractors;
- removal of tumors, papillomas;
- injection under the mucous membrane of medicinal products;
- endovezical electrocoagulation of the ulcer.
Thus, cystoscopy of the bladderhelps to diagnose many of his pathologies, and also conduct their treatment. It lasts 45 minutes, then the patient can go home. However, this study has a number of complications and contraindications.
