Indications and how coagulation works
Endoscopic coagulation is resorted to when conservative measures (hemostatics, lavage, intravesical therapy) do not stop bleeding from the bladder. Typical situations: radiation cystitis after irradiation of the pelvic organs, hemorrhagic cystitis during chemotherapy, bleeding vessels after TUR of the prostate or bladder tumor, vascular malformations of the mucosa. Under spinal anesthesia, through a resectoscope, the cavity of the bladder is washed from clots, the mucous membrane is examined, and each bleeding area is coagulated with a ball electrode or laser. For diffuse radiation cystitis, the entire affected area is treated, sometimes several sessions are required. After surgery, a catheter with flushing is installed for 1–2 days; The patient spends 1–2 days in the hospital.
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.
