Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cystoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources
PubMed2003

Combined vaginoscopy-cystoscopy: a novel simultaneous approach improving vesicovaginal fistula evaluation.

PURPOSE: Using a device that permits simultaneous viewing on the same display (picture in picture) of 2 images we performed combined vaginoscopy-cystoscopy (CVC) during evaluation for vesicovaginal fistula as a means of better visualization, allowing more precise identification and better preoperative planning. MATERIALS AND METHODS: A regular cystoscope and a 10 mm 0-degree laparoscope were used. Each was attached to a different microcamera and light source. The cameras were hooked to the back of a Twinvideo (Karl Storz Endoscopy, Tuttlingen, Germany), allowing a wide variety of views combining the 2 images. Cystoscopy was performed as usual and the laparoscope was used for vaginoscopy with a transparent vaginal speculum to maintain the vagina open, while allowing visualization of the vaginal wall. The 2 images were combined in picture in picture, providing confidence during the fistula identification process. Urinary leakage was viewed simultaneously with guide wire passage through the cystoscope and vaginal wall, showing the exactly fistula position. RESULTS: The CVC procedure using 2 images in picture in picture allows precise identification during evaluation for vesicovaginal fistula. CONCLUSIONS: CVC has become a routine procedure in suspicious cases or in those of a confirmed diagnosis of vesicovaginal fistula at our institution. It increases the likelihood of fistula diagnosis and identification, allowing better surgical planning.

Colposcopy↗
PubMed2004

Urological injuries during cesarean section: intraoperative diagnosis and management.

PURPOSE: We report a single center experience with emergency urological consultations and interventions during cesarean sections, and provide several guidelines for the intraoperative diagnosis and management of urological trauma in this specific clinical setting. MATERIALS AND METHODS: From 1996 to 2003 urological consultations were required in 29 of 10,439 abdominal deliveries (0.3%). Patient files were reviewed for obstetric, surgical and followup data. RESULTS: In 20 patients (69%) cesarean section was done on an emergency basis for fetal distress or placental abruption. Of the 29 urological consults 12 (42%) were for inadvertent cystotomy and 17 (58%) were for suspected injuries to the ureter. Patients with inadvertent cystotomy underwent concomitant assessment of ureteral patency by direct insertion of ureteral catheters through the ureteral orifice. Ureteral obstruction was identified in 1 case and promptly repaired by dissecting the ureter and releasing offending sutures that were angulating the ureter and occluding the lumen. Patients with suspected ureteral damage and an intact bladder were studied by endoscopic means (14) or direct surgical dissection and exposure of the ureter (3). Endoscopic assessment was performed by cystoscopic inspection of stained urine flow from the orifices following the administration of intravenous dye (indigo carmine) or by retrograde ureteral catheterization. One patient was found to have incomplete ureteral transection, which was repaired primarily over a self-retaining ureteral stent. CONCLUSIONS: Key factors to obtain optimal results in the management of urological injuries during cesarean sections are the early recognition and immediate repair of damage. Ureteral catheterization via a cystoscope or directly through the orifices should be considered the modality of choice to assess ureteral intactness. Algorithms for urological assessment in this clinical setting are provided.

Adult↗
PubMed2005

Performance of urine test in patients monitored for recurrence of bladder cancer: a multicenter study in the United States.

PURPOSE: We assessed the performance of the ImmunoCyt immunocytochemical test for detecting bladder cancer recurrence in patients with prior superficial bladder cancers compared with cystoscopic and histological findings. MATERIALS AND METHODS: A total of 341 patients with a history of bladder cancer undergoing monitoring were evaluated at 4 sites. The results of cytology and/or ImmunoCyt were analyzed for sensitivity and specificity compared with biopsy confirmed cancer. RESULTS: The overall sensitivity of cytology alone, ImmunoCyt alone and the 2 methods combined was 23%, 81% and 81%, respectively. The specificity of cytology alone, ImmunoCyt alone and of the 2 methods combined was 93%, 75% and 73%, respectively. The immunocytochemical test was more sensitive than cytology for detecting grades 1 and 2, and stages Ta, T1, and T2 urothelial carcinoma, and it was equally sensitive for detecting grade 3 cancers and carcinoma in situ (CIS). The sensitivity of the combined tests for grades 1 to 3/CIS was 79%, 90% and 82%, while for stages Ta, T1, T2+ and CIS it was 83%, 75%, 100% and 100%, respectively. The overall positive and negative predictive values of the combined tests were 37% and 95%, respectively. Importantly the immunocytochemical test could detect 71% of small (less than 1 cm) tumors. CONCLUSIONS: ImmunoCyt is a sensitive test for detecting bladder cancer. Because of its high sensitivity for detecting small tumors, even those of low histological grade, and its high negative predictive value, this test may have a role in decreasing the frequency of cystoscopic examinations for monitoring patients with low risk bladder cancer.

Antibodies, Monoclonal↗
PubMed1983

Histological and urodynamic study of the bladder in enuretic children.

In a study of the bladders of 12 enuretic children by cystoscopy, light microscopy and urodynamics, cystoscopic trabeculation was found in 10 cases. Histologically, the trabeculation resembled adult trabeculation of obstructive aetiology, collagen infiltration being the characteristic hallmark. Using urodynamic measurements, the bladders behaved like those of adult enuretics; 10 out of 12 were unstable and voiding occurred at relatively high pressures. There was no correlation between symptoms and either cystoscopic or histological trabeculation.

Adolescent↗
PubMed1988

Electrohydraulic lithotripsy of bladder stones. A Hong Kong experience.

Forty transurethral electrohydraulic lithotripsy procedures for bladder stones have been done. The rigid cystoscope was adequate in most cases but the rigid nephroscope was advantageous in large stones because of its larger bore and range of accessories. Use of the flexible cystoscope for stone extraction was difficult but it could be used with a few friable stones of less than 1 cm or for follow-up.

Adult↗
PubMed1995

Ploidy and Tn-antigen expression in the detection of transitional cell neoplasia in non-tumour-bearing patients.

OBJECTIVE: To study the effectiveness of combining DNA ploidy and the blood-group related membrane antigen Tn as bladder tumour markers which have been individually associated with high tumour grade and poor prognosis. In particular to (i) determine whether use of these two markers would improve tumour detection compared with either alone, particularly of high grade disease and (ii) determine whether intermediate rates of marker expression would occur in bladder cancer patients with no current tumour compared with those with a tumour and a control group with benign prostatic hypertrophy. PATIENTS AND METHODS: A total of 102 patients undergoing cystoscopic monitoring for either benign prostatic hyperplasia (BPH) or for transitional cell carcinoma (TCC) at the Repatriation Hospital and Flinders Medical Centre were included in the study. The patients comprised three study groups, those with BPH (n = 37), with TCC but no tumour present (n = 38) and those with TCC and a tumour present at cystoscopy (n = 27). Exfoliated cells obtained from bladder washings at cystoscopy were double-labelled using a monoclonal antibody to the Tn antigen and a DNA stain, propidium iodide and examined by flow cytometry. RESULTS: Rates of marker expression in 27 patients with tumours were 30% for Tn antigen, 30% for aneuploidy and 48% for either marker. Marker expression was strongly associated with tumour grade, with no expression at grade 1, 38% (3/8) tumours at grade 2 and 90% (9/10) at grade 3. In patients with a history of bladder tumours but no current tumour, rates were intermediate (30%) compared with patients with current transitional cell carcinoma (42%) and control patients (19%). CONCLUSION: The use of Tn antigen combined with DNA flow cytometry can increase tumour detection, particularly of high grade, aggressive disease. Gradation of expression of these markers across patient groups at increasing risk of a tumour, with intermediate expression in patients with no current tumour, suggests that marker expression may be detecting a preneoplastic stage of the disease, which is not possible with cytology. Given two parallel disease processes for superficial papillary and for high grade disease with invasive potential, the expression of high grade tumour markers in cells from cystoscopically normal bladders may represent a pre-clinical stage of aggressive disease. The identification of patients at risk of invasive disease using combinations of tumour markers may offer advantages in clinical management, particularly when no tumour is present and therefore no histopathological assessment is made.

Aged↗
PubMed1995

Superficial bladder cancer: for how long should a tumour-free patient have check cystoscopies?

OBJECTIVE: To determine the probability of a patient with superficial bladder cancer developing a recurrent tumour after having remained tumour free for 2 or more years. PATIENTS AND METHODS: One-hundred and seventy-nine patients with Ta or T1 tumours at diagnosis, a minimum follow-up of 3 years and a minimum of 2 years remaining tumour free were identified. Thirteen patients had more than one episode that was eligible for inclusion and there were therefore 192 tumour-free episodes for analysis. Survival curves of the probability of being recurrence-free against time were constructed for the whole group, for subgroups of Ta and T1 tumours and for subgroups with characteristics at diagnosis suggesting a good, intermediate and poor prognosis. RESULTS: The probability of a patient developing a recurrence after 2, 5 and 10 years of being tumour free was 43, 22 and 2% respectively. No patient had a recurrence after remaining tumour free for 12 years. No patient who had been tumour free for at least 2 years progressed to muscle invasion or metastases. There was no significant difference in the probability of recurrence between Ta and T1 tumours after 2 years of remaining tumour free. CONCLUSION: The optimum length of cystoscopic follow-up for patients with superficial bladder cancer is unknown, but patients continue to develop recurrences even after many years of being tumour free. If a patient is to discontinue cystoscopic follow-up, then alternative methods of assessment should be applied.

Adult↗
PubMed1990

Ultrasonography compared with intravenous urography in the investigation of adults with haematuria.

OBJECTIVE: To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN: Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each was aware of the details of the request form but not of the findings of the other investigation. SETTING: Radiology department of a teaching hospital. PATIENTS: 155 Consecutive adult patients (aged 18-93) referred from general practitioners and hospital outpatient clinics with a history of haematuria. FOLLOW UP: When results of both examinations proved normal no clinical or radiological follow up was sought. All abnormal findings of either investigation were correlated with results of subsequent imaging studies or operative findings. RESULTS: 81 Patients (52%) had normal findings on urography and ultrasonography. Overall, the findings of ultrasonography concurred with those of urography in 144 cases (93%). Among the discrepant findings of the two investigations ultrasonography missed two ureteric calculi; one was in a non-dilated ureter, and in the other case ultrasonography detected the secondary ureteric dilatation. Ultrasound examination alone detected four bladder tumours not visible on urography with sizes ranging from 5 to 21 mm, representing one fifth of the 20 cystoscopically proved bladder tumours detected in the series. Ultrasonography detected all the 22 neoplastic lesions discovered in the study (20 bladder, two renal). Ultrasonography clarified the nature of renal masses evident in three urograms (simple cysts). CONCLUSIONS: Ultrasonography is a safe and accurate method of investigating the urinary tract in adults with haematuria. When combined with a single plain abdominal radiograph it proved to be superior to urography as the primary imaging study in this series. Ultrasonography should certainly be preferred to urography if cystoscopy is not planned. No urothelial tumours of the upper urinary tract were found in the series, reflecting their rarity. For those patients in whom ultrasonography and plain radiography have shown no abnormality and in whom cystoscopic appearances are normal urography would be advisable to exclude urothelial tumours of the upper urinary tract.

Adolescent↗
PubMed1984

Urinary bladder tumors studied by cystosonography. Part II: Staging.

Correlation between the sonographic staging and the clinical staging as determined by excretory urography, CT, cystoscopy, bimanual examination under anesthesia, and biopsy was possible in 14 of 17 cases of bladder tumor. Ultrasound failed to stage three cases either because the tumor was not seen by sonography (one case) or because of technically suboptimal images (two cases). The cystoscopically obtained biopsy specimens were adequate to make pathologic staging possible in 12 of 14 cases. There was agreement between the sonographic and clinical staging in all 14 cases and with the pathologic staging in all 12 adequately staged cases. The shortcomings of pathologic staging using the cystoscopic biopsy and the criteria of sonographic staging are discussed. Although sonography was demonstrated to be more accurate than conventional methods, further experience is necessary before conclusions can be drawn.

Humans↗
PubMed2005

[Subureteral polydimethylsiloxane injection for the endoscopic treatment of vesicoureteral reflux].

INTRODUCTION: Endoscopic subureteral injection has been successfully used to treat vesicoureteral reflux (VUR) in children. The aim of this study was to review our results with subureteral polydimethylsiloxane injection in terms of effectiveness, long term follow-up and morbidity. MATERIAL AND METHOD: Twenty-eight children with VUR were treated with this technique. VUR was unilateral in eight patients (28.6%) and bilateral in 20 patients (71.4%). Indications for endoscopic treatment were the same as those for open surgery. The polydimethylsiloxane implant was injected transureterally below the ureteral meatus in 50 ureters on an outpatient basis. Reflux grade was low (II-III) in 36% and high (IV-V) in 64%. RESULTS: The mean follow-up was 18 months (12 months-4 years). VUR was corrected in 43 ureters (86%) corresponding to 21 patients. Reflux resolved in 40 ureters after one polydimethylsiloxane injection (80%) and in 43 ureters (86%) after two injections. An endoscopic retreatment to correct the reflux was performed in six ureteral units. Cystoscopic findings in these patients with endoscopic failure were mound displacement toward the bladder neck in five ureters and marked volume loss on the mound in one. All these patients underwent a second subureteral dose, which controlled VUR in three ureters (50%). CONCLUSIONS: Our results confirm that endoscopic subureteral polydimethylsiloxane treatment is a simple procedure with low morbidity that is well tolerated by the patient. In our experience, it can be used in double ureters. The effectiveness of this procedure seems to be related to the grade of reflux, the cystoscopic appearance of the ureteral orifice, volume loss and mound displacement.

Child↗
PubMed1999

Diagnostic value of voided urine and bladder barbotage cytology in detecting transitional cell carcinoma of the urinary tract.

In this article we report on our experience with the use of urine cytology for the screening and diagnosis of transitional cell carcinoma (TCC) of the bladder and upper urinary tracts at our institution between January 1987 and December 1995. A total of 76 patients were included in the study. All patients had voided urine cytology studies read as positive or highly suspicious for malignancy and no prior history of TCC of the urinary tract. All these patients subsequently underwent cystoscopy, bladder/ureteral barbotage cytology, random bladder biopsies, and radiographic studies of the upper tracts. Of the 76 patients with positive urine cytology, 53 also had barbotage urine cytologies which were positive. Six of these patients were found to have cystoscopically evident TCC of the bladder, and 1 patient had upper tract TCC. Three other patients subsequently went on to develop TCC of the bladder at 52, 89 and 111 months of follow-up. An additional patient was diagnosed with upper tract TCC at 12 months of follow-up. Among the 23 patients with negative bladder/ureteral barbotage cytology, 3 patients, 2 at the time of initial cystoscopy, and one 15 months later, showed evidence of TCC. Median patient follow-up was 97 (range 35-132) months. Thus of 76 patients with initial positive voided urine cytology studies, only 9 proved to have TCC at initial work-up, while 5 other patients were diagnosed with TCC during a median follow-up of 97 months. The statistical diagnostic values of the bladder/ureteral barbotage urine cytology studies at the time of cystoscopic work-up were: sensitivity 77%; specificity 31%; positive predictive value 13%, and negative predictive value 91%. Our data suggest that in patients without a previous history of TCC, the diagnostic value of bladder barbotage urine cytology is insignificant, and therefore not cost effective to be included as part of the routine work-up of TCC. Moreover, in patients with initially positive voided urine cytology and negative work-up, if the cytology subsequently becomes negative, the likelihood of the development of TCC is low. However, if the initially positive cytology continues to remain positive, there is a much higher probability of TCC being detected in this population.

Biopsy↗
PubMed2003

Urodynamic study and potassium sensitivity test for women with frequency-urgency syndrome and interstitial cystitis.

PURPOSE: The intravesical potassium chloride (KCl) sensitivity test has been used to detect urothelial leakage in patients with frequency-urgency syndrome and interstitial cystitis (IC). It is unclear whether urodynamic studies can predict a positive KCl test. This study compared the urodynamic results for women with different KCl responses who suffered from frequency-urgency syndrome and IC. METHODS: A total of 196 women suffering from frequency, urgency and/or bladder pain were enrolled in this study. These patients underwent a urodynamic study with a concurrent KCl test. The urodynamic results were compared between the patients who had positive and those who had negative KCl tests and between the patients with and without characteristic IC under cystoscopic hydrodilatation. RESULTS: Among 196 women, 138 (70.4%) had a positive and 58 (29.6%) a negative KCl test. Among the patients with a positive KCl test, 128 underwent cystoscopic hydrodilatation: 44 were proven to have characteristic IC, and 84 were not. Patients with a negative KCl test had a larger residual urine volume and a higher incidence of poor relaxation of the urethral sphincter than those with a positive test. However, patients with a positive KCl test and proven IC did not differ in urodynamic parameters from non-IC patients. The symptom of bladder pain could not predict a positive KCl test nor characteristic IC either. CONCLUSIONS: This study shows that no specific urodynamic parameter or specific symptoms can predict a positive KCl test in patients with frequency-urgency syndrome or IC. Patients with bladder pain at full bladder and a positive KCl test had only a 45.2% chance to have characteristic IC.

Administration, Intravesical↗
PubMed1978

[Value of transurethral laser therapy in the treatment of bladder carcinoma].

A new method has been developed allowing the introduction of the argon laser beam into the water-filled bladder using normal operation cystoscopes. The energy is applicated to the bladder by means of a light conductor which is placed into the bladder through the working channel of an operation cystoscope. Treating large tumors of the bladder we laser the resection bed after electroresection (TUR). The sole use of laser therapy on large tumors of the bladder is not to be recommended because of the uncertainty of their total destruction. On the other hand, the sole laser coagulation of small relapses of tumor up to the size of raspberries restricted to the mucous membrane seems to be more effective than electroresection. The advantage of laser treatment is the absence of electric power flow through the tissue which avoids muscle convulsions of the bladder and electric power leakage. Besides of this, laser therapy being painless allows treatment without anesthesia. So far 68 patients with tumors of the bladder have been treated by transurethral laser therapy combined with electroresection (TUR). The aim of transurethral laser therapy is the reduction of recidivity of bladder tumors.

Electrocoagulation↗
PubMed1986

Integral photoradiation therapy of multifocal bladder tumors.

Focal and diffuse hematoporphyrin derivative (HpD) photodynamic therapy was used for the treatment of resistant transitional cell carcinoma in situ (Tis) in 30 patients. Patients were given HpD intravenously followed by either focal light irradiation (630 nm) or diffuse bladder irradiation via a light bulb fiber. The light source was an argon ion pumped dye laser circulating rhodamine B dye. All patients were followed with periodic cystoscopic examinations, bladder biopsies, and urine cytologic examinations. All of the 15 patients who underwent focal therapy had biopsy and cytologic evidence of disappearance of the lesion in the treated area at the 3-month follow-up cystoscopic examination. Eight patients have experienced one or more recurrent lesions either in the treated area or in distant areas, and in each the recurrence was successfully treated with HpD photodynamic therapy. Eight of the 11 patients with diffuse Tis have returned for their 3-month follow-up evaluation, and all demonstrated disappearance of tumor (3 of these 8 patients have subsequently developed focal recurrent Tis). Four patients had diffuse Tis plus Ta lesions (2 patients) or T2 lesions (2 patients), and all had disappearance of the Tis, but persistence of the Ta or T2 disease. We conclude that HpD photodynamic therapy appears effective in the treatment of resistant Tis.

Aged↗
PubMed1982

Correlation between cytology and cystoscopy in the follow-up of patients with bladder tumours.

The correlation between cytology and cystoscopy was established using data from 450 cytologic and cystoscopic examinations performed on 401 urology outpatients. Cytology specimens were interpreted by cytopathologists, without access to any clinical information. 311 examinations were performed on patients with present or past bladder tumour history and 139 on patients who were examined for other urological causes. Cytology specificity was good, with a low rate of false-positive results, and revealed 36% of cystoscopically visible tumors; sensitivity increased with tumour grade. In some patients, positive cytology preceded the appearance of tumoral lesions by several months. Cytology and cystoscopy are complementary methods for use in the management of patients with bladder tumours.

Cystoscopy↗
PubMed2005

Office bladder distention with electromotive drug administration (EMDA) is equivalent to distention under general anesthesia (GA).

BACKGROUND: Bladder distention is commonly used in diagnosis and treatment of interstitial cystitis (IC). Traditionally performed in the operating room under general or spinal anesthesia (GA), it is expensive and associated with short term morbidity. Office bladder distention using electromotive drug administration (EMDA) has been suggested as an alternative that is well tolerated by patients. We report the first comparative findings of patients undergoing both office distention with EMDA and distention in the operating room (OR) with GA. METHODS: This retrospective chart review identified 11 patients participating in two protocols of EMDA bladder distention who also underwent bladder distention under GA either prior to or after the EMDA procedure. RESULTS: The median absolute difference in bladder capacity between GA and EMDA was only 25 cc; the median percent difference was 5%. Cystoscopic findings, while not prospectively compiled, appear to have been similar. CONCLUSION: This study represents the first comparison between distention with EMDA versus GA and confirms the technical feasibility of performing bladder distention in an office setting. The distention capacity achieved in the office was nearly identical to that in the OR and the cystoscopic findings very similar. Further investigation into the comparative morbidity, cost, and other outcome measures is warranted to define the ultimate role of EMDA bladder distention in the clinical evaluation and care of patients with IC.

Adult↗
PubMed2007

Reflex UroVysion testing of bladder cancer surveillance patients with equivocal or negative urine cytology: a prospective study with focus on the natural history of anticipatory positive findings.

A proportion of patients under surveillance for recurrent bladder carcinoma with no immediate evidence of bladder tumor recurrence have positive multitarget fluorescence in situ hybridization (FISH; UroVysion, Vysis, Downers Grove, IL) results. The course of these "anticipatory positive" cases and the time to bladder tumor recurrence remains unknown. We followed up 250 patients with urine cytologic results, concurrent multitarget FISH, and cystoscopic examination for recurrent urothelial carcinoma. Of 81 cases (32.4%) with FISH-positive results, tumor recurrence developed in 60 (74.0%). Of 169 (67.6%) FISH-negative cases, recurrent urothelial carcinoma developed in 22 (13.0%). Of 211 patients (84.4%) with negative cystoscopic examination results, 56 (26.5%) had positive FISH results, and in 35 (62.5%) of these patients, recurrent urothelial carcinoma developed. Approximately 27% of patients under bladder carcinoma surveillance without immediate evidence of tumor recurrence will have a positive FISH result, defining the anticipatory positive subset. In about 65% of this anticipatory positive group, recurrent bladder urothelial carcinoma developed within 29 months.

Cystoscopy↗
PubMedDate not supplied

Orthotopic ureterocele masquerading as a bladder tumor in a woman with pelvic pain.

Single system orthotopic ureteroceles often present in adulthood are associated with characteristic radiographic findings. We present the case of a 54 year old woman with 8 months of urgency/frequency and pelvic pain that has the cystoscopic appearance of a bladder tumor. Cystoscopic images, radiographs and intraoperative photos demonstrate the work-up, evaluation, and treatment of this unique single system orthotopic ureterocele containing a calculus. This patient demonstrates the need for cystoscopy accompanied by upper tract imaging in patients with new onset pelvic pain, urgency/frequency, and frequent urinary tract infections.

Cystoscopy↗