Name of the Procedure:

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic

• Common Names: Bladder scope, Ureteral scope, Kidney scope
• Technical Terms: Cystourethroscopy, Ureteroscopy, Pyeloscopy

Summary

Cystourethroscopy with ureteroscopy and/or pyeloscopy is a diagnostic procedure where a healthcare provider inserts a camera-equipped scope into the bladder, ureters, and kidneys to visually examine these areas and diagnose various conditions.

Purpose

This procedure addresses issues related to the urinary tract, such as unexplained urinary symptoms, hematuria (blood in urine), recurrent urinary tract infections, kidney stones, or suspected cancers. The primary goal is to identify the underlying cause of these symptoms or conditions to guide further treatment.

Indications

• Persistent or recurrent urinary tract infections
• Blood in urine (hematuria)
• Unexplained pelvic or flank pain
• Abnormal kidney imaging results
• Suspected urinary tract cancers
• Kidney stones or other obstructions
• Congenital urinary tract abnormalities

Preparation

• Fasting may be required for several hours before the procedure.
• Patients may need to adjust or temporarily discontinue certain medications (e.g., blood thinners).
• Diagnostic tests such as urinalysis, urine culture, and blood tests may be required.
• Patients should arrange transportation home due to possible sedation effects.

Procedure Description

1. The patient is positioned, typically lying flat on their back.
2. Anesthesia or sedation is administered to minimize discomfort.
3. The healthcare provider inserts a cystoscope through the urethra to examine the bladder.
4. If necessary, a ureteroscope or pyeloscope is further passed into the ureters and kidneys to visualize these areas.
5. The scope transmits video images to a screen, allowing direct visualization of the urinary tract.
6. If suspicious areas are found, biopsies may be taken.
7. The scopes are carefully removed after the examination is complete.

Duration

The procedure usually takes between 30 minutes to 1 hour, depending on the extent of the examination and whether biopsies are taken.

Setting

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

Personnel

• Urologist or specialized surgeon
• Registered nurse
• Anesthesiologist or nurse anesthetist (if sedation is used)
• Medical assistant or technician

Risks and Complications

• Infection
• Bleeding
• Injury to the urinary tract
• Temporary urinary discomfort or difficulty
• Allergic reaction to anesthesia

Benefits

• Accurate diagnosis of urinary tract conditions
• Identification of exact locations of stones or tumors
• Direct visualization of any structural abnormalities
• Enables targeted treatment planning
• Early detection of malignancies

Recovery

• Patients are usually monitored for a short period post-procedure.
• Mild discomfort, blood-tinged urine, or frequent urination may occur for 1-2 days.
• Pain management may include over-the-counter pain relievers.
• Patients are advised to drink plenty of fluids.
• Avoid strenuous activities for a day or two.
• Follow-up appointments may be scheduled to discuss results or further treatment.

Alternatives

• Imaging studies such as ultrasound, CT scan, or MRI
• Non-invasive urine tests or cystoscopies without ureteroscopy or pyeloscopy
• Each alternative has varying degrees of diagnostic accuracy and invasiveness.

Patient Experience

During the procedure, patients may feel pressure or slight discomfort as the scope is inserted and moved. Post-procedure, there might be a burning sensation during urination and minor cramping. Discomfort typically resolves within a couple of days, and pain management options will be provided to enhance patient comfort.