Cystoscopy

Question 1

Patients with bladder tumors presenting for
cystoscopy frequently have what preexisting health
problems?

Answer 1

CHF, CAD, COPD, PVD, cerebrovascular disease, and/or renal
impairment
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 881.

Question 2

List common preoperative diagnoses in patients

presenting for cystoscopy.

Answer 2

Benign prostatic hypertrophy; hematuria; cancer of the urethra,
ureter, prostate, renal pelvis and bladder, hydronephrosis,
strictures; urinary tract stones, interstitial or hemorrhagic
cystitis; ureteropelvic junction obstruction.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 878.

Question 3

How is a patient positioned for a cystoscopy?

Answer 3

Lithotomy position
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 878.

Question 4

List complications of cystoscopy.

Answer 4

Fever/bacteremia, bladder perforation, and peroneal nerve
injury due to lithotomy position
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 882.

Question 5

When regional anesthesia is used for cystoscopy,
what level of block is desired for urethral
procedures? Ureteral procedures?

Answer 5

T9-T10 for urethral procedures, T8 for procedures involving the
ureters.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 881.

Question 6

How might a bladder perforation present in an

anesthetized patient?

Answer 6

Tachycardia, HTN, and in some cases, decreased BP
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 886.

Question 7

How might a bladder perforation manifest in an

awake patient?

Answer 7

Complaints of shoulder pain
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 886.

Question 8

Patients with what disorders often present for

repeated cystoscopies due to nephrolithiasis?

Answer 8

Paraplegics and quadriplegics
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 881.