PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “CYSTOSCOPY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2005

Results of urine cytology testing and cystoscopy in women with irritative voiding symptoms.

OBJECTIVE: The purpose of this study was to assess rates of urinary cytologic abnormalities and cystoscopic outcomes in women with irritative voiding symptoms who were examined at a urogynecology clinic. STUDY DESIGN: All urinary cytology studies results that were sent between January 1, 2000, and July 31, 2003, for the evaluation of irritative voiding symptoms were reviewed. Data were then extracted from the charts of a subset of these patients to evaluate cystoscopic outcomes. Demographics, risk factors for urothelial cancer, laboratory results, and radiology imaging results were then analyzed and compared between patients with and without abnormal cytology and cystoscopic results. RESULTS: Of the 1783 total urinary cytology that were reviewed, 1661 test results were read as normal (93.2%); 112 test results (6.3%) were read as atypical, and 3 test results (0.2%) were read as unsatisfactory. Seven cytologic test results were categorized as suspicious or malignant, which accounts for only 0.4% of all cytologic test results that were sent. Of the 564 consecutive women whose cases were chosen for subanalysis, cytology was normal in 91.5% and atypical in 8.5% of cases. No cytology were suspicious or malignant. Cystoscopic findings were normal in 548 patients (97.2%). Only 1 patient (0.2%) received a diagnosis of transitional cell carcinoma. CONCLUSION: Urinary cytology and cystoscopy are low yield tests and should not be used routinely in the initial evaluation of women with irritative voiding symptoms.

Aged↗
PubMed2002

[Fluorescence cystoscopy in bladder cancer: what future?].

Bladder transitional cell carcinoma, limited to the lamina propria, or superficial in 80% of the cases, is characterized by a high recurrence rate up to 70% in the three years following the first treatment. However, the constant evolution of the endoscopic techniques, useful to its diagnosis and treatment, contributed to reduce about by half this recurrence rate at three months. The actual development concerns new fluorescence detection methods, adapted to the standard endoscopic equipment. This new technique or fluorescence cystoscopy aims at improving the visual contrast between tumor and normal tissue in order to obtain a precise mapping of the diseased bladder. Thus, it allows to detect a carcinoma in situ (CIS) with a sensitivity around 80 to 90%. Its impact on the progression of the disease remains however to be demonstrated.

Aminolevulinic Acid↗
PubMed1998

Bladder petechiae after cystoscopy and hydrodistension in men diagnosed with prostate pain.

PURPOSE: We determined if men with prostate pain syndromes have petechiae in the bladder after hydrodistension. MATERIALS AND METHODS: A total of 60 men with the diagnosis of prostate pain and without bacteriuria underwent cystoscopy and hydrodistension under a general or regional anesthetic. RESULTS: Of the 60 men 35 (58%) had moderate to severe petechiae similar in appearance to women with interstitial cystitis after hydrodistension. Men with moderate to severe bladder petechiae had fewer leukocytes in expressed prostatic secretions, smaller bladder capacities and less often testicular pain than men with more normal appearing bladders after hydrodistension. Symptomatic improvement 2 to 6 weeks after hydrodistension was more common in men with moderate to severe petechiae than in those with fewer petechiae. Absence of rectal pain predicted symptomatic improvement after hydrodistension. CONCLUSIONS: We suggest that bladder petechiae, and possibly interstitial cystitis or a related condition, may be more frequently associated with prostate pain syndromes in men than previously appreciated.

Adult↗
PubMed1987

Prone flexible cystoscopy: an adjunct to percutaneous stone removal.

Percutaneous removal of renal calculi is completed most often in the United States after initial placement of a retrograde ureteral catheter. Catheterization usually is accomplished with a rigid cystoscope with the patient in a dorsal lithotomy position, following which the patient must be turned to a prone position for percutaneous puncture and stone removal. We report our experience with the use of a flexible cystoscope with the patient in a prone position for placement of a retrograde catheter. In male patients this approach was difficult secondary to urethral length and angulation. Currently, in male patients we prefer a supine approach with the flexible cystoscope. In female patients the prone approach was performed easily. Among female patients prone cystoscopy for retrograde ureteral catheterization resulted in decreased operating room time, less manipulation of the anesthetized patient and creation of a 2-tiered field to maintain the sterility of the retrograde ureteral catheter. We found the prone approach to be feasible and effective in female patients.

Adult↗
PubMed1979

Cystoscopy in children: indications for its use in common urologic problems.

The use of cystoscopy in children as part of the routine urologic evaluation in 4 diagnostic categories is evaluated for its ability to provide significant data and influence the course of management and cost effectiveness. Records of patients with hematuria, voiding dysfunction, urinary tract infection and vesicoureteral reflux were reviewed. Our analysis of these data suggests that this procedure has certain well defined indications. Its omission when these indications are not fulfilled presents the potential for considerable monetary savings without reduction in the quality of medical care.

Child↗
PubMed1978

Gram-negative endocarditis following cystoscopy.

Patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The American Heart Association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, Serratia marcescens and possibly Proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.

Aged↗
PubMed1975

Cardiac rhythm in men during cystoscopy.

Cardiac rhythm was monitored prospectively in 69 men during 191 cystoscopies. Ectopic beats from ventricular and supraventricular foci occurred in a significantly greater proportion of procedures in men with (76 per cent) compared to men without (16 per cent) heart disease. Other arrhythmias occurred to a lesser extent but there was no significant difference between men with and without heart disease. Plasma lidocaine was detected in significant amounts following intraurethral injection used for local anesthesia. Comparison of the types of arrhythmias that occurred during cytoscopy and the type of anesthetic used showed that significantly fewer ventricular ectopic beats occurred with general (8 per cent) or epidural anesthesia (13.8 per cent) as opposed to local lidocaine anesthesia (48.7 percent). Among the 3 anesthetic groups there was no difference with respect to frequency of supraventricular ectopic beats. No permanent cardiovascular complications occurred although several potentially serious dysrhythmias were seen.

Adult↗
PubMed2000

Urinary tract infection and patient satisfaction after flexible cystoscopy and urodynamic evaluation.

OBJECTIVES: To investigate the incidence of symptomatic and asymptomatic bacteriuria and to assess patient satisfaction after flexible cystoscopy (FC) and urodynamic (UD) evaluation in a prospective survey. The incidence of urinary tract infection after FC and UD studies and the use of prophylactic antibiotics are issues of debate. The tolerability and acceptance of FC and UD studies by patients have not been thoroughly documented. It would be helpful to be able to give such information to patients before performing these procedures. METHODS: A total of 215 nonconsecutive patients seen as outpatients for FC and UD studies to evaluate various indications were studied. A midstream urine sample was taken before and 48 hours after the procedures. Patients were given a questionnaire that inquired about the presence of lower urinary tract symptoms before and 48 hours after the procedures. The self-administered questionnaire included questions to assess patients' tolerance of the procedures and how it compared with their expectations. RESULTS: Of the 201 patients analyzed (FC 103, UD studies 98), 9 patients (4. 5%) developed significant bacteriuria within 48 hours of FC and UD studies. Only 2 patients with significant bacteriuria reported newly developed symptoms within 48 hours. In a subgroup of 25 patients who were given prophylactic antibiotics for various reasons, 6 (24%) reported new symptoms, although none developed significant bacteriuria. The association between patients who had preprocedure pyuria (n = 7) and the development of significant growth after the procedure (n = 6) was significant (P <0.01). In response to the patient-satisfaction questionnaire, 166 (82.5%) reported that the procedure was not as bad as they expected, and 200 (99.5%) said that they would undergo the test again if necessary. CONCLUSIONS: FC and UD studies are safe, well-tolerated procedures. The addition of prophylactic antibiotics in these procedures is unnecessary, unless specific indications are present.

Adult↗
PubMed2003

Multiple intravesical linear staples identified during surveillance cystoscopy after laparoscopic nephroureterectomy.

Laparoscopic nephroureterectomy has faced technical criticism secondary to the unknown effects of urine-exposed intravesical or intraureteral staples. Although not reported, staples exposed to urine theoretically create a nidus for encrustation and stone formation. We present a case of a 66-year-old man after left laparoscopic ureterectomy for ureteral malignancy. Surveillance cystoscopy at 6 months revealed a nearly complete intravesical titanium staple line without encrustation. Successful transurethral removal of all staples with standard cystoscopic graspers revealed no immediate, or delayed, sequelae.

Aged↗
PubMed1996

Intravenous salbutamol treatment for penile erection arising during cystoscopy of cervical spinal cord injury patients.

Two patients with long-standing tetraplegia after spinal cord injury developed reflex penile erection in the operation theatre. One had not received any anaesthesia, and penile erection occurred after introduction of the cystoscope into the urethra, and also autonomic dysreflexia. Intravenous salbutamol, in a dose of 10 micrograms, produced immediate and persistent penile detumescence and salbutamol-induced fall in blood pressure was of therapeutic value. In the second patient, penile erection occurred during general anaesthesia prior to cystoscopy. Immediate and persistent penile detumescence was achieved with intravenous salbutamol 20 micrograms. There was transient fall of blood pressure which responded to intravenous infusion of 0.9% sodium chloride. Salbutamol-induced fall in blood pressure is of therapeutic value in those spinal cord injury patients who develop, in addition to penile erection, autonomic dysreflexia precipitated by urethral instrumentation, or bladder distension with the irrigating fluid. Intravenous salbutamol is preferable to intra-cavernosal phenylephrine, noradrenaline, metaraminol, and epinephrine, or intravenous ephedrine which are contraindicated in patients with hypertension.

Adrenergic beta-Antagonists↗
PubMed2003

The place of cystoscopy and hydrodistension in the diagnosis of interstitial cystitis: a potpourri of opinions emanating from an International Consultation on IC in Kyoto, Japan, March 28-30, 2003.

The place of cystoscopy and hydrodistension in the diagnosis of interstitial cystitis (IC) was discussed by an international and Japanese panel of IC researchers. Cysto and hydrodistension (HD) has been traditionally regarded as pivotal to the diagnostic process. To assess the experts' opinions a questionnaire was circulated which revealed that 20 of the 31 responders regarded cysto and HD to remain as an important inclusion criterion in the diagnosis of IC (with 8 undecided and 3 against the inclusion). The questionnaire further demanded opinions about the specificity of the known IC changes at cysto and HD, correlation with the clinical picture, false positives, and methodology of the examination.

Cystitis, Interstitial↗
PubMed2002

The community-based morbidity of flexible cystoscopy.

OBJECTIVE: To evaluate patients' experience after flexible cystoscopy (FC), particularly concentrating on the prevalence and degree of symptoms, the frequency of visits to their General Practitioner (GP), subsequent antibiotic rates and the actual incidence of urinary tract infection (UTI). PATIENTS AND METHODS: Consecutive patients (420) presenting for FC were audited prospectively. A pain score for the procedure was recorded immediately afterward (linear scale 0-10) and a self-administered questionnaire completed at 7 days, to assess the objective and subjective symptoms and their duration, and the incidence of GP visits and subsequent antibiotic provision noted. An interim analysis was conducted on the initial 274 datasets received. To estimate the incidence of FC-induced UTI, the final 110 patients were asked not to consult their GP but to present to the urology department at 3 days after FC (or the emergency department if clinically necessary). These patients had initially provided a mid-stream urine (MSU) sample before FC and were assessed symptomatically with a subsequent sample obtained if a urinary dipstick test 3-days after FC was abnormal. RESULTS: In all, 384 (91%) evaluable forms were returned. The median (range) pain score for FC was 1.1 (0-8.5), with seven patients (1.8%) recording a pain score of > 5 (all men); 382 patients (99.5%) declared they would be happy to undergo an identical procedure in the future if medically indicated. Pain on voiding was reported in 190 patients (50%), urinary frequency in 142 (37%) and gross haematuria in 73 (19%). Eighteen of the initial 274 patients (6.6%) visited their GP, with 15 (5.5%) of these receiving antibiotics. The MSU data from the final 110 patients showed a FC-mediated infection in three (2.7%). CONCLUSION: Although FC is well tolerated, gross haematuria, urinary frequency and dysuria occur afterward much more frequently than expected. Patients should be thoroughly counselled before FC about these potential symptoms, to reduce their concern, any unnecessary GP visits and the use of antibiotics.

Adult↗
PubMed2004

Patient tolerance during outpatient flexible cystoscopy--a prospective, randomized, double-blind study comparing plain lubrication and lidocaine gel.

OBJECTIVE: To compare the tolerance of flexible cystoscopy with topical anesthetic versus simple lubrication when the assigned lubricant is instilled 5 min before the exploration. MATERIAL AND METHODS: A total of 185 consecutive patients were randomly assigned either to simple lubrication (Group 1) or to lidocaine hydrochloride gel (Group 2). Thirteen patients had some kind of difficulty during exploration (stenosis) that required additional manipulation or electrocoagulation for small relapses and were excluded from the final analysis, leaving 172 patients suitable for inclusion. After the intervention, all patients were surveyed regarding their discomfort and pain levels using a verbal scale and a visual analog scale ranging from zero to 10. A chi2 analysis was performed for comparison of qualitative covariables, and quantitative covariables were compared using Student's t-test. RESULTS: The 172 patients were evenly distributed between the two groups. Of those in Group 1, 89% noted little or no discomfort, compared to 84% in Group 2. Some pain or intense pain was noted by 10% and 16% in Groups 1 and 2, respectively (p > 0.05). The average value on the visual analog scale was 2.10 and 1.97 in Groups 1 and 2, respectively (p > 0.05). CONCLUSION: There are no differences in the perception of discomfort and pain by patients when anesthetic lubricant or simple lubrication are used if the waiting time before the exploration is 5 min.

Adult↗
PubMed1990

Historical and modern role of cystoscopy and bladder mucosal biopsy in detecting bladder cancer in a high-risk population.

The use of cystoscopy and bladder biopsy to screen cohorts of persons with no history of bladder carcinoma would be unsatisfactory because of the low prevalence of the disease, even in the highest risk occupations. Cystoscopy/biopsy should follow noninvasive modern-day techniques that can be used for screening at reasonable cost and no risk to the workers involved. Dipstick testing for hematuria, urinary cytology, flow cytometry, quantitative fluorescence image analysis, and other emerging technologies are far more useful as screening methods. Examples of bladder tumors and benign lesions are included to demonstrate the heterogeneity of bladder carcinoma and the difficulties the urologist faces in deciding which lesions may be malignant. Positive preliminary tests increase the sensitivity and specificity of the diagnostic examination.

Biopsy↗
PubMed2005

A surveillance schedule for G1Ta bladder cancer allowing efficient use of check cystoscopy and safe discharge at 5 years based on a 25-year prospective database.

PURPOSE: In the absence of clear evidence, surveillance of low grade superficial bladder cancer by regular check cystoscopy may continue unnecessarily, or discharge from followup may occur empirically. We review the followup during a prospective 25-year period of patients presenting with G1Ta bladder cancer, and it is this analysis on which we base a safe schedule for discharge. MATERIALS AND METHODS: A prospectively kept, computerized record of bladder cancers diagnosed between 1978 and 1985 and subsequently followed up at the Western General Hospital, Edinburgh was reviewed. RESULTS: A total of 115 patients with G1Ta disease were followed for a mean of 19.4 years. Tumor status at 3 months was the strongest prognostic factor for recurrence. Although the absence of tumor at 1 year was also a favorable prognostic sign, it was not for 5 years that the situation entirely stabilized (recurrence developed in 8 of 66 such patients between 1 and 5 years). Of those who did not have recurrence in 5 years, 98.3% patients remained tumor-free for 20 years. In contrast in those with recurrence at 3 months the recurrence rate was much higher. Overall 12% of patients experienced progression, mostly in year 1. None of the 8 who had their first recurrence after year 1 had disease progression. CONCLUSIONS: Patients with G1Ta disease who are free of recurrence for 5 years after presentation can be safely discharged. We propose to alter the regime for patients with no recurrence in year 1 and discharge them at 5 years.

Adult↗
PubMed1984

Nalbuphine and Althesin anaesthesia. A controlled double-blind comparison for cystoscopy.

In a double-blind, randomized study of 52 unpremedicated outpatients undergoing cytoscopy, either nalbuphine 20 mg or saline 2 ml was given intravenously immediately before induction of anaesthesia with Althesin 0.05 ml/kg. Increments of Althesin 0.5 ml were used to maintain anaesthesia. The patients received nalbuphine required less Althesin than those who received saline (p less than 0.001) for a similar duration of surgery, and there was less movement during anaesthesia (p less than 0.001). During surgery hyperventilation was observed in the patients who received saline; those who received nalbuphine had lower respiratory rates and higher peak expired CO2 levels (p less than 0.001), and also a smaller increase in pulse rate (p less than 0.05). Recovery after surgery was faster in the patients who received nalbuphine than those who did not (p less than 0.05) and both patients (p less and anaesthetists (p less than 0.001) graded Althesin anaesthesia as better after nalbuphine than after saline. Intravenous nalbuphine 20 mg improved Althesin anaesthesia for cystoscopy without apparent disadvantages.

Adjuvants, Anesthesia↗
PubMed1985

Meptazinol as an analgesic adjunct to total intravenous anaesthesia in cystoscopy patients.

Sixty-four unpremedicated patients undergoing cystoscopy received either intravenous meptazinol 2 mg/kg or saline in equivalent volume in a randomised, double-blind manner immediately before induction of anaesthesia with Althesin. Inclusion of meptazinol reduced the total dose of anaesthetic required, allowed a more rapid recovery and was associated with less movement in response to surgery. The patients in the control group tended to hyperventilate, and had lower end-tidal CO2 tension (p less than 0.001), and also higher pulse rates during surgery (p less than 0.01) than the meptazinol group. However, the patients who received meptazinol had a more frequent incidence of complications during induction and recovery (p less than 0.05).

Adjuvants, Anesthesia↗