Name of the Procedure:

Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus. Commonly referred to as cystoscopy or ureteroscopy.

Summary

A cystourethroscopy is a procedure that allows your doctor to look inside the bladder and urethra using a thin tube with a camera (cystoscope). The process also involves the placement and manipulation of a catheter in the ureter, but it does not include the removal of any stones present in the ureter.

Purpose

This procedure is used to diagnose and manage urinary issues such as blockages, bleeding, or abnormal growths within the bladder and urethra. While manipulating ureteral catheters, it can help to alleviate obstructions or ensure the ureter is functioning properly without removing any ureteral stones.

Indications

• Persistent urinary tract infections (UTIs)
• Blood in the urine (hematuria)
• Painful urination (dysuria) with unclear causes
• Difficulty or discomfort during urination
• Suspected blockages or strictures in the urinary tract
• Ureteral stones that need to be assessed but not removed

Preparation

• Patients may be instructed to fast a few hours before the procedure.
• Certain medications may need to be paused, especially blood thinners.
• Pre-procedure tests such as urine analysis may be required.

Procedure Description

1. The patient is positioned and anesthesia (local, regional, or general) is administered.
2. The cystoscope, a thin and flexible tube with a camera and light, is gently inserted through the urethra into the bladder.
3. The bladder is filled with a sterile solution to expand it, providing a better view.
4. The doctor examines the lining of the bladder and urethra for any abnormalities.
5. If needed, a ureteral catheter is inserted through the cystoscope up into the ureter and manipulated to help relieve obstructions or assess function.
6. The procedure is concluded without removing any ureteral stones present.
7. The cystoscope is carefully withdrawn, and any discomfort is managed.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Performed in an outpatient clinic, hospital, or a specialized urology center.

Personnel

• Urologist performing the procedure
• Nurses assisting with patient preparation and care
• Anesthesiologist if sedation or general anesthesia is used

Risks and Complications

• Mild discomfort or burning during urination for a few days
• Urinary tract infection
• Bleeding from the urethra or bladder
• Rare risks include injury to the urethra or bladder

Benefits

• Accurate diagnosis of urinary tract issues
• Relief from certain blockages without surgery
• Information that can lead to appropriate treatment plans

Recovery

• Patients may be monitored for a short time post-procedure.
• Increased fluid intake to flush the urinary system.
• Mild pain relievers for discomfort.
• Follow-up appointments to review findings and plan further treatment.

Alternatives

• Ultrasound or CT scans for imaging stones or blockages.
• Medications to manage symptoms and smaller stones.
• Open surgical procedures to remove larger stones or address complex obstructions.

Patient Experience

• Some discomfort during and after the procedure.
• Urgency and frequency of urination might be temporarily increased.
• Instructions for pain management and steps to ease any irritation experienced during urination.