When is it necessary to wash out a tamponade?
Signs of tamponade: intensely blood-stained urine, then pain in the lower abdomen, urge without result and complete urinary retention - clots block the exit. A regular catheter does not help. In the clinic, under spinal anesthesia, a cystoscope-resectoscope with a wide channel is installed, the clots are crushed and washed out with a syringe-evacuator, and the cavity is examined. The source found - a bleeding vessel, the edge of a tumor or a bed after surgery - is coagulated. After the procedure, a three-way catheter is placed for 1–2 days with constant flushing. In case of tamponade against the background of a tumor, its TURP and histology are simultaneously performed.
The cause of bleeding is then treated separately: tumor - TUR or cystectomy, radiation cystitis - intravesical therapy, coagulation disorders - drug correction. If there is blood in the urine with pain and urinary retention, contact the clinic immediately - both clinics below are open 24 hours a day.
Indications for cystoscopy
- blood in the urine (hematuria) - excludes a bladder tumor;
- chronic or recurrent cystitis that cannot be treated;
- suspicion of a tumor, polyp, leukoplakia, bladder diverticulum;
- a stone or foreign body in the bladder;
- frequent, painful or difficult urination of unknown cause;
- control after surgery for a bladder tumor (every 3–6 months);
- removal or replacement of the ureteral stent, assessment of urethral stricture.
How does the procedure work?
The patient is positioned on a urological chair. A gel with an anesthetic is injected into the urethra, which relieves sensitivity after 5–10 minutes. Then the doctor inserts a cystoscope - flexible (thinner, more comfortable, more often in men) or rigid (allows for manipulation) - and fills the bladder with a sterile solution to straighten the walls. The image is displayed on the monitor, and the doctor sequentially examines the urethra, bladder neck, ureteric orifices and the entire mucous membrane.
If a suspicious formation is detected, a biopsy is immediately taken; in case of bleeding, the vessel is coagulated; in case of bladder tamponade, clots are washed away. Diagnostic cystoscopy lasts 10–20 minutes, with manipulations – up to 30–40 minutes. At the request of the patient or with a rigid cystoscope, intravenous sedation is used.
Preparation
Take a general urine test and culture a few days in advance: if there is an active infection, the procedure is rescheduled so as not to spread bacteria higher up. If you are taking blood thinning medications, tell your doctor; if you are planning a biopsy, they will be discontinued by agreement. On the morning of the procedure, take a shower; Empty your bladder before the office. You can eat as usual if sedation is not planned (then 6 hours on an empty stomach).
After cystoscopy
In the first 1-2 days, there may be a slight burning sensation when urinating and a pinkish tint to the urine - this goes away on its own. Drink more water to flush out your urinary tract; the doctor may prescribe a short course of uroantiseptic to prevent infection. If you have a fever, severe pain or inability to urinate, contact the clinic immediately. The conclusion is issued immediately, the biopsy result is given in 7–10 days.
Cystoscopy in Tashkent: where to do it
In the clinics below, cystoscopy is performed using video endoscopic equipment by urologists with endoscopic experience; if a tumor is detected, TUR of the bladder, histology and observation by a urological oncologist are available in the same clinic. Prices are indicated according to the official price list, anesthesia and biopsy are paid separately.
