Cistoscopy of the bladder in women and men is quite common. This is an extremely informative procedure that helps to evaluate the work of the bladder and detect a number of diseases even at the initial stages. But patients are interested in questions about how cystoscopy is performed, whether it is associated with certain complications.
What is a cystoscopy?
Cystoscopy is an endoscopic examination method that allows you to examine the inside of the bladder and urinary tract. It is worth noting that this procedure is of extremely important diagnostic value, as it helps to determine the presence of certain diseases and even carry out some therapeutic measures without the help of a surgeon.
A cystoscope is a special device shaped like a long narrow tube. Outside, the tube is surrounded by a metal cylinder, as well as a special lighting system. In the center of the cylinder there are also additional channels that are designed to introduce instruments into the bladder (for example,catheters, forceps, electrodes, etc.).
It is also worth noting that two types of cystoscopes are currently used. There are standard rigid instruments and so-called flexible cystoscopes that provide less discomfort.
This procedure is performed on patients of both sexes. However, it is believed that cystoscopy of the bladder in men is much more difficult and necessarily requires local anesthesia - severe discomfort is associated with the peculiarities of the anatomical structure.
Indications for the procedure
In the presence of certain problems in the functioning of the urinary system, patients are recommended endoscopic examination. Bladder cystoscopy in women, men and children is performed in the presence of such ailments and symptoms as:
- presence of blood impurities in urine samples;
- frequent inflammation of the bladder;
- urinary disorders, the cause of which could not be found using other diagnostic methods;
- enuresis;
- chronic lower abdominal and pelvic pain;
- presence of atypical cells in urine samples;
- increased contractile activity of the bladder;
- presence or suspicion of the presence of stones in the urinary tract;
- neoplasms in the bladder that were detected during ultrasound or computed tomography (cyst, polyp, tumor, etc.);
- suspected development of interstitial cystitis.
In any case, it should be understood thatonly the attending physician can prescribe such a procedure.
Preparation for cystoscopy of the bladder
Of course, in order for the procedure to give the most accurate results, it is necessary to properly prepare for it. More precisely, the attending physician will tell you about precautionary measures and recommendations. However, be sure to tell your doctor about all medications you are taking, as some of them may interfere with the reliability of the results. In particular, the list of prohibited drugs includes various non-steroidal anti-inflammatory drugs, drugs for the treatment of arthritis, as well as some painkillers. You should also at least temporarily stop taking aspirin and anticoagulants, as these drugs increase the likelihood of bleeding.
In addition, cystoscopy of the bladder in women is not performed during menstruation - in such cases, the procedure is simply transferred to another time. In the evening, on the eve of the procedure, it is recommended to take a broad-spectrum antibacterial agent (for example, Monural, although the doctor will tell you more precisely about this). One sachet will help get rid of a lot of complications in the future.
The cleanliness of the external genitalia is also extremely important. Therefore, preparation for bladder cystoscopy also includes morning hygiene procedures, because otherwise there is a high probability of introducing a bacterial or fungal infection into the urinary tract. If the procedure will be performed under general anesthesia, then nothing is better.not to eat in the morning.
For local anesthesia, as a rule, special painkillers are used, which are injected directly into the urethra. The patient usually needs to buy such drugs on his own - be sure to ask your doctor about this.
There is an opinion that you should not go to the toilet before a cystoscopy, as the bladder must be full. In fact, this statement is incorrect, since if necessary, the doctor himself will inject the required amount of fluid into the bladder cavity.
How is a bladder cystoscopy done? Procedure Description
Immediately it should be noted that cystoscopy can be performed both on an outpatient and inpatient basis. Before starting, the doctor determines whether the patient needs pain relief. General anesthesia is indicated for surgical interventions and therapeutic measures - in such cases, an anesthetist should be next to the patient.
For convenience, the patient is offered to sit in a special chair, similar to a gynecological one. If a person is conscious, then the urethra is treated with an anesthetic, for example, "Prilocaine" or "Lidocaine" - these substances have freezing properties and make the tissues less sensitive. Today, special gels are becoming more and more popular, which not only anesthetize the internal walls of the urethra, but also lubricate the urinary tract well and eliminate friction.
What does a cystoscopy look like? First, the cystoscope is thoroughly lubricated with sterile glycerin. This remedyexcellent as a lubricant, as it does not interfere with the transparency of the optical medium.
After inserting the instrument into the bladder cavity, the doctor releases the residual urine. Further, a solution of furacilin is supplied there in order to rinse and disinfect the walls of the bladder. In the future, the doctor determines the capacity of the bladder - for this purpose, the same solution of furacilin is fed into it. The patient is asked to report to the doctor if they feel the urge to urinate.
When the bladder is full, the doctor can begin to examine the mucous membrane. Particular attention is paid to the bottom of the bladder, since most often inflammatory or pathological processes are localized here.
In some cases, the procedure is combined with chromocystoscopy. In this procedure, the patient is injected intravenously with a solution of indigo carmine, a blue dye. The use of a contrast agent allows you to determine the activity of each of the ureters and, accordingly, evaluate the work of the kidneys.
Rigid cystoscopy and its features
In addition to the standard procedure, there is also a rigid cystoscopy. This technique is widely used not only to examine the mucous membrane of the bladder, but also to remove certain formations. In particular, this is how cystoscopy with bladder biopsy is performed when the doctor requires laboratory analyzes of tissue samples. In addition, polyps, small cysts, tumors, etc. can also be removed with an endoscope.
Quite often, this type of cystoscopy is performed under general anesthesia. Local anesthesia is also possible - the anesthetic is injected into the back, as this helps to numb the body from the waist down.
Cystoscopy and medical manipulations
Quite often, cystoscopy in women, men and pediatric patients is associated with various therapeutic measures. In particular, during an endoscopic examination of the bladder, the doctor may perform procedures such as:
- stop bleeding from urinary tract tissue;
- removal of benign or malignant neoplasms in the bladder;
- elimination of obstructions;
- Gentle destruction of stones in the bladder or urinary tract;
- dissection of an existing stricture at the mouth of the ureter or urethra;
- Installing a catheter;
- Punch biopsy.
As you can see, bladder cystoscopy (the photo is in the article) is not only a diagnostic, but also a minimally invasive treatment procedure. And this is also important.
What to expect after the procedure?
After cystoscopy, the doctor will be able to inform you almost immediately about the presence of certain problems, as well as give the necessary recommendations. The only exceptions are those cases where the procedure involves a biopsy - you will need to wait for the results of laboratory tests.
It should be noted that most often within a few days, patients feel cramps and pain of varying intensity when urinating. This phenomenon is completelynormal - you just need to be patient until everything passes. But the use of painkillers is not recommended, since most of these drugs thin the blood, increase the likelihood of bleeding.
Cystoscopy of the bladder in women (and in men) can cause pulling pains in the lower abdomen, which also disappear after a few days. On the first day, a change in the color of urine is possible - often it is brownish, and sometimes with visible impurities of blood. This is also regarded as quite normal. Patients are advised to drink more fluids in order to clear the bladder faster and change the chemical composition of the urine.
Sometimes doctors prescribe antibiotics to patients - this is a preventive measure that helps prevent the development of infectious diseases and inflammatory processes.
If your condition worsens every day, you should consult a doctor. Potentially serious situations include lower back pain, urinary retention, fever, and the formation of blood clots in the urine - here you can not do without the help of a specialist.
Are there any complications?
Many patients in preparation for the procedure are interested in whether there are any side effects that cystoscopy can lead to. Complications in this case are possible. The most common consequences include trauma to the urethra. Sometimes during the procedure, the urethra is also injured, and the patient may form a so-called "false passage" forurine.
Urinary retention is another dangerous condition, which, however, is not diagnosed very often. Injury to certain parts of the urinary system leads to bleeding - sometimes blood clots can block the urinary tract, which is a threat to human he alth.
The most common complications are urinary tract infections. The penetration and activity of bacterial, viral and fungal microorganisms lead to urethritis and cystitis (inflammation of the bladder mucosa). In more severe cases, the infection penetrates deeper, affecting the tissues of the kidneys, which ends with pyelonephritis. Fortunately, prophylactic use of antibacterial agents minimizes the likelihood of bacterial inflammation.
Contraindications for cystoscopy
It should be noted right away that such a procedure is not carried out in every case, since contraindications still exist. For example, cystoscopy of the bladder in men is not performed if, during the diagnostic process, the patient has exacerbations of certain diseases of the prostate and testicles.
Contraindications also include acute inflammatory diseases that affect the mucous membrane of the urethra. In such cases, appropriate therapy must first be carried out. Also, cystoscopy is prohibited in the presence of a fresh injury to the urethra. A violation of the patency of the urethra makes the procedure almost impossible.
General contraindications include bleeding of unknown origin - inIn such cases, patients are advised to undergo an examination, identify the source of bleeding and undergo the necessary therapy. Cystoscopy is not recommended against the background of the so-called resorptive fever, the occurrence of which is due to the release of toxins into the blood from the focus of a purulent process or bacterial inflammation.
Endoscopic examination of the bladder: patient reviews
Today, many patients are prescribed this procedure. Cystoscopy is considered an extremely important diagnostic method that allows you to detect a lot of diseases in time. But, of course, feedback from patients who have undergone the procedure remains an important issue.
First of all, it is worth noting that cystoscopy always gives the desired result and helps to establish a diagnosis and make further appointments for patients. As for subjective sensations during the procedure, many factors matter here, in particular the physiological and anatomical features of the human body, the pain threshold, the skill and professionalism of the doctor. Some patients complain of only mild discomfort, while others experience real pain. In any case, the procedure does not last long, and local anesthesia can make it less unpleasant.
After cystoscopy, many patients complain of discomfort, cramps and pain during urination. But, again, these sensations pass after 1-2 days.
Another interesting question: in which rooms is a bladder cystoscopy performed? Where to do this procedure? ATsome polyclinics offer patients an examination of the bladder directly in the urologist's office. In extreme cases, you can use the services of a private clinic. Be sure to ask the doctor who ordered your cystoscopy about this.