Cystoscopy for the gynaecologist – how to do a cystoscopy TOG 2017

Question 1

Indications for cystoscopy

Answer 1

Visible/unexplain haematruia without UTI >45yrs
Visible haematuria + raised WCC >60yrs
Dysuria + unexplained, non visible haemturia >60
Recurrent UTI
Bladder pain syndrome
Voiding symptoms
Vesicovaginal or colovesivle fistulae
Urethral stricture
Congenital genital tract abnormality

Question 2

Cystosocopy is used in parts of which operations

Answer 2

Mid urethral sling/colposuspension
IV botox
Staging gynae cancer

Question 3

Contraindication to cystoscopy

Answer 3

Untreated UTI

Question 4

Risks cystoscopy

Answer 4

> 1/10 - mild pain/bleeding after passing urine
Occasional risks
1/10-1/50 - Infection
Rare <1/50 - temporary insertion catheter, delayed bleeding requiring removal of clots or further surgery, injury to urethra, perforation of bladder

Question 5

Do women require Abx for cystoscopy

Answer 5

Rigid - yes IV gent at anaesthesia
Flexible - only in selective cases, botox/recurrent UTI/mechanical heart valves within 6 months

Question 6

Anaesthesia for rigid and flexible cystoscopy

Answer 6

Rigid - spinal/GA
Flexible - local