Cystoscope Health Dictionary

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Cystoscope: From 1 Different Sources

An instrument for viewing the interior of the URINARY BLADDER. It consists of a narrow tube carrying a small electric lamp at its end; a small mirror set obliquely opposite an opening near the end of the tube; and a telescope which is passed down the tube and by which the re?ection of the brightly illuminated bladder wall in the mirror is examined. It is of great value in the diagnosis of conditions like ulcers and small tumours of the bladder.

Fine CATHETERS can be passed along the cystoscope, and by the aid of vision can be inserted into each ureter and pushed up to the kidney, so that the urine from each kidney may be obtained and examined separately in order to diagnose which of these organs is diseased.

Health Source: Medical Dictionary
Author: Health Dictionary

Cystoscopy

The examination of the urethra and bladder using a cystoscope inserted up the urethra. A cystoscope is a rigid metal or flexible fibre-optic viewing instrument, sometimes with a camera at the tip (see endoscopy). Cystoscopy is used to inspect the bladder for calculi, bladder tumours, and sites of bleeding and infection, and to obtain urine samples from the ureters to look for infection or tumour cells. Radiopaque dye may be injected into the ureters via the cystoscope during the X-ray procedure of retrograde pyelography (see urography).

Treatment, including removal of bladder tumours or calculi and insertion of stents (narrow tubes) into a ureter to relieve an obstruction, can all be performed via the cystoscope.... cystoscopy

Coelioscopy

A method of viewing the interior of the abdomen in patients in whom a tumour or some other condition requiring operation may be present but cannot with certainty be diagnosed. The examination is carried out by making a minute opening under local anaesthesia, and inserting an ENDOSCOPE – a long ?exible instrument bearing an electric lamp and telescopic lenses like that for examining the bladder (CYSTOSCOPE) – into the abdominal cavity. Certain of the abdominal organs can then be directly inspected in turn.... coelioscopy

Culdoscopy

Culdoscopy is a method of examining the pelvic organs in women by means of an instrument comparable to a CYSTOSCOPE, inserted into the pelvic cavity through the VAGINA. The instrument used for this purpose is known as a culdoscope.... culdoscopy

Endoscope

A tube-shaped instrument inserted into a cavity in the body to investigate and treat disorders. It is ?exible and equipped with lenses and a light source. Examples of endoscopes are the CYSTOSCOPE for use in the bladder, the GASTROSCOPE for examining the stomach and the ARTHROSCOPE for looking into joints (see also FIBREOPTIC ENDOSCOPY).... endoscope

Transurethral Resection

The use of a special CYSTOSCOPE (a resectoscope) inserted through the URETHRA to resect the PROSTATE GLAND or bladder tumours. (See also RESECTION.)... transurethral resection

Urethra, Diseases Of And Injury To

Trauma Injury to the urethra is often the result of severe trauma to the pelvis – for example, in a car accident or as the result of a fall. Trauma can also result from catheter insertion (see CATHETERS) or the insertion of foreign bodies into the urethra. The signs are the inability to pass urine, and blood at the exit of the urethra. The major complication of trauma is the development of a urethral stricture (see below).

Urethritis is in?ammation of the urethra from infection.

Causes The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe in?ammation and urethritis. Non-speci?c urethritis (NSU) is an in?ammation of the urethra caused by one of many di?erent micro-organisms including BACTERIA, YEAST and CHLAMYDIA.

Symptoms The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.

Treatment This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation.

Stricture This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.

Symptoms The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine ?ow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).

Treatment The traditional treatment was the periodic dilation of the strictures with ‘sounds’

– solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.... urethra, diseases of and injury to

Urethritis

Inflammation of the urethra, usually due to an infection but sometimes having other causes.

Urethritis may be caused by various infectious organisms, including the bacterium that causes gonorrhoea. Nongonococcal urethritis may be caused by any of a large number of different types of microorganisms. Urethritis may also be caused by damage from an accident

or from a catheter or cystoscope.

Other possible causes include irritant chemicals, such as antiseptics and some spermicidal preparations.

Treatment of infection is with antibiotic drugs.... urethritis

Bladder Neck Incision

an operation that involves an incision through the bladder neck that is extended into the prostate to relieve *lower urinary tract symptoms. This procedure is usually performed under a general or spinal anaesthetic through a cystoscope. It is not as extensive as a transurethral resection of the prostate and is therefore associated with a comparatively lower incidence of side-effects.... bladder neck incision

Fulguration

(electrodesiccation) n. the destruction with a *diathermy instrument of warts, growths, or unwanted areas of tissue, particularly inside the bladder. This latter operation is performed via the urethra and viewed through a cystoscope.... fulguration

Memokath

n. trade name for a nickel-titanium alloy prostatic *stent used as a minimally invasive treatment for men with *lower urinary tract symptoms due to benign prostatic hyperplasia (see prostate gland) who are unfit for surgery. The stent is placed in the prostatic section of the urethra and bladder neck using a flexible cystoscope. The stent expands when warm water is passed through it; cold water causes contraction and allows removal. Less commonly this stent can be used in the ureter in the management of ureteric strictures.... memokath

Urinary Bladder, Diseases Of

Diseases of the URINARY BLADDER are diagnosed by the patient’s symptoms and signs, examination of the URINE, and using investigations such as X-RAYS and ULTRASOUND scans. The interior of the bladder can be examined using a cystoscope, which is a ?breoptic endoscope (see FIBREOPTIC ENDOSCOPY) that is passed into the bladder via the URETHRA.

Cystitis Most cases of cystitis are caused by bacteria which have spread from the bowel, especially Escherichia coli, and entered the bladder via the urethra. Females are more prone to cystitis than are males, owing to their shorter urethra which allows easier entry for bacteria. Chronic or recurrent cystitis may result in infection spreading up the ureter to the kidney (see KIDNEY, DISEASES OF).

Symptoms Typically there is frequency and urgency of MICTURITION, with stinging and burning on passing urine (dysuria), which is often smelly or bloodstained. In severe infection patients develop fever and rigors, or loin pain. Before starting treatment a urine sample should be obtained for laboratory testing, including identi?cation of the invading bacteria.

Treatment This includes an increased ?uid intake, ANALGESICS, doses of potassium citrate to make the urine alkaline to discourage bacterial growth, and an appropriate course of ANTIBIOTICS once a urine sample has been ana-lysed in the laboratory to con?rm the diagnosis and determine what antibiotics the causative organism is likely to respond to.

Stone or calculus The usual reason for the formation of a bladder stone is an obstruction to the bladder out?ow, which results in stagnant residual urine – ideal conditions for the crystallisation of the chemicals that form stones – or from long-term indwelling CATHETERS which weaken the natural mechanical protection against bacterial entry and, by bruising the lining tissues, encourage infection.

Symptoms The classic symptom is a stoppage in the ?ow of urine during urination, associated with severe pain and the passage of blood.

Treatment This involves surgical removal of the stone either endoscopically (litholapaxy); by passing a cystoscope into the bladder via the urethra and breaking the stone; or by LITHOTRIPSY in which the stone (or stones) is destroyed by applying ultrasonic shock waves. If the stone cannot be destroyed by these methods, the bladder is opened and the stone removed (cystolithotomy).

Cancer Cancer of the bladder accounts for 7 per cent of all cancers in men and 2·5 per cent in women. The incidence increases with age, with smoking and with exposure to the industrial chemicals, beta-napththylamine and benzidine. In 2003, 2,884 men and 1,507 women died of bladder cancer in England and Wales.

Symptoms The classical presenting symptom of a bladder cancer is the painless passing of blood in the urine – haematuria. All patients with haematuria must be investigated with an X-ray of their kidneys, an INTRAVENOUS PYELOGRAM (UROGRAM) and a cystoscopy.

Treatment Super?cial bladder tumours on the lining of the bladder can be treated by local removal via the cystoscope using DIATHERMY (cystodiathermy). Invasive cancers into the bladder muscle are usually treated with RADIOTHERAPY, systemic CHEMOTHERAPY or surgical removal of the bladder (cystectomy). Local chemotherapy may be useful in some patients with multiple small tumours.... urinary bladder, diseases of

Photodynamic Therapy

(PDT, photoradiation therapy, phototherapy, photochemotherapy) 1. a treatment for some types of superficial cancers. A light-sensitive agent (porfimer sodium [Photofrin] or temoporfin [Foscan]) is injected into the bloodstream and remains in cancer cells for a longer time than in normal cells. Exposure to laser radiation produces an active form of oxygen that destroys the treated cancer cells. The laser radiation can be directed through a fibreoptic bronchoscope into the airways, through a gastroscope into the oesophagus, or through a cystoscope into the bladder. PDT causes minimal damage to healthy tissue, but as it cannot pass through more than about 3 cm of tissue, it is restricted to treating tumours on or just under the skin or on the lining of internal organs. Photodynamic therapy makes the skin and eyes sensitive to light for six weeks or more after treatment. 2. a treatment for wet age-related *macular degeneration that involves the intravenous injection of a light-sensitive agent (verteporfin, Visudyne) which passes to the abnormal leaking blood vessels in the retina. The agent is activated when a cold laser light is directed at the macula, sealing the abnormal vessels and thus preventing further leakage and macular damage. The effect is to limit visual loss and stabilize vision.... photodynamic therapy

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