Transcript Transrectal Ultrasound and Prostate Biopsy

Cystoscopy
Cystoscopy and Stent Removal
Cystoscopy and Biopsy
PATIENT INSTRUCTIONS and
CONSENT FORM
Appointment
You Have Been Scheduled For A Cystoscopy
__________________________at _________________________a.m/p.m.
In our office located at
[ ] Avon, 120 Simsbury Road
[ ] Farmington: 399 Farmington Ave.
[ ] Glastonbury: 330 Western Blvd.
[ ] Meriden: 455 Lewis Ave.
[ ] Hartford: 85 Seymour Street, Suite 416
[ ] Enfield: 100 Hazard Avenue
Let’s Get You Ready
First: The Terminology

Cystoscopy: A Procedure For Viewing The
Urethra And Entire Interior Of The Bladder
 Cystoscope: The Telescope And Tube Inserted
Into The Bladder
 Stent: A Small Tube Inserted Into The Ureter
(Tube Connecting The Bladder With The Kidney)
 Biopsy: The Term Used To Clip A Small Piece
Of Tissue For Pathological Analysis
The Goal of A Cystoscopy


To Determine The Health Of The Urethra, And Bladder
 Blood In Urine, Frequent Urinary Tract Infections
 Bladder Stones
 Cystitis (Bladder Inflammation)
 Suspicious Tissues
• Biopsy Suspicious Tissues For Pathological
Analysis
To Remove A Previously Inserted Stent
Cystoscopy
3 Different Procedures
 Cystoscopy

Viewing of the Bladder Only
 Cystoscopy



with Biopsy
Viewing of the Bladder
Biopsy of Suspicious Tissues
 Cystoscopy

Procedure
with Stent Removal
Viewing of the Bladder
Removal of the Stent
Cystoscopy: Male
Cystoscopy: Female
Purpose of a Cystoscopy
Assist In Obtaining Biopsies (“Bx”)
 Targeting Of Suspicious Areas
 Guidance For Systematic Biopsies
 Collect A Urine Sample From The Bladder
 Remove A Previously Inserted Stent
 Treat Certain Bladder Conditions

Cystoscopy Procedure

Using A Small Flexible Cystoscope With A
Light




Local Anesthetic With Lubricant Is Used For Ease
Of Entry Into Urethra
Inserted Up To The Bladder
Water Or Saline Infused Into Bladder
Physician Looks Through Telescope For
Abnormalities
•
•

May Biopsy Suspicious Tissues
May Remove A Previously Inserted Stent
Total Time: 10 Minutes
Tissue and Cell Analysis
 Tissues
from Biopsies and Cells in
the Urine are sent for Pathological
Analysis

To Determine:
• Inflammation
• Cancerous Tissues
• Cancerous Cells

Type and Categorization
Preparation for Cystoscopy



Let Your Urologist Know The Medications You Take
• Blood Thinner Medicines: Coumadin, Plavix, Aspirin
• Over-the-counter
• Vitamin E
• Glucosamine
Let Your Urologist Know
• If You Are Allergic To Local Anesthesia
 Novocaine
 Xylocaine
Let Your Urologist Know If You Are Allergic To
• Latex Or Iodine Type Compounds
Preparation
The Day of the Cystoscopy

You May Drive Before And After The Procedure
 Empty Your Bladder Just Before The Procedure
 Total Time Of Procedure Is 10 Minutes
 Complete Consent Form Upon Arrival
How is the Cystoscopy is Done
 Office

Procedure
You May Drive Yourself To The Appointment
 Local Anesthesia
(Lidocaine) Desensitizes
The Urethra. Time 5 Minutes
 Actual Cystoscopy: 3-4 Minutes
 Removal of Stent or Biopsy. 1-2 minutes
 Time From Beginning To End Is About 10
Minutes
What to Expect During the
Cystoscopy
 Mild Abdominal
Discomfort
 Strong Sense Of Urgency To Void
 If A Biopsy Is Taken, A Momentary Twinge

Then A Slight Burn Sensation If The Site Of
The Biopsy Is Cauterized
 If A Stent

Is Removed,
A Momentary Feeling Near The Kidney. It
Normally Takes 1-2 Seconds To Remove The
Stent.
How Painful Will The Procedure
Be?
 The
Procedure Will Be Uncomfortable
 Pain Will Be Minimal


Lubricant With Anesthetic Is Used To
Desensitize The Urethra
The Vast Majority Of Patients Can Tolerate
This In An Office Setting And Thereby
Avoid Hospitalization
• Anxiety Heightens The Pain Response
What To Expect After the
Cystoscopy
 Blood

In The Urine
Typically Resolves Within 8-12 Hours
• More Frequent In Men Than Women
 Burning
Sensation During Urination
 More Frequent Urination During The Next
Day Or Two
Blood In Urine – What to Look For



Look At Your Urine In A Clear Glass If
You Are Worried About The Amount Of
Blood You See.
Red, But Clear = Ok (Like Diluted Red
Punch)
 This Is Expected
 Drink More Water
Thick And Dark Red = Too Bloody
 Rest And Drink More Water
What to Call Us About
Complications

Cystoscopy Carries Rare Risk Of Complications
 There Is A 1% Chance Of An Infection
 Less Than 1% Chance Of More Serious
Bleeding
 Men With Large Prostates May Develop Urine
Retention And Require Catheters To Drain
The Urine
 Cystoscopy May Not Be Performed On Men
With Narrowing Of The Urethra (Urethral
Stricture)
Please Call
 Fever
Higher Than 100 Degrees
 Dark, Thick Red Urine That Does Not
Clear With Increased Fluid Intake And
Rest
 Pain Of Burning During Urination That
Last More Than Two Days
Bladder and Urine Tissue
Pathology Results



Typically, Results Are Back Within 10 Working
Days.
 Special Staining And Second Reviews May
Take Longer.
Your Results Will Be Given To You By Phone
If You Have Not Heard From Our Office Within
10-14 Days, Please Call
Consent Form


Please Thoroughly Read The Consent Form
It Explains In More Detail The Cystoscopy
Procedure
 Ask Yourself:



Are You Comfortable With Knowing About The
Procedure?
Have All Your Questions Been Answered?
When Complete, Please Sign The Consent
Form Indicating You Have Read And Understand
The Procedure. Bring It With You To Your
Appointment
Billing

Your Insurance Will Be Billed For:


The Procedure by Hartford Clinical Associates
A Laboratory Will Bill For The Pathological Analysis.
• A Reference Laboratory May Bill For The Technical
Preparation Of The Slides For The Pathologist.

Number of Bills You May Receive
• Hartford Clinical Associates for the Procedure
• A Pathologist Group for the Pathological Analysis
• Another Laboratory for the Technical Preparation of Slides