Name of the Procedure:

Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration.

Summary

Cystourethroscopy with insertion of a radioactive substance is a diagnostic and potentially therapeutic procedure used to examine the inside of the bladder and urethra. It may involve taking tissue samples for biopsy, treating abnormal tissue (fulguration), and introducing a radioactive substance for imaging or treatment purposes.

Purpose

This procedure addresses issues within the urinary bladder and urethra, such as diagnosing bladder cancer, assessing bladder conditions, and treating abnormal tissues. The goals include accurate diagnosis, guided treatment, and improved management of urological conditions.

Indications

• Hematuria (blood in the urine)
• Frequent urinary tract infections
• Suspected bladder or urethral abnormalities
• Bladder cancer follow-up or treatment
• Unexplained urinary symptoms

Preparation

• Fasting may be required for a few hours before the procedure.
• Discontinuation or adjustment of certain medications (e.g., blood thinners).
• Pre-procedure diagnostic tests such as urine analysis or imaging tests may be necessary.

Procedure Description

1. The patient is positioned comfortably, typically in a supine position.
2. Local, regional, or general anesthesia is administered to minimize discomfort.
3. A cystoscope (a thin tube with a camera) is inserted through the urethra into the bladder.
4. The bladder is filled with sterile water to expand it and provide a clear view.
5. The urologist inspects the bladder and urethra for abnormalities.
6. A radioactive substance may be introduced through the cystoscope for imaging or therapeutic purposes.
7. If necessary, biopsies (tissue samples) are taken or abnormal tissues are treated (fulguration).
8. The cystoscope is removed, and the patient is taken to a recovery area.

Duration

The procedure typically takes between 15 to 45 minutes, depending on its complexity.

Setting

This procedure is performed in a hospital, outpatient clinic, or a specialized surgical center.

Personnel

• Urologist or surgeon
• Nurse or medical assistant
• Anesthesiologist (if general or regional anesthesia is used)

Risks and Complications

• Urinary tract infection
• Bleeding or blood in the urine
• Pain or discomfort during urination
• Bladder or urethral injury
• Allergic reaction to the anesthetic or other medications

Benefits

• Accurate diagnosis of urological conditions
• Targeted treatment of bladder abnormalities
• Improved symptom management
• Enhanced ability to monitor and treat bladder cancer

Recovery

• Patients may experience mild discomfort and blood-tinged urine for a day or two post-procedure.
• Drinking plenty of fluids can help flush the bladder.
• Pain can be managed with over-the-counter pain relievers.
• Avoid strenuous activity for 24-48 hours.
• Follow-up appointments may be scheduled to discuss biopsy results or further treatment.

Alternatives

• Ultrasonography or CT scans for imaging
• Non-invasive urine tests
• Observation and symptomatic management for mild conditions
• Intravesical therapy or systemic chemotherapy for bladder cancer

Patient Experience

• Patients may feel mild pressure or discomfort during the procedure.
• Post-procedural pain is generally mild and manageable.
• Feeling of urgency to urinate may persist briefly.
• Healthcare staff will provide detailed instructions for a comfortable recovery.