Download Flexible Cystoscopy - James Paget University Hospital

James Paget University Hospitals
NHS Foundation Trust
Flexible Cystoscopy
Patient Information
Introduction
You have been advised by your GP or hospital doctor to have a
flexible cystoscopy.
This procedure requires your formal consent.
If you are unable to keep your appointment please notify the
department as soon as possible. This will enable the staff to
give your appointment to someone else and they will be able to
arrange another date and time for you.
This booklet has been written to enable you to make an
informed decision in relation to the investigation. At the back of
the booklet is the consent form.
The consent form is a legal document, so please read it carefully.
Once you have read and understood all the information,
including the possibility of complications, and you agree to
undergo the procedure please sign and date the consent form.
This is in duplicate allowing you to keep a copy for your records.
If there is anything you do not understand or wish to discuss
further but still wish to attend do not sign the forms but bring
them with you and you can sign it after you have spoken to a
healthcare professional.
2
What is Flexible Cystoscopy?
‘Cysto’ is Greek for bladder and ‘scopy’ meaning to look;
therefore flexible cystoscopy is a simple, quick look into the
urinary bladder. During a cystoscopy a tube containing a
miniature telescopic camera is passed down the urethra so that
the doctor can examine the inside of the bladder. It is usual
to look at the urethra itself; the urethra is the name of the
tube which connects the bladder to the outside of the body.
In women this is a very short tube and in men a longer tube
running through the penis.
During the procedure the doctor may need to take some tissue
samples from the bladder for analysis. The samples will be
retained. A photograph may be taken for your records.
The procedure will be performed by a doctor specialising in
urology.
Why do I need a Flexible Cystoscopy?
You have been advised to undergo this investigation to try and
find the cause for your symptoms, help with treatment and if
necessary to decide on further investigations.
There are many reasons for this investigation including: passing
blood in the urine, difficulty passing urine, repeated infections.
There is no alternative examination to this procedure apart from
a rigid cystoscopy under a general anaesthetic.
3
Medical information
Anticoagulants and antiplatelet medication
You will only need to stop antiplatelet or anticoagulant
medication if you are having a therapeutic procedure. Your
consultant will advise you.
If you have ever been told that you have CJD or vCJD or were
put at risk of developing it, please ring the department as soon
as possible.
Medical devices
If you have a pacemaker or implantable cardiac device (ICDS)
or defibrillator that has not been checked within the last six
months please telephone the department as soon as possible. If
the device has been checked in the last six months then all you
need to do is inform the nurse on admission of the device and
date last checked.
How do I prepare for a Flexible Cystoscopy?
No special preparation is required; you can eat and drink
as normal before the test. You can simply turn up for your
appointment in the endoscopy unit, have the cystoscopy and
leave afterwards.
On arrival in the endoscopy unit your details will be checked and
you may be asked some questions about your general health
and current medications. Your blood pressure and pulse may be
recorded. You will be given the opportunity to change into a
hospital gown; this is to avoid getting your clothes wet during
the procedure. You will also be asked to empty your bladder,
you may be asked to provide a sample at this time in which case
a container will be provided.
You will be taken into the endoscopy room and introduced
to the doctor and nurse looking after you. You will be made
comfortable on the trolley and the doctor will then clean the
genital area with mild cleaning fluid and surround the area with
a sterile paper sheet. Try not to touch this with your hands.
4
Local anaesthetic jelly will then be squeezed into the urethra
from a tube or syringe; this lubricates and numbs the tube.
The tip of the penis may be gently squeezed to stop the jelly
escaping. After the jelly has had time to work the flexible
cystoscopy is performed.
The tip of the instrument is gently inserted into the urethra, the
image will be displayed on the television screen and you may be
given a commentary of the procedure.
Men may be asked to try to pass urine to allow the scope to pass
through the sphincter muscle just below the prostate gland, this
will relax the sphincter. Don’t worry you will not pass urine but
there may be a momentary stinging sensation as the sphincter
opens.
The flexible cystoscope has a control device to allow the doctor
to steer it by bending the tip. Once the instrument is in the
bladder twisting the instrument and steering it in this way
enables the whole of the bladder to be viewed.
Sterile saline or glycine will be run into the empty bladder
through the cystoscope to stretch out all the folds and fill the
bladder, this way the entire bladder can be seen. At the end of
the examination you will need to pass water again.
The nurse will stay with you throughout the examination which
is very quick. You may experience slight discomfort but it will
not last long.
What else may be done during the procedure?
During the procedure it is possible to:
• Remove fine tubes (stents) placed in the bladder and ureter
during a previous operation. It is also possible to replace them
at the same time if required.
• Operate on small growths in the bladder using high
frequency current (diathermy).
• Perform injection treatment for an irritable bladder.
5
What are the risks of Flexible Cystoscopy?
Mild burning or bleeding when passing urine for a short period
after the procedure.
Urine infection requiring antibiotics.
Very rarely, retention of urine (inability to pass urine) or delayed
bleeding.
Following the procedure
You are advised to increase your fluid intake for 24 to 48 hours.
You may pass some blood in the urine for the first 24 hours.
You may feel some discomfort or mild burning on passing urine
but this will get better after a day or two.
If you are still experiencing discomfort or bleeding after three
days, a temperature or pain, then please consult your GP.
Advice can be obtained from the endoscopy unit Monday to
Friday 08.00 to 18.00 hours. In an emergency outside of these
hours phone the Accident and Emergency department on
01493 452559.
Privacy and Dignity
Please note we have single sex changing, recovery and toilet
facilities available in the unit.
Please be advised that relatives are not permitted into the
procedure room with the patient or into the recovery areas. This
is to protect other patient’s privacy, dignity and enable staff to
concentrate on looking after the patients.
6
James Paget University Hospitals
NHS Foundation Trust
Courtesy and respect
Responsive communication
Attentively kind and helpful
Effective and professional
• A welcoming and positive attitude
• Polite, friendly and interested in people
• Value and respect people as individuals
So people feel welcome
• Listen to people & answer their questions
• Keep people clearly informed
• Involve people
So people feel in control
• Look out for dignity, privacy & humanity
• Attentive, responsive & take time to help
• Visible presence of staff to provide care
So people feel cared for
• Safe, knowledgeable and reassuring
• Effective care / services from joined up teams
• Organised and timely, looking to improve
So people feel safe
The hospital is able to arrange for an
interpreter to assist you in communicating
effectively with staff during your stay
through INTRAN.
If you need an interpreter or a person to sign,
please let us know.
If you require a large print version of this
booklet, please contact PALS on
01493 453240
Author:
Judy Dron,
Senior Sister, Endoscopy Suite
8
© October 2011
Revised April 2015
James Paget University Hospitals NHS
Foundation Trust
Review Date: April 2018
EN 15 version 2