LESSON 3: Procedures in Genitourinary Surgery

Section v: operations on the scrotum, penis, and urethra

3-43

[Previous] [Next]

3-43. CYSTOSCOPY

a. General. This procedure is the visual inspection of the interior of the bladder and examination of adjacent structures by means of an instrument (cystoscope) introduced via the urethra into the bladder. The examination may be done as an end in itself, or may be the first step in a series of examinations or treatments that may be accomplished transurethrally.

b. Patient Preparation. The patient is placed in the lithotomy position perineal, preparation is carried out, and the patient is draped with a lithotomy fenestrated sheet and leggings. Surgical jelly is required to lubricate instruments passed into the urethra. A local or general anesthetic may be administered. The surgeon will require a circulator, but probably not a scrub assistant.

c. Operative Procedure.

(1) The surgeon assembles the cystoscope, fitting the obturator into the sheath. The light is tested, and the circulating team member adjusts the current to the proper brightness.

 

(2) The instrument is lubricated and inserted into the patient's urethra. The obturator is removed and the telescope inserted into the sheath. The surgeon puts his eye to the eyepiece and makes his examination. The bladder is distended with irrigating fluid. The surgeon adjust the flow and volume with the stopcock. Then the obturator or telescope is removed, the irrigating fluid flows out.

 

(3) Other procedures such as catheterization, biopsy, or stone removal are carried out by exchanging or supplementing the cystoscope lens with the appropriate accessory instrument.

 

(4) Kidney function studies, cystometry, and X-ray examinations may be performed and various specimens of urine collected. When the examination is concluded, the instrument is removed. A urethral catheter may be inserted as required.

 

[Previous] [Next]