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Cystoscopy with - without anesthesia

The article was professionally consulted with Specialist Doctor I Nguyen Hung - Doctor of Endocrinology - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.
Cystoscopy is a method to diagnose and treat urinary tract diseases that is being widely applied today. This is a technique to assess the causes and status of diseases in the bladder - urethra, from which to have a timely and effective treatment plan. Currently, there are 2 endoscopic techniques: cystoscopy with anesthesia and cystoscopy without anesthesia.

1. What is a cystoscopy?

Cystoscopy is a procedure in which a doctor evaluates the lower urinary tract, including the bladder and urethra, through an endoscope. This procedure is done by using an endoscope inserted into the bladder through the urethra. The doctor can look directly into the endoscope or through a computer screen that displays the endoscope.
The time to perform the procedure depends on the complexity of the pathology. For mild diseases, simple treatment, the procedure takes only about 10-15 minutes.
Indications for cystoscopy:
Diagnosis of causes of hematuria symptoms, in case of gross hematuria, recurrent hematuria; Screening, checking bladder tumor, upper urinary tract urolithiasis, urethral tumor or urinalysis; In the case of pelvic tumors, to investigate the invasion and compression of the tumor with the bladder and ureters; Follow-up after treatment of superficial bladder tumor (early stage);
bướu bàng quang
Hình ảnh nội soi bướu bàng quang
Urinary disorders: urinary frequency, difficulty urinating, urge to urinate...; Repeated urinary tract infections; Bladder overactivity, bladder neurosis; Cases of urinary incontinence; Diagnosis and treatment of interstitial cystitis; Chronic pelvic pain ; Bladder neck stenosis , urethral stricture ; Bladder injury ; Ejaculation with blood; Infertility due to obstruction; Pick up foreign bodies, small stones in the bladder; Suspected urogenital - genitourinary tuberculosis; vesicoureteral reflux, ureteral cyst; Bladder-vaginal fistula or bladder-bowel fistula; Abnormal cases of anatomical structure or structure of the lower urinary tract: bladder diverticulum, urethral diverticulum, urethral stone, bladder stone, foreign body in bladder lumen...;
Contraindications for cystoscopy
Acute urinary tract infections; Allergy to Lidocaine; Severe urethral stricture; Cases where the patient does not cooperate: unable to bear pain, psychosis, ... (need pain relief, pre-anesthesia support).
Dị ứng
Người bệnh có tiền sử dị ứng thuốc gây tê Lidocain

2. Technical procedure of cystoscopy

Preparation:
The patient does not eat or drink from the night before the endoscopy day; Your doctor may prescribe antibiotics before the procedure; Collect a urine sample before performing a cystoscopy; For cystoscopy procedures performed under local anesthesia without fasting; Notify your doctor if you are taking blood thinners such as warfarin, aspirin and ibuprofen.
2.1. Cystoscopy with anesthesia Pain relief for patients: inject pain medication to the patient before the procedure (Feldene, Mobic..), local anesthetic with Xylocaine (usually a gel) injected through the line. urethra. Patient position: obstetric position. Endoscopy: place a cystoscope, give water and bladder to check the condition of the bladder, urethra, two ureteral openings. 2.2. Cystoscopy without anesthesia The patient is dressed in hospital clothes, lying on his back on a flat bed, cleaned outside of the urethra and surrounding skin. The doctor applies gel to the urethral opening and the bronchoscope to make it easier for the endoscope to enter the urethra, reducing discomfort for the patient; The doctor pushes the endoscope gently into the urethra, toward the bladder. A sterile solution is given through an accessory channel in the laparoscope to slowly fill the bladder so that the doctor can see the lining of the bladder more easily;
Nội soi bàng quang bằng ống mềm
Nội soi bàng quang cần được thực hiện đúng kỹ thuật
The cystoscopy process only lasts from 5 to 10 minutes if it is only for the purpose of checking and observing the inside of the bladder. However, in cases where the doctor performs other procedures such as taking a tissue biopsy sample from the lining of the bladder, the cystoscopy time may be longer; The endoscope is gently pulled out. If the patient has a pathology, the specimen will be sent for testing and must wait a few days for histological results.

3. Complications can occur after cystoscopy

Bleeding during or after the procedure: you may see a small amount of blood the first time you urinate. Most women who have a biopsy during a cystoscopy will see blood in their urine. The amount of bleeding is usually very small. Healthcare professionals may pass water through a catheter into the bladder to flush out blood or to remove any remaining blood clots (also known as 'bladder lavage'). Urinary tract infection: after the endoscopy you feel the need to urinate many times and only urinate a small amount each time with discomfort, you may have a urinary tract infection. If these symptoms get worse, tell your doctor. You may need to treat this symptom with antibiotics. Urethral stricture: caused by scar tissue forming in your urethra. However, urethral stricture is quite rare after the first cystoscopy. If this happens, you may need further surgery to correct it.
Hẹp niệu đạo
Tình trạng hẹp niệu đạo ở người bệnh
Perforation in the bladder: if this happens, your doctor will place a catheter in your bladder for a few days to allow the hole to heal. If the hole doesn't heal, you'll likely need another surgery to fix it. Cystoscopy is a technique commonly used in the diagnosis and treatment of a number of pathologies in the urinary tract. When performing this procedure, the patient needs to strictly follow the doctor's instructions to ensure effective diagnosis, high accuracy and reduce the risk of complications. If you have any questions about possible complications after a cystoscopy, consult your doctor for advice and answers.

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