A cystourethroscope is a medical instrument that is able to view the bladder and the urethra. This instrument is a specialized type of endoscope, and is made up of a thin tube with a light and camera attached for maximum viewing. The cystourethroscope allows the surgeon to diagnose problems during a cystourethroscopy, as well as take therapeutic measures such as performing biopsies using tiny surgical instruments that are passed through the tube. The endoscope is quickly assembled and able to have other instruments and accessories attached to it as well. It is able to view at a number of angles and can also be equipped with an attachment for teaching purposes.
The sheath of the instrument is made of metal and has fiber optic telescope attachments to allow a viewing angle of zero to 170 degrees. The telescopes are interchangeable to allow full viewing of the bladder wall for the presence of ulcers, tumors or diverticula, which are small abnormal pouches that form in the weak part of the wall. Lenses with a zero to 30 degree visibility are used for scoping the urethra, and the 70 degree lens is used to view the bladder walls. The diagnostic tests and operation of the cystourethroscope are usually performed by a urologist. This is a highly specialized field and can take extensive training over many years.
The patient is typically asked to urinate prior to the examination and the scope is then lubricated and inserted into the urethra and on into the bladder. Some patients report slight discomfort when the instrument is inserted and fluids are injected, which allows the urologist to scope the entire bladder with ease. A cystourethroscope also has the ability to irrigate, collect urine samples, and catheterize patients. This involves inserting a catheter, or hollow tube, into the patient to allow fluids to be released. Cystourethroscopy can take anywhere from 10 to 40 minutes to complete, and is also employed to check for blood in the urine, urinary tract infection or injury, bladder or kidney stones and signs of an enlarged prostate.
Cystourethroscopy can be performed with a rigid scope as well as a flexible tool, which is attached to the viewing scope. The difference is in the insertion method. The rigid scope requires the patient to lie on their back on a tilted table with their legs up and slightly apart. This is known as the lithotomy position. This position is not required when the flexible scope is used.