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At least 19 recordsLinked to original sources
PubMed1992

The flexible cystoscope.

We have been using the flexible cystoscope since 1987. Detailed information is given concerning the technique of flexible cystoscopy, its indications, advantages and disadvantages. A comparison is made with the results obtained using the rigid cystoscope in an initial series of 100 patients, yielding false negative results in only 8% of cases during the learning period. The flexible scope can be successfully employed for Neodymium YAG laser coagulation of superficial bladder tumours. The conclusion is reached that once the urologist has learned how to use it, he will consider the flexible cystoscope as a fundamental tool in his diagnostic armamentarium and false negative results will decrease almost to zero, especially if additional investigations, namely cytology, are routinely adopted.

Cystoscopes↗
PubMed1991

A user's guide to flexible cystoscopes.

This survey, carried out on behalf of the BAUS Instruments Committee, aims to assist the urologist in choosing a flexible cystoscope. The 5 most commonly available flexible cystoscopes (from ACMI, Olympus, Pentax, Storz and Wolf) were assessed in a clinical setting for handling, image quality and user satisfaction. Several technical characteristics, including deflection range, irrigant flow rate and optics, were tested in the laboratory. Whilst all instruments were satisfactory, the favourite of our testing panel was the Olympus CYF-2, which also came out best in the technical assessment and has the most comprehensive service support. The cheaper Storz instrument also performed well.

Cystoscopes↗
PubMed1991

[Initial clinical experience with video-cystoscope].

The endoscopic image processing system which has a very small change coupled device (CCD) at the distal tip of an endoscope, can give us a quite different imaging information from the conventional optical endoscopes, of which the main functions were just to "see inside the human body". The advantage of this endoscopic image processing system has been well recognized but, since the scope diameter could not be made smaller due to the size limitations of the CCD chip itself, the system has not been utilized in the field of Urology. In cooperation with Olympus Optical Co., we have studied a system called Urological Video Information System (UVIS) in order to utilize the image processing system for Urology. In our system a special light source with RGB light output is utilized together with a conventional optical cystoscope and a video converter is connected to the eyepiece of the scope in order to observe endoscopic images on the monitor. Endoscopic images can be stored in an image filing system when necessary. The image quality of UVIS is inferior to that of the conventional cystoscopes at the moment and there are several other technical problems to solve but, as witnessed in the field of Gastroenterology, it is expected that this kind of electronic system will become much more important in the future. This report covers the current problems and some considerations of them as an initial study.

Acute Disease↗
PubMed1990

A cystoscopically directed biopsy technique developed in canine pancreaticoduodenal transplantation.

Present methods of monitoring for allograft dysfunction in pancreaticoduodenal transplantation (urinary amylase, scintigraphy) give indirect evidence and do not consistently allow recognition of early, potentially reversible rejection from other causes of allograft dysfunction. For better diagnosis of allograft dysfunction, adequate tissue specimens must be obtained without trauma to the allograft. We devised a cystoscopically directed needle biopsy technique to obtain tissue from the canine pancreaticoduodenal allograft. This technique is made feasible by a duodenocystostomy similar to that in human pancreaticoduodenal transplantation. The duodenum acts as a port of entry for the biopsy instruments, providing access to the pancreas. A 24F side-viewing nephroscope is used to view the duodenum. The tissue specimen is obtained with an 18-gauge, 350 mm Menghini aspiration needle inserted by way of the nephroscope through the duodenum and into the pancreas. Pancreaticoduodenal allotransplantation with a duodenocystostomy for exocrine drainage was performed in 18 dogs. Of 59 serial biopsy specimens obtained, 41 (69.5%) were adequate for pathologic evaluation. The principal complication associated with the technique was minimal bleeding at the biopsy site, occurring in 22 of the 59 biopsy procedures. This cystoscopically directed biopsy technique appears to be safe, often obtains adequate tissue for diagnosis, and may be directly applicable for distinguishing causes of allograft dysfunction in human pancreaticoduodenal transplantation.

Animals↗
PubMed1978

Development of a carbon dioxide laser cystoscope.

A 50-watt carbon dioxide continuous laser coupled to a Zeiss surgical microscope was used to study the characteristics of laser-induced lesions on the exteriorized canine bladder. The relationship of energy to the depth of the lesion created by the laser was evaluated. Healing, vertical temperature transmission and hemostasis were studied. A prototype carbon dioxide laser cystoscope then was constructed and used endoscopically to create surgical lesions in the intact canine bladder.

Animals↗
PubMed1987

Preoperative cystoscopic findings in resectable rectal adenocarcinoma.

Forty-nine patients underwent preoperative cystoscopy prior to surgical resection for adenocarcinoma of the rectum. There were 30 men and 19 women ranging in age from 26 to 78 years, with a median age of 59 years. Surgical resections consisted of abdominoperineal resection, posterior exenteration, or total pelvic exenteration. Twenty patients had positive findings on preoperative cystoscopy while 29 had negative findings. Of the 20 patients with positive cystoscopic findings, eight (40%) had either urologic symptoms or abnormal microscopic findings on urinalysis; however, only one of these eight patients had tumor invasion of the bladder wall at cystoscopy, while the remaining seven had associated benign conditions. In the 29 cystoscopy procedures in which findings were negative, only three patients (10%) had urologic symptoms or abnormal results of urinalysis, none of which were secondary to the rectal carcinoma. We conclude that urinary symptoms can be misleading and unreliable when predicting neoplastic involvement of the bladder by carcinoma of the rectum because of the high incidence of associated benign disorders of the bladder. Therefore, cystoscopy does not have a useful role in staging patients undergoing surgery for rectal carcinoma in terms of local tumor extension.

Adenocarcinoma↗
PubMed1992

The use of a cystoscopically placed cobra catheter for directed irrigation of lower pole caliceal stones during extracorporeal shock wave lithotripsy.

As the general experience with extracorporeal shock wave lithotripsy (ESWL) for renal calculi broadens, it is increasingly evident that the clearance of stone fragments in lower pole calices needs to be improved. The stone-free rate after treatment for lower caliceal stones is consistently less than that for other upper tract locations. Use of a cystoscopically placed cobra catheter for directed irrigation during ESWL resulted in an increase of our lower caliceal stone-free rate at 1 and 3 months of followup to 71% (15 of 21) compared to 33% (8 of 24) of randomly selected controls at 1 month and 54% (13 of 24) at 3 months. We conclude that pre-ESWL placement of a cobra catheter into the lower pole calix and intermittent irrigation during the procedure are potentially useful adjuncts in the successful treatment of lower caliceal calculi.

Cystoscopy↗
PubMed1990

Evidence that the soluble interleukin 2 receptor level may determine the optimal time for cystoscopically-directed biopsy in pancreaticoduodenal allograft recipients.

In 18 consecutive pancreaticoduodenal allograft recipients (15 combined kidney/pancreas and 3 pancreas only after a prior successful kidney transplantation) operated on between December 1987 and February 1989, we studied the soluble interleukin 2 receptor (SIL-2R) level over time. All pancreaticoduodenal allografts were transplanted with exocrine drainage via a duodenocystostomy that allowed for cystoscopically directed needle biopsies of the pancreas. Of these 18 recipients, at 6 weeks after transplantation, 6 had had no rejection episodes or cytomegalovirus disease (control group), an acute allograft rejection had developed in 7, CMV disease developed in 4, and both rejection and CMV disease developed in 1 by 12 days after transplantation. SIL-2R level increased in all patients during immunosuppressive induction therapy (preoperative mean +/- SE, 1637 +/- 284 U/mL; maximum, 4367 +/- 687 U/mL). After induction therapy, the mean was 2768 +/- 432 U/mL. In all 6 recipients in the control group, SIL-2R level continued to decrease. However, SIL-2R level was significantly higher compared with controls, in those who had CMV disease (levels were increased at a mean of 7 days before diagnosis of CMV disease) and in those who had acute rejection episodes (levels were increased a mean of 7 days before the clinical diagnosis of rejection). Factors that did not cause an increase in SIL-2R level included acute pancreatitis, wound infection, operative procedures, and CsA nephrotoxicity. SIL-2R level can be useful for monitoring pancreaticoduodenal allograft recipients. Increases predict impending rejection or CMV disease, prior to the onset of organ dysfunction. When SIL-2R level increases, we recommend cultures of blood and urine to exclude CMV and pancreaticoduodenal allograft biopsy to confirm early rejection prior to the initiation of potentially dangerous antirejection therapy.

Biopsy↗
PubMed1978

Cystoscopic picture of Schistosoma haematobium in Egyptian children correlated to intensity of infection and morbidity.

Cystoscopy was done on 45 children, 5--12 yr old, infected with Schistosoma haematobium. On the basis of urinary egg output, the children were classifed as having mild, moderate, or heavy infection and the cystoscopic picture was correlated with their egg output and with their signs and symptoms. Lesions reported, in descending order of frequency, were: hyperemia, sandy patches, tubercles, ulcers, nodules, and polyps. Multiple schistosomal lesions were present in some patients and the frequency and severity of lesions correlated with the heaviness of infection. Individual variation in the severety of response to S. haematobium was observed.

Child↗
PubMed1990

Histologic diagnosis of rejection by using cystoscopically directed needle biopsy specimens from dysfunctional pancreatoduodenal allografts with exocrine drainage into the bladder.

To determine the histologic features of rejection and to identify nonrejection causes of human pancreatic allograft dysfunction, we analyzed 31 needle biopsy specimens (17 pancreatic, 14 duodenal) obtained under cystoscopic direction from 15 dysfunctional pancreatoduodenal allografts with exocrine drainage into the bladder. Eight allografts undergoing rejection showed the most common histologic features of rejection to be diffuse mixed inflammatory infiltrates of pancreatic acinar tissue and duodenum wall. Diffuse infiltration of pancreatic acinar tissue by neutrophils was the earliest histologic change in rejection. Seven dysfunctional allografts not undergoing rejection ("nonrejection") showed a normal pancreas or various changes including acinar dilation with inspissation of secretions, fibrosis, cytomegalovirus inclusions, and enzymatic necrosis. The histologic changes in the duodenum paralleled those in the pancreas in both rejection and nonrejection allografts. We conclude that the histologic features of rejection in pancreatoduodenal allografts are distinctive. The changes seen in biopsy specimens accurately reflect the state of the graft and can be used to diagnose rejection and to identify other causes of graft dysfunction. Biopsy samples from the duodenum as well as the pancreas are diagnostically useful. The biopsy findings can be used to guide the clinical management of rejection and in the development of other noninvasive tests for rejection.

Biopsy, Needle↗