Urological manipulations
Cystoscopy is an endoscopic method for the study of the bladder and urethra, which is the inspection of the mucous membranes of these organs with a special optical system.
Indications for cystoscopy.
When hematuria (bleeding with urine) cystoscopy is performed to identify the site of bleeding. Even if inspection of the mucosa and will not be identified source of bleeding, then it can be argued that it is in the kidney or the ureter, respectively, to perform other methods.
In the presence of a foreign body in the cavity of the bladder cystoscopy is simply the "gold standard" diagnosis. The fact that this method can not only accurately determine the size and nature of the foreign object, but also to solve the issue with the treatment of the patient. For example, when a small party of a body with smooth contours and edges, they can be removed naturally with the help of a cystoscope.
With the same purpose of a cystoscopy and if you suspect the presence of calculi in the cavity of the bladder, which is referred to in medicine urolithiasis. As well as third-party bodies, urolithiasis, cystoscopy may be one of treatment methods.
Traumatic injuries of the urethra and bladder are also absolute indications for carrying out cystoscopy. Using this method it is possible to diagnose the size and position of the breaks and bruises of the mucous membrane of the urethra and bladder.
Another absolute indication for cystoscopic examination. need to consider cancers of the bladder and urethra. In fact, for the diagnosis of this disease at the time and was designed by this method.
The action of the physician in cystoscopy
Depending on the type of cystoscope after its introduction, the urologist examines the bladder mucosa into the hole of the optical device or monitor. At this time it needs to define all pathological formations that are in this anatomical area. It is desirable that this be done as quickly as possible, because, as already mentioned, manipulation of the device in the cavity of the bladder is delivered to the patient discomfort.
The duration and timing of stay in hospital
The duration of cystoscopy, and many other medical manipulations depends on the disease, the type of the device and the skills of a specialist. For example, inspection of the normal mucous membrane of the bladder and urethra will not need more than five minutes. If we add to this time another five minutes to prepare for the procedure, it turns out that in the best case, from start to finish it takes no more than ten minutes.
Time of hospital stay before and after the procedure is not determined by the manipulation, and disease, which obliged the doctor to begin the procedure. If the diagnosis is not revealed any pathological condition, the patient can go home the same day.
Contact laser lithotripsy – a method of non-surgical removal of kidney stones, ureteral and bladder urolithiasis. Method of contact lithotripsy refers to the new modern endoscopic methods of crushing stones.
How to be the procedure?
Performed contact lithotripsy under spinal or General anesthesia. Into the bladder introduced a special endoscope (a thin) and is conducted further through the ureter to the location of the stone. This procedure of crushing of stones takes place under direct visual control and allows you to remove stones in one procedure. At the end of the procedure, if indicated in the ureter installed a special drainage tube – a stent, which in consequence is also non-invasive way.
The length of stay in hospital is determined by the course of the disease. The majority of patients discharged on the third day after the intervention.
Bipolar transurethral resection in adenoma of the prostate (TURP) is the gold standard, the most effective surgical operation, which quickly reduces symptoms of benign prostatic hyperplasia.
The advantage of the TURP before the open operation
- the lack of soft tissue injuries when you access the prostate gland
- clearly controlled hemostasis during surgery
- less long-term rehabilitation of patients in postoperative period
- the possibility of surgical treatment in patients with severe concomitant diseases, and urgently.
Indications for TURP:
1. Any volume of the prostate.
2. obesity
3. severe concomitant disease, as contraindication to open surgery
4. earlier surgeries on the bladder, prostate, abdominal wall; after laser treatments, thermotherapy, hyperthermia
5. true and false recurrences of adenoma
6. the combination of benign prostatic hyperplasia with chronic prostatitis and prostate stones
7. prolonged conservative treatment of benign prostatic hyperplasia
Contraindications: acute inflammatory diseases of the genitourinary system, the inability to place the patient in the urology chair (ankylosis of the hip joints, etc.). In recent years, testimony to the TURP expanded.
As be operated?
At TURP, the surgeon inserts a special tool with a scope (resectoscope) into your urethra and uses small cutting tools to remove all the prostate tissue along the urethra and compressing it. After the procedure, the bladder is installed rubber catheter 3 to 5 days. The TURP usually quickly eliminates the symptoms of disorders of urination, most men note improvement in the quality of urination shortly after the procedure. However, this method is also not devoid of complications.
Possible complications TURP: bleeding, damage to bladder wall, ureters, and pyo-inflammatory complications, damage to the urethra.
Late: the structure of the urethra, bladder neck sclerosis, retrograde ejaculation
