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Running Head; CYTOSCOPY
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Cystoscopy
Name
Date
CYTOSCOPY
Contents
Background History ................................................................. Error! Bookmark not defined.
Modern Cytoscope……………………………………………………………………………………………………………………………..4
Images from a Cystoscope…………………………………………………………………………………………………………………..7
References…………………………………………………………………………………………………………………………………………..9
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Introduction
Cystoscopy refers to the procedural use of a Cystoscope by a physician to examine the
bladder. The instrument referred to as cystoscope is inserted into the urethra of either a male or a
female in order to view the inside of the urethra.
A cystoscope is a thin, fiber optic tube with a light and a small camera at one of its ends;
there have been many improvements on equipment that has led to the current cystoscope. The
first one was an invention by a German young army surgeon by the name Bozzini, who had been
very frustrated by locating bullets in the body of his patients (Lee, 1910). He came up with an
instrument covered with sharkskin, which housed a lighting candle inside a chimney made of
metal.
It was called –the Lichtleiter. It had a mirror on the inside that reflected light from the
candle; through the viewing window and examiner could see gallbladder stones past the mirror
down the attachment (Squier, 1911). Difficulties in use of this equipment led to its improvement
through the years; in the mid-1880s, there were several improvements on the Lechleiter. One that
used petroleum was developed by Antoine Desormeaux, it was a long metal, which contained a
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mirror that reflected light from a petroleum lamp. It also had the Lechleiter’s problem of
becoming hot while in use.
Philip skinner made a more advanced instrument while he was still in the University of
Pennsylvania; the instrument was light, classy and easier to use (Jackson, 1919). A working
Cystoscope was presented by a German urologist by the name Maximilian Carl-Friedrich Nitze;
this was in collaboration with the Viennese instrument maker. His instrument also got hot very
hot due to the tungsten wire used to light, which was a major drawback. More improvements led
to the current Cystoscope.
A modern Cystoscope
The physician inserts the Cystoscope in to the urethra (a vessel that carries urine from the
bladder to the outside of the body). Through the lenses that resemble those of a microscope, a
physician focuses on the inner environment of the urinary tract. The Cystoscope carries images
from the tip to the other end; it has a light at the end or the tip. They are used by a physician to
identify possible chances of abnormalities in the urinary tract; they are also used during surgical
procedures to enable a surgeon to view the interior of the urinary tract (Lee, 2010).
There are two types of cystoscopies, classified according to the flexibility; they are
flexible and rigid Cystoscopy. In men, it is very painful to insert the Cystoscope, because of the
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thin prolonged urethra. Flexible cystoscopy is therefore more advisable to use than the rigid
cystoscopy in males, it is though carried out with local anesthesia on both sexes; instilled into the
urinary tract via the urethra, five to ten minutes prior to the beginning of the actual procedure.
The rigid Cystoscopy can be performed under similar conditions, though it is performed
generally under the general anesthesia, because of the painful caused by scope. In female the
cystoscopy is less painful compared to that of men (Squier, 1911).
The Cystoscope is used in case of several conditions; urinary tract infection, presence of
blood in urine, inability to hold urine, presence of unusual cells in urine, need to place a catheter
in the bladder, pain during urination, blockage of urinary tract unusual growth, and presence of
stone in the urinary tract (Jackson, 1919).
In case of stones lodged upper in the urinary tract, a physician inserts a finer scope, which
is called Ureteroscope. It is inserted into the bladder and up into the ureter (a vessel that carries
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urine from kidney to bladder); the stones are then removed by the physician. For larger stones,
they are broken with a laser beam into smaller pieces, which are the passed out with urine.
Some precautions that one should take before undertaking a cystoscopy include; they
should inform the physician if they have allergies to any medicines. This will minimize the
chances of complications arising from cystoscopy; some people are very sensitive to certain
types of drugs. They patients are therefore required to inform their physicians of any reactions
they have towards drugs. They should also inform the physicians in case they had bleeding
problems, and take anticoagulant medicines. Female patients should also inform their physicians
in case they are pregnant to avoid further complications (Squier, 1911).
According to Lee, the patients should strictly follow instructions on when to stop eating
and drinking; there are surgeries that require one to be empty stomach and if one fails to follow
these instructions, they might end up having complications. Patients may be administered spinal
or general anesthesia before cystoscopy. This is to make them more comfortable and prevent the
acute pain that comes with insertion of the Cystoscope.
The instrument is gently inserted by the physician during the actual procedure, slowly
into the urethra; it is slowly glided into the bladder. The bladder is then stretched by filling it
with sterile liquid; for example water or saline, which flow through the Cystoscope. There is
urging to urinate and mild discomfort in the urinary bladder experienced by the patient, as it
reaches capacity (Lee, 2010).
Images from a Cystoscope
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Cystoscopy will only take long if a physician is required to take a biopsy, or if he or she
finds a stone; removing the stone prolongs the cystoscopy.
There are several possible risks of cystoscopy. After the cystoscopy procedure, the
patient may have mild burning as he or pass urine; some will express it as stinging when they are
urinating. The urine may also appear to have stains of blood. The condition is improved after one
or two days; this should be done by taking a lot of fluid. Frequently visiting the toilet, burning
when urinating, rising temperatures, shivering or feeling cold, and feeling unwell generally; are
symptoms of risks of infection.
According to Johnson, researches conducted in America and the world at large show that
cancer of the bladder is the seventh leading cancer in the world, and the fourth leading in the
United States. Further researches have shown that, cystoscopy effectively identifies possible
chances of cancer and thus early treatment is administered; reducing the risk of this type of
cancer.
People should visit physicians and recommend a cystoscopy in case they suspect there is
an abnormality with their bladder or the urinary tract; this will enable them to identify chances of
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having cancer of the bladder in its early stages and thus early treatment. This will reduce the risk
of cancer of the bladder which is acutely rising in the whole world.
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References
Johnson, A. B. (1919). Operative therapeusis. New York: Appleton
Lee, C. T., & Wood, D. P. (2010). Bladder cancer: Diagnosis, therapeutics, and management.
New York, NY: Humana Press.
Squier, J. B., & Bugbee, H. G. (1911). Manual of cystoscopy. New York city: P.B. Hoeber.
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Multiple Questions
Inflammation of the serous membrane that surrounds the abdominopelvic
cavity is called:
a. periostitis.
b. peritoneopathy.
c. peritonitis.
d. serusitis.
e. seropathy.
c. peritonitis
The condition in which the bladder herniates into the vagina is called:
a. vaginocele.
b. cystoptosis.
c. cystopathy.
d. cystitis.
e. cystocele.
e. cystocele
A narrowing or stricture of the urethra is called:
a. urethratresia.
b. urethrostenosis.
c. urethritis.
d. urethrism.
e. urethrophraxis.
b. urethrostenosis
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An abnormal dilation of the renal pelvis due to accumulated urine that cannot
flow past the obstruction is called:
a. pyelopathy.
b. pyelostenosis.
c. hydronephrosis.
d. ureterectasis.
e. anuria.
c. hydronephrosis
A hemorrhage from the urethra is called:
a. urethrorrhagia.
b. urethrolithiasis.
c. urethropathy.
d. urethrodynia.
e. urethrostenosis.
a. urethrorrhagia
Excessive or frequent urination after going to bed is called:
a. polyuria.
b. hyperuria.
c. enuresis.
d. nocturia.
e. dysuria.
d. nocturia
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An involuntary delay in initiating urination is called:
a. hesitancy.
b. anuria.
c. oliguria.
d. enuresis.
e. incontinence.
a. hesitancy
Inflammation of the bladder is called:
a. vesicocele.
b. vesicodynia.
c. cystitis.
d. cystopathy.
e. nephritis.
c. cystitis
The presence of pus cells in the urine is called:
a. pyuria.
b. hematuria.
c. pusuria.
d. oliguria.
e. dysuria.
a. pyuria
An inherited disease in which sacs of fluid develop in the kidney is called:
a. Wilms tumor.
b. nephroma.
c. nephroblastosis.
d. polycystic kidney.
e. nephrocele.
d. polycystic kidney
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Excessive urination is called:
a. polyuria.
b. nocturia.
c. anuria.
d. oliguria.
e. dysuria.
a. polyuria
The two most common causes of end-stage renal disease include diabetes and:
a. arteriosclerosis.
b. hypertension.
c. ischemia.
d. necrosis.
e. nephroptosis.
b. hypertension
Suspension or fixation of a floating or moveable kidney is called:
a. nephrorrhaphy.
b. nephropexy.
c. nephroptosis.
d. nephrolithiasis.
e. nephrolithotomy.
b. nephropexy
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A procedure in which high-frequency sound waves produce images of the
bladder to determine bladder volume and identify incomplete bladder emptying
is called:
a. cystoscopy.
b. cystography.
c. electromyography.
d. bladder ultrasonography.
e. cystourethrography.
d. bladder ultrasonography
The test used to evaluate blood flow, structure, and function of the kidneys
after IV injection of a radioactive tracer is called:
a. intravenous pyelography.
b. computed tomography scan of the kidneys.
c. renography.
d. renal nuclear scan.
e. electromyography.
d. renal nuclear scan
Crushing of a stone is called:
a. lithiasis.
b. lithotomy.
c. lithotripsy.
d. lithogenesis.
e. lithectomy.
c. lithotripsy
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The visual examination of the bladder for evidence of pathology, to obtain
biopsies, and to remove pathological tissue is called:
a. cystoscopy.
b. cystopexy.
c. cystotomy.
d. vesicocele.
e. vesicostomy.
a. cystoscopy
Which procedure measures the contraction of muscles that control urination
using electrodes placed in the rectum and urethra?
a. Myorrhaphy
b. Electromyorrhaphy
c. Electromyography
d. Urethrography
e. Urethromyography
c. electromyography
The physical, chemical, and microscopic evaluation of a urine specimen is
called:
a. specific gravity.
b. urinalysis.
c. renal dialysis.
d. urogram.
e. urochesia.
b. urinalysis
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What type of dialysis removes toxic wastes from the body using the membrane
that lines the abdominal cavity?
a. Toxodialysis
b. Hemodialysis
c. Filtrate dialysis
d. Glomerular dialysis
e. Peritoneal dialysis
e. peritoneal dialysis
What type of dialysis filters waste-filled blood by diverting it to an artificial
kidney machine and then returning the cleansed blood to the patient's
bloodstream?
a. Toxodialysis
b. Hemodialysis
c. Filtrate dialysis
d. Glomerular dialysis
e. Peritoneal dialysis
b. hemodialysis
The surgical fixation of the bladder is called:
a. cystocele.
b. cystoptosis.
c. cystopexy.
d. cystitis.
e. cystogram.
c. cystopexy
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Imaging of the urethra is called:
a. urethrography.
b. ureterography.
c. ureterogram.
d. urethromyogram.
e. urethromyography.
a. urethrography
Visual examination of the urethra is called:
a. uroscopy.
b. cystoscopy.
c. ureteroscopy.
d. pyeloscopy.
e. urethroscopy.
e. urethroscopy
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