Cystoscopy Procedure Note

 

HPI:

 

PROCEDURE: Cystoscopy w/ blue light

 

INDICATION FOR PROCEDURE: Bladder cancer surveillance

 

ANESTHESIA: 2% lidocaine jelly

 

SURGEON: Dr. Nicholas Ottaiano

 

ASSISTANT: Philip Rose

 

STAFF: Dr.

 

EBL: NONE

 

 

PROCEDURE IN DETAIL:

 

After informed consent, a 18F foley catheter was placed into the bladder in normal sterile technique with lubricant. 10cc of water was placed into the balloon. Cysview was injected into the bladder. The foley catheter was capped and the patient waited 1 hour.

 

After the hour, the foley catheter was removed and the patient was prepped and draped in normal sterile cystoscopic fashion. A flexible cystoscope was inserted into the urethra and then the bladder after which the Cysview was suctioned out of the bladder via the tubing attached to the cystoscope. This was repeated until adequate visualization was confirmed under blue light. The bladder was systematically inspected using white and blue light. The scope was retroflexed to inspect bilateral ureteral orifices and prostate. Cystoscope was then removed with further inspection of the prostate.

 

Cells [WERE/WERE NOT] then collected for cytology

 

 

Findings in summary:

 

 

1. Bladder:

 

-Ureteral orifices are normal and in orthotopic position with bilateral

efflux noted

 

-On retroflexion, the median lobe of the prostate mildly protruded

 

intravascularly. The prostate looked hyperemic.

 

-The mucosa was normal and specifically, no papillary lesions were noted. A

picture was initially taken of a concerning pink lesion, but after washing the

bladder, the lesion was no longer concerning.

 

-Moderate Trabeculations

 

 

2. Prostate:

 

-The prostatic urethra did not demonstrate considerable bilobar enlargement

 

-Based on cystoscopic impressions, prostate was short

 

 

3. Anterior Urethra:

 

-No stricture disease appreciated

 

 

Impression:

 

Patient underwent cystoscopy with cysview. No lesions concerning for bladder

cancer were identified. Patient's prostate looked hyperemic and is likely the

source of hematuria patient has been having.

Garrett Brinkley MD

PGY1, Urology