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At least 199 records · Page 11Linked to original sources

PubMed1986

Supine flexible cystoscopy.

We attempted cystoscopy with a flexible instrument and ureteral catheter insertion in 152 supine patients. Cystoscopy was successful in 147 patients (97 per cent) and ureteral catheters were inserted in 133 (91 per cent). Examinations with this instrument are tolerated better than those with rigid cystoscopes, which may improve patient compliance with followup examinations. The current drawbacks, namely a smaller field of view, lower visual acuity and, sometimes, inadequate irrigant flow rates, may be reduced or overcome with improvements in instrument design.

Adolescent↗

PubMed1986

Bedside flexible cystoscopy: an approach to the critically ill patient.

A 15F flexible fiberoptic choledochonephroscope was used to perform bedside flexible cystoscopy in 5 critically ill patients. All 5 patients were receiving pressor agents, and 4 were intubated and dependent on a respirator. A ureteral stent was placed in the renal pelvis in 3 patients. The flexible endoscope enables the urologist to bring diagnostic and therapeutic cystoscopy directly to the bedside.

Aged↗

PubMed1980

The role of excretory urography and cystoscopy in the evaluation and management of women with recurrent urinary tract infection.

We examined the roles of excretory urography and cystoscopy in the evaluation and management of 153 otherwise healthy women seen consecutively with recurrent urinary tract infections. The excretory urograms were entirely normal in 89 per cent of the patients; the abnormalities were incidental findings with no influence on subsequent management. These results, combined with the known expense and risks inherent in the use of iodinated radiologic contrast material, suggest that excretory urography be limited to those patients possessing other risk factors. These include a history of unexplained hematuria, obstructive symptoms, neurogenic bladder dysfunction, renal calculi, analgesic abuse, severe diabetes mellitus or bacteriologic evidence of rapid recurrence suggesting bacterial persistence within the urinary tract or an enterovesical fistula. On the other hand, cystoscopy under local anesthesia has essentially no risks and occasionally will yield information helpful in future management.

Adolescent↗

PubMed1979

Evaluation of importance of cystoscopy in staging gynecologic carcinomas.

Of 265 patients with gynecologic carcinoma undergoing initial evaluation during a 5-year period 238 were staged prospectively with procedures that included cystoscopy. Endometrial carcinoma was noted in 98 patients, none of whom had evidence of bladder extension nor did the clinical stage of disease change after cystoscopy. Of 120 patients with carcinoma of the cervix 7 were found to have extension of tumor to the bladder. The clinical stage was elevated in 3 of these cases but remained unchanged in 4 because of the cytoscopic findings. Of all 238 patients with gynecologic carcinoma 3 (1 per cent) also were found to have unsuspected low grade transitional cell carcinoma of the bladder.

Carcinoma, Squamous Cell↗

PubMed1979

Hypothermia during infant cystoscopy.

Two cases of hypothermia during prolonged infancy cystoscopy are reported. A significant decrease in the core temperature also was noted when irrigating the bladders of small mongrel dogs with room temperature water. The complications of infant hypothermia are reviewed and the factors that predispose the infant to acute changes in body temperature are emphasized. The measures of maintaining the core temperature in the pediatric surgical patient are discussed and particular situations when prolonged cystoscopy may occur, necessitating warming of irrigation fluids, are presented.

Animals↗

PubMed1996

Urethroscopy, cystoscopy, and biopsy of the feline lower urinary tract.

This article discusses the utility and limitations of urethroscopy and cystoscopy in both male and female cats. The special equipment and techniques necessary to adequately visualize the urethra and bladder of female cats are described in some detail. The emerging ability to visualize the male urethra is introduced. Photographs taken through the cystoscope are used to illustrate both normal anatomy and lesions likely to be encountered with cats with lower urinary tract disease. Cystoscopy is an important diagnostic tool for an inclusionary and exclusionary diagnosis of interstitial cystitis (sterile idiopathic inflammation).

Anesthesia↗

PubMed2002

Prediction of muscle invasion of bladder cancer by cystoscopy.

OBJECTIVES: Urologists make a decision on whether to indicate staging procedures for primary lesions of bladder cancer by findings of cystoscopy. However, cystoscopic findings for prediction of muscle-invasive bladder cancer have not been fully evaluated. METHODS: Two hundred seventy consecutive events of 165 patients with bladder cancer were included in this study. Multivariate analysis by a logistic regression model was applied to analyze cystoscopic findings for prediction of muscle invasion of bladder cancer. RESULTS: Logistic regression analysis revealed that the size, stalk and configuration of the cancer were independent and significant factors that predict muscle invasion of bladder cancer. CONCLUSIONS: Cystoscopic findings of bladder cancer may predict muscle invasion. When invasion is suggested by cystoscopy, imaging studies may be necessary before TUR of the cancer as well as deep resection of it.

Adult↗

PubMed2002

Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies.

OBJECTIVES: To assess the variability between institutions in the recurrence rate at the first follow-up cystoscopy (RR-FFC) after transurethral resection (TUR) in patients with stage Ta T1 bladder cancer. METHODS: A total of 2410 patients from seven EORTC phase III trials conducted between 1979 and 1989 were included. Patients with single and with multiple tumors were analyzed separately according to whether or not they received adjuvant intravesical treatment. RESULTS: The RR-FFC varied greatly between institutions. For patients with a single tumor, it ranged from 3.4% to 20.6% for patients not receiving any intravesical adjuvant treatment and from 0% to 15.4% in those receiving it. In patients with multiple tumors who had adjuvant treatment, it varied between 7.4% and 45.8%. There was a slight decrease over time in the recurrence rate for patients with single tumors, particularly in those receiving adjuvant intravesical treatment. CONCLUSIONS: For both patients with single and with multiple tumors, the percentage of patients with a recurrence in the bladder at the first follow-up cystoscopy after TUR varies substantially between institutions and cannot be explained by the factors that were assessed. It is suggested that the quality of the TUR performed by the individual surgeons may be responsible.

Aged↗

PubMed1978

Autonomic hyperreflexia during cystoscopy in patients with high spinal cord injuries.

Cystoscopic procedures were performed on 102 patients with histories of traumatic spinal cord lesion; 57 patients had sensorimotor levels above T7, and the remaining 45 patients had levels below T7. In 40 of the 57 patients (70 per cent) with levels above T7, signs and symptoms of autonomic hyperreflexia were seen during bladder distension and cystoscopy; the remaining 17 of these patients (30 per cent) did not have this response. No autonomic hyperreflexia was seen during cystoscopy in any of the 45 patients with sensorimotor levels below T7.

Adolescent↗

PubMed1997

A prospective, randomized, double-blind study comparing lignocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy.

OBJECTIVE: To determine the optimum duration for the retention of 2% lignocaine gel intraurethrally as an anaesthetic for flexible cystoscopy in men. PATIENTS AND METHODS: A prospective, randomized, double-blind, placebo-controlled trial was conducted in two parts. Initially, the importance of duration was determined, i.e. whether pain relief was significantly improved when lignocaine gel was instilled for longer than is currently practised. As pain relief was improved by retaining the lignocaine gel for longer, the optimum time was determined in a second trial. Initially, 90 patients were divided into four groups receiving 20 mL of 2% lignocaine gel or plain lubricating gel for 5 or 25 min. Subsequently, 60 men were divided into two groups receiving 20 ml of 2% lignocaine gel for 15 or 25 min. The patients' discomfort was recorded using a 4-point descriptive pain scale and a 100 mm non-graphical visual analogue scale. RESULTS: In the first study, those patients receiving lignocaine gel for 25 min experienced significantly less pain than the other three groups. In the second, lignocaine gel in the urethra for 15 min provided the same level of pain relief as lignocaine for 25 min. CONCLUSION: Pain during flexible cystoscopy can be significantly reduced when 20 mL of 2% lignocaine gel is left in the urethra for 15 min; lignocaine gel would be more effective when left for longer than is currently practised.

Analgesia↗

PubMed2000

Indication of cystoscopy in patients with asymptomatic microscopic haematuria.

To establish the appropriate indication of cystoscopy in patients with asymptomatic microscopic haematuria, we reviewed 263 cases with positive reaction for urinary dipstick test on annual health screening examination. On initial examination, 18 highly significant lesions, 52 moderately significant lesions and 38 insignificant lesions were detected. No underlying lesion could be found in 96 patients and no microscopic haematuria in 59 patients. However, bladder cancers were detected in only 8 (3.0%) cases. All patients with bladder cancer were older than 40 years. These facts suggest that cystoscopy is not necessary for patients with a single microscopic haematuria and those younger than 40 years.

Adolescent↗

PubMed2002

Cystoscopy-assisted laparoscopic resection of extramucosal bladder endometriosis.

BACKGROUND AND PURPOSE: Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location of the lesion. Therefore, laparoscopic examination represents the gold standard for the diagnosis of pelvic endometriosis. We describe a case of recurrent bladder endometriosis treated by a combined endoscopy technique. CASE REPORT: A 43-year-old woman presented with pelvic pain, dysmenorrhea, and persistent cystitis. The endometriotic lesion on the posterior wall of the bladder consisted in a 2.5-cm nodule growing into the vesical muscularis and raising the overlying peritoneum. We performed laparoscopic resection employing a cystoscopy-assisted technique in order to preserve the integrity of the vesical mucosa. Resection was carried out and monitored from inside the bladder with the cystoscope and laparoscope lights turned on during the whole procedure ("light-to-light" technique). CONCLUSION: This minimally invasive combined endoscopic procedure could represent a good alternative to partial cystectomy for muscle-infiltrating bladder endometriosis that does not involve the vesical mucosa.

Adult↗

PubMed2005

Is antibiotic prophylaxis required for flexible cystoscopy? A truncated randomized double-blind controlled trial.

PURPOSE: To examine the incidence of urinary tract infection (UTI) after flexible cystoscopy (FC) and determine whether prophylactic norfloxacin reduces this incidence compared with placebo. PATIENTS AND METHODS: A double-blind trial was performed, randomizing 234 patients to either 400 mg of norfloxacin or placebo prior to FC. All patients provided a midstream urine specimen (MSU) before the procedure, as well as at day 3 and day 7 after FC. In addition, a telephone questionnaire was performed to correlate the nature and severity of any symptoms associated with UTI. RESULTS: Interim analysis was performed because of the low recruitment rate, and a significantly lower infection rate than expected meant that the trial was discontinued. There was one symptomatic UTI in the placebo group (0.82%) and one in the norfloxacin group (0.89%). The UTI in the placebo group was de novo, while the infection in the norfloxacin group was secondary to pre-FC bacteriuria. There was no difference in the infection rates in the two groups. The overall infection rate (de novo and secondary to existing bacteruria) after FC was 0.85%. CONCLUSION: Infection after flexible cystoscopy is rare and not associated with significant morbidity. A much larger study would be required to determine whether antibiotic prophylaxis significantly reduces the rate of postprocedure UTI.

Anti-Infective Agents↗

PubMed1999

The value of intra-operative cystoscopy at the time of laparoscopic hysterectomy.

The aim of this study was to determine the usefulness of routine intra-operative cystoscopy in documenting ureteral injury during total laparoscopic hysterectomy with vault suspension and to document the incidence of this complication in a large series. The charts of 118 patients who underwent laparoscopic hysterectomy with vault suspension from January 1992 to January 1998 were retrospectively reviewed. The patients underwent intra-operative cystoscopic evaluation to verify ureteral permeability and bladder integrity. Intra-operative ureteral obstruction occurred in four patients (3.4%). All complications were immediately fixed and there were no postoperative ureteral problems. No late ureteral complications were observed. Intra-operative cystoscopy allows for early recognition and treatment of obstructive ureteral injuries and may reduce the rate of late postoperative complications during advanced laparoscopic procedures.

Cystoscopy↗

PubMed2001

Can biological markers replace cystoscopy? An update.

Cystoscopy is currently considered the gold standard for the detection of bladder tumors. The role of urine cytology in the initial detection and follow-up of patients is under discussion. New elaborative and rapid assays are available that may circumvent the low sensitivity and poor reproducibility of urine cytology. The methods that have been tested extensively are the nuclear matrix protein (NMP22) assay, the BTA stat assay, and the BTA TRAK enzyme-linked immunosorbent assay. Both outperform cytology in the detection of low-grade lesions. The specificity of both assays, however, lags behind that of cytology. The data from retrospective analyses are insufficient to justify clinical integration, and the need to replace cystoscopy with these novel assays remains to be proven.

Biomarkers↗

PubMed2003

Screening cystoscopy and biopsy in patients with neuropathic bladder and chronic suprapubic indwelling catheters: is it valid?

PURPOSE: Screening for bladder malignancy in patients with neuropathic bladder and a chronic indwelling catheter by cystoscopy and biopsy is commonly performed. Despite this practice the test has not been fully validated to date. We analyzed our experience with this screening test and explored its validity when applied to our patients. MATERIALS AND METHODS: We performed a retrospective analysis of screening biopsies in 36 patients with neuropathic bladder and a chronic indwelling catheter who had undergone yearly screening from 5 years after catheter insertion. Mean time since suprapubic catheter insertion was 12.1 years (range 8.7 to 23.8). RESULTS: No tumors were ever identified in our screened group. However, histological findings were frequently abnormal, of which the most common are active chronic cystitis and squamous metaplasia. CONCLUSIONS: Our study reinforces the increasing body of evidence suggesting that screening cystoscopy and biopsy in this group of patients is not valid. As a screening test, it fulfils few of the necessary criteria.

Adult↗

PubMed2003

Combined vaginoscopy-cystoscopy: a novel simultaneous approach improving vesicovaginal fistula evaluation.

PURPOSE: Using a device that permits simultaneous viewing on the same display (picture in picture) of 2 images we performed combined vaginoscopy-cystoscopy (CVC) during evaluation for vesicovaginal fistula as a means of better visualization, allowing more precise identification and better preoperative planning. MATERIALS AND METHODS: A regular cystoscope and a 10 mm 0-degree laparoscope were used. Each was attached to a different microcamera and light source. The cameras were hooked to the back of a Twinvideo (Karl Storz Endoscopy, Tuttlingen, Germany), allowing a wide variety of views combining the 2 images. Cystoscopy was performed as usual and the laparoscope was used for vaginoscopy with a transparent vaginal speculum to maintain the vagina open, while allowing visualization of the vaginal wall. The 2 images were combined in picture in picture, providing confidence during the fistula identification process. Urinary leakage was viewed simultaneously with guide wire passage through the cystoscope and vaginal wall, showing the exactly fistula position. RESULTS: The CVC procedure using 2 images in picture in picture allows precise identification during evaluation for vesicovaginal fistula. CONCLUSIONS: CVC has become a routine procedure in suspicious cases or in those of a confirmed diagnosis of vesicovaginal fistula at our institution. It increases the likelihood of fistula diagnosis and identification, allowing better surgical planning.

Colposcopy↗

PubMed1981

A double-blind trial of half-strength Polybactrin Soluble GU bladder irrigation in cystoscopy.

In an attempt to reduce post-cystoscopy urinary tract infection half-strength Polybactrin Soluble GU solution was used as the bladder irrigating fluid. Although the infection rate was markedly reduced, this just failed to be significant. However, it is believed that with a better combination of antibiotics the incidence of post-cystoscopy urinary tract infection can be significantly reduced.

Aged↗