Name of the Procedure:

Cystourethroscopy with removal of foreign body, calculus, or ureteral stent from urethra or bladder (simple)

Summary

Cystourethroscopy, commonly referred to as a cystoscopy, is a medical procedure that allows a doctor to view the inside of the urethra and bladder using a thin, flexible tube with a camera called a cystoscope. In this procedure, the doctor also removes any foreign bodies, stones (calculi), or ureteral stents that may be present in the urethra or bladder.

Purpose

This procedure is performed to remove objects that do not belong in the urethra or bladder, such as foreign bodies, stones, or stents that are causing discomfort or potential medical complications. The goal is to alleviate symptoms like pain, urinary difficulties, or infection and to restore normal function of the urinary tract.

Indications

• Presence of bladder stones or urethral stones
• Foreign objects in the bladder or urethra
• Need to remove or replace ureteral stents
• Symptoms such as severe pain, frequent urinary tract infections (UTIs), hematuria (blood in urine), or difficulty urinating
• Patients with imaging studies (e.g., ultrasound, CT scan) confirming the presence of foreign bodies, stones, or stents in the urinary tract

Preparation

• Fasting for a few hours before the procedure may be required.
• Adjustments to medications, particularly blood thinners, as advised by the physician.
• Diagnostic tests such as urine tests, blood tests, or imaging studies may be performed.
• Some patients may need a course of antibiotics to prevent infection.

Procedure Description

1. Patient is positioned comfortably, often lying on their back.
2. Local anesthesia is applied to numb the urethra; sometimes sedation or general anesthesia may be used.
3. A cystoscope (a thin, flexible tube with a camera) is gently inserted into the urethra and guided into the bladder.
4. The interior of the bladder and urethra is examined on a video monitor.
5. Small instruments may be passed through the cystoscope to grasp and remove any foreign bodies, stones, or stents.
6. The procedure is typically straightforward and aims to be minimally invasive.
7. Once the removal is complete, the cystoscope is carefully withdrawn.

Duration

The procedure usually takes about 15 to 30 minutes, depending on the complexity.

Setting

Cystourethroscopy is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Urologist (performing the procedure)
• Nursing staff (assisting during the procedure)
• Anesthesiologist or sedation nurse (if anesthesia or sedation is used)

Risks and Complications

• Mild discomfort or pain in the urethra or bladder
• Slight bleeding or blood in the urine
• Infection, although rare, can occur and may require antibiotics
• Injury to the urethra or bladder wall
• Reactions to anesthesia, if used

Benefits

• Relief from pain or discomfort caused by stones, foreign bodies, or stents
• Increased ability to urinate normally
• Decreased risk of urinary tract infections

Recovery

• Patients can usually go home the same day.
• Drinking plenty of fluids to flush the urinary system.
• Mild discomfort or burning during urination may be experienced for a few days.
• Follow-up appointments to ensure proper healing and to monitor for any complications.

Alternatives

• Lithotripsy (breaking down stones using shock waves)
• Open surgical removal (if cystourethroscopy is not viable)
• Medication management to dissolve certain types of stones
• Observation or leaving a stent in place if it is not causing issues

Patient Experience

• The patient may feel mild discomfort or pressure during the procedure.
• Post-procedure, there might be a slight burning sensation when urinating, which typically subsides within a few days.
• Pain management includes over-the-counter pain relievers and increased fluid intake to help ease symptoms and flush out the urinary system.