Diagnosis and Treatment of Urogynecological Conditions
Cystoscopy is a modern and safe diagnostic method widely used in urogynecology. It is a minimally invasive examination that allows the specialist physician to examine the interior of the bladder and urethra using a thin surgical instrument called a cystoscope. It is a thin, flexible or rigid instrument called telescope, that has a small camera and lighting at its tip. The cystoscope is inserted through the urethra and reaches the bladder, allowing the doctor to see the interior of the bladder and urethra in real time through a screen.
In the field of urogynecology, cystoscopy plays a crucial role in diagnosing and treating various conditions that affect the women's urogenital system. This examination provides direct visual access to the internal structures, enabling accurate diagnosis and targeted therapeutic management.
Indications for Cystoscopy in Urogynecology
Diagnostic Indications
Cystoscopy is indicated in many cases of urogynecological conditions. The main diagnostic indications include:
- Chronic Cystitis and Urinary Tract Infections: When women face recurrent urinary tract infections or chronic cystitis symptoms, cystoscopy can reveal underlying causes such as anatomical abnormalities, chronic inflammation, or characteristic features seen in painful bladder syndrome or interstitial cystitis.
- Hematuria: The presence of blood in urine is an important indication for cystoscopic examination, as it may indicate various pathological conditions from simple inflammations to more serious neoplasms.
- Overactive Bladder Symptoms: Women suffering from overactive bladder with symptoms such as frequency, urgency, and nocturia can benefit from cystoscopic evaluation.
- Therapeutic Applications
Beyond diagnosis, cystoscopy offers therapeutic capabilities:
- Stone Removal: Cystoscopy allows safe removal of small stones from the bladder.
- Tissue Biopsy: When suspicious lesions are detected, a tissue sample can be taken for histopathological examination.
- Intravesical Therapy: In certain cases, medications can be administered directly into the bladder through the cystoscope, such as intravesical Botox in cases of urgency-type incontinence.
Preparation for the Examination
Preparation for cystoscopy is simple and does not require special prerequisites. Patients are advised to:
- Perform preoperative urine testing to rule out infection (urinalysis)
- Inform the doctor about any medications they are taking
- Avoid taking anticoagulant medications if recommended by the urogynecologist
Cystoscopy Procedure
Technical Characteristics
Cystoscopy lasts approximately 15-30 minutes. The procedure includes:
- Patient Positioning: The woman is positioned in gynecological position
- Antisepsis: The area is cleaned with antiseptic solution
- Local Anesthesia: Local anesthetic is applied to the urethra
- Cystoscope Insertion: The instrument is gently inserted through the urethra
- Examination: The bladder is filled with sterile fluid and examined completely
Types of Cystoscopes
In modern urogynecology, different types of cystoscopes are used:
- Flexible Cystoscopes: Offer greater patient comfort and are ideal for diagnostic examinations.
- Rigid Cystoscopes: Provide better image quality and are suitable for therapeutic interventions.
Benefits and Advantages
Cystoscopy offers significant advantages in urogynecological practice:
- Accurate Diagnosis: Allows direct visualization of pathological changes that cannot be detected by other methods.
- Minimally Invasive: Does not require surgical incisions and can be performed on an outpatient basis.
- Rapid Recovery: Patients can return to their daily activities immediately after examination.
- Therapeutic Capabilities: Combines diagnosis and treatment in one procedure.
Possible Complications and Side Effects
Although cystoscopy is considered a safe examination, there are some possible side effects:
- Temporary burning during urination
- Mild hematuria for 24-48 hours
- Rarely, urinary tract infection (cystitis)
Post-Procedure Care
After cystoscopy, patients are advised to:
- Drink plenty of fluids for 24-48 hours
- Avoid intense physical activity for one day
- Monitor for signs of infection
- Contact the doctor if concerning symptoms appear
Modern Advances in Cystoscopy
Cystoscopy technology continues to evolve, offering improved capabilities:
- High-Resolution Cystoscopes: Provide excellent image quality for more accurate diagnosis.
- Photodynamic Diagnosis: Use of special drugs for better visualization of neoplasms.
- Narrow Band Imaging: Improved detection of vessels and tissue changes.
Conclusion
Cystoscopy is a fundamental diagnostic and therapeutic tool in modern urogynecology. This safe and effective method offers women immediate diagnosis and appropriate treatment of urogynecological problems. With continuous technological evolution, cystoscopy continues to improve, providing even greater accuracy and comfort for patients.
Choosing an experienced urogynecologist to perform cystoscopy ensures optimal results and procedure safety. Women experiencing urogynecological symptoms should not hesitate to discuss with their doctor the possibility of cystoscopic examination.
Speak with Kostis Nikolopoulos to explore whether cystoscopy is right for you.
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