429 results on '"Flexible cystoscopy"'
Search Results
152. Air insufflation versus water irrigation during flexible cystoscopy: a prospective randomized study.
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RANA, A., RASHWAN, H.M., STOW, J. WEST OF, NG, P.E.P., and CHISHOLM, G.D.
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- 1994
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153. Ureteric stenting with magnetic retrieval: an alternative to traditional methods
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Usman M Haroon, Ijaz A. Cheema, John A O'Kelly, Kieran J. Breen, Abdul J Rauf, James C. Forde, Barry B McGuire, and Liza McLornan
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Male ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Flexible cystoscopy ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Ureteroscopy ,Ureteric stent ,Device Removal ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Magnetic Phenomena ,Significant difference ,Stent ,General Medicine ,equipment and supplies ,Surgery ,surgical procedures, operative ,Cost analysis ,Female ,Stents ,Ureter ,business ,Complication - Abstract
Ureteric stents are frequently placed following endo-urological procedures. These stents cause significant morbidity for patients. Standard ureteric stents are removed by flexible cystoscopy. This procedure can be unpleasant for patients and requires additional resources. A newly designed magnetic stent allows removal in an outpatient setting. The aim of our study is to compare the magnetic stent and standard ureteric stents with regard to morbidity, pain on stent removal and cost-effectiveness. This study was carried out across two sites between September 2016 and July 2017. In site A, a magnetic stent (Urotech, Black-Star®) is removed by magnetic retrieval device. Fifty consecutive patients completed the validated Ureteric Stent Symptom Questionnaire (USSQ) and visual analogue scale (VAS) at the time of stent removal. On site B, a soft polyurethane stent (Cook Universa) was removed by flexible cystoscopy. Fifty patients were identified retrospectively and completed questionnaires by post. Cost analysis was also performed. One hundred questionnaires were included for analysis. No significant difference in stent morbidity as assessed by the USSQ was shown between both groups. Median duration of stenting was significantly shorter in the magnetic stent group (5.5 versus 21.5 days, p more...
- Published
- 2018
154. Developing a new one-stop urology diagnostics service
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Sarah Hillery
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Service (business) ,Urologic Diseases ,medicine.medical_specialty ,business.industry ,Single visit ,Urology ,030232 urology & nephrology ,Urodynamic studies ,Diagnostic Techniques, Urological ,Flexible cystoscopy ,030230 surgery ,Nursing Staff, Hospital ,Ultrasound prostate ,United Kingdom ,Unit (housing) ,03 medical and health sciences ,0302 clinical medicine ,Treatment plan ,Health care ,Medicine ,Humans ,business ,Hospital Units ,General Nursing - Abstract
A newly built NHS ‘one-stop’ urology diagnostics unit has been created to provide a genuinely patient-centred experience for all new patients presenting with urological symptoms. Patients across the region now receive not only their initial specialist consultation, but also all diagnostic investigations and a treatment plan during a single visit to the unit. The purpose-built service has reduced the patient diagnostic pathway from several visits over many weeks to a matter of hours. The unit has facilities for urodynamic studies, ultrasound, flexible cystoscopy and trans-rectal ultrasound prostate biopsy in addition to full physiological measurement capabilities. Designing a new purpose-built unit in the current healthcare climate brought its own challenges as the project progressed. Having the right nursing team in place was essential, and this article describes the insights afforded in developing the project. more...
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- 2018
155. Recurrent Urinary Tract Infections in Women: What Is the Evidence for Investigating with Flexible Cystoscopy, Imaging and Urodynamics?
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Angela Ng, Nicola Santoni, Rachel Skews, and Omar M. Aboumarzouk
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Pediatrics ,medicine.medical_specialty ,Urinary system ,Urology ,030232 urology & nephrology ,MEDLINE ,Disease ,Flexible cystoscopy ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Risk Factors ,medicine ,Outpatient clinic ,Humans ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Cystoscopy ,Urodynamics ,Upper tract ,Urinary Tract Infections ,Gynaecological problems ,Female ,business - Abstract
Background/Aims/Objectives: Women with recurrent urinary tract infections (UTIs) are commonly referred to urology outpatient clinics. However, there is no clear consensus in existing guidelines as to if, or how, these should be investigated. The primary outcome was to evaluate all available literature to determine the percentage of abnormal findings in non-pregnant women with recurrent simple UTIs. Secondary outcomes were to determine the percentage that were serious, consequential or incidental findings. Methods: A full literature search was performed of the following databases: MEDLINE; Pubmed; Cochrane Central Register of Controlled Trials-CENTRAL; and ClinicalTrials.gov. Two assessors reviewed the articles independently. Any discrepancy was discussed and an agreement reached. Results: The literature search yielded 662 titles; 652 were excluded on initial review. A further 13 studies were gathered from references of yielded papers. After full review, 12 were included for analysis. These showed that < 1.5% of women investigated for recurrent simple UTIs with imaging or flexible cystoscopy had life-threatening pathology, but up to 67% had abnormal urodynamics. Conclusions: Women presenting with simple recurrent UTIs should have a flow rate and post-void residual measured. Cystoscopy is not warranted and imaging is unlikely to be of value in the absence of symptoms of upper tract disease or gynaecological problems. more...
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- 2018
156. PD13-06 PATIENT SATISFACTION WITH TELECYSTOSCOPY: USE OF REMOTE VIDEO TECHNOLOGY FOR BEDSIDE FLEXIBLE CYSTOSCOPY
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Adam J. Folbe, Alexander D. Tapper, Frank Burks, Jay B. Hollander, and Harjivan Kohli
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medicine.medical_specialty ,Patient satisfaction ,business.industry ,Urology ,Medicine ,Medical physics ,Video technology ,Flexible cystoscopy ,business - Published
- 2018
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157. Is Antibacterial Therapy Warranted before Outpatient Flexible Cystoscopy for Bladder Tumor Surveillance?
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Harry W. Herr
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medicine.medical_specialty ,Antibacterial therapy ,medicine.diagnostic_test ,business.industry ,Urology ,Bladder tumor ,Medicine ,Flexible cystoscopy ,Cystoscopy ,business - Published
- 2019
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158. Investigation of uncomplicated recurrent urinary tract infections in women
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SR Parsons, NC Cornish, B Martin, and SD Evans
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Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Ultrasound scan ,Urinary system ,030232 urology & nephrology ,Flexible cystoscopy ,Cystoscopy ,Post void residual ,Surgery ,Secondary care ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,business - Abstract
Background: Recurrent urinary tract infections (UTIs) in women are common despite anatomically normal urinary tracts and are frequently referred to secondary care for further assessment. Patients and methods: Clinic letters and pathology reports of 244 women referred to our centre over a 2-year period with uncomplicated recurrent UTIs were reviewed to determine the investigations they underwent in both primary and secondary care. Results: A significant proportion of women do not meet the criteria for recurrent UTIs as their infections are not proven on culture. The majority of women undergo both renal tract ultrasound scan (USS) and flexible cystoscopy. Though USS was found to demonstrate relevant pathology, flexible cystoscopy, however, did not reveal any relevant pathology. Conclusion: Investigation of women with recurrent uncomplicated UTIs should be done with adequate cultures and renal tract USS. more...
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- 2016
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159. Flexible cystoscopy can be performed by nurses - An eight day post procedure questionnaire measuring pain and symptoms, in male out-patients after flexible cystoscopy
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Tom Christensen, Elisabeth Arndal, Eva Rye Rasmussen, and Mille Folker
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,Post-Procedure ,medicine ,Urology ,General Medicine ,Cystoscopy ,Flexible cystoscopy ,business ,Out patients - Published
- 2015
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160. Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way
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Zhensheng Zhang, Zhi Cao, Chao Zhang, Chuanliang Xu, Shuxiong Zeng, Liang Tang, Xiao-lin Wang, and Yinghao Sun
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Adult ,Male ,medicine.medical_specialty ,Lidocaine ,Visual analogue scale ,Urology ,medicine.medical_treatment ,Pain ,Flexible cystoscopy ,Sodium Chloride ,law.invention ,Young Adult ,Randomized controlled trial ,law ,Pressure ,medicine ,Humans ,Pain Management ,Local anesthesia ,Anesthetics, Local ,Therapeutic Irrigation ,Saline ,Aged ,Pain Measurement ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Cystoscopy ,Middle Aged ,Surgery ,Male patient ,Anesthesia ,business ,Gels ,medicine.drug - Abstract
To evaluate the impact of increasing irrigation pressure when performing flexible cystoscopy for male patients on visual analog scale pain scores.A total of 168 male patients admitted to our clinic for flexile cystoscopy by the same urologist between March 2011 and December 2012 were randomized to three equal groups, each of which had 56 patients. Different irrigation pressures were easily achieved by adjusting the height of irrigation solution bag (1000 mL of 0.9% saline). The height difference between the bag and the bed (for cystoscopy) of group 1, 2, and 3 was 80, 100, and 150 cm, respectively. All patients received 10 mL lidocaine gel for 3 minutes for local anesthesia before flexible cystoscopy. Patients' pain feeling was recorded on a visual analog scale (VAS) ranging from 0 to 10 after the cystoscopy. The duration of the procedure for each patient was also recorded.The mean pain score on VAS was 2.95±1.31, 2.48±1.26, and 1.66±1.00 in group 1, 2, and 3, respectively. Compared to group 1 and 2, the mean pain score was significantly lower in group 3 (p0.001, Mann-Whitney U-test), and the mean pain score in group 2 was statistically significantly lower than that in group 1 (p=0.045, Mann-Whitney U-test). Patients who were with high irrigation pressure experienced less discomfort at cystoscopy. Patient age and duration of the procedure for each group were comparable.Achieving higher irrigation pressure for flexible cystoscopy by adjusting the height of irrigation solution bag improves male patients' comfort. It is recommended for male patients. more...
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- 2015
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161. Can routine outpatient follow-up of patients with bladder cancer be improved? : A multicenter prospective observational assessment of blue light flexible cystoscopy and fulguration
- Author
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Zare, Reza, Grabe, Magnus, Hermann, Gregers G., Malmström, Per-Uno, Zare, Reza, Grabe, Magnus, Hermann, Gregers G., and Malmström, Per-Uno
- Abstract
Background: The aim of this prospective cohort study was to determine the feasibility of incorporating blue light flexible cystoscopy (BLFC) and biopsy/fulguration into routine outpatient follow-up of non-muscle invasive bladder cancer patients. Methods: The study included patients with non-muscle-invasive bladder cancer (NMIBC) who were scheduled for routine follow-up. Hexaminolevulinate was instilled in the outpatient department, and the bladder was examined under white light and then with BLFC. Biopsies were taken from all suspicious lesions. Small tumors and suspicious lesions were fulgurated on site; patients with larger lesions were referred to the operating room for resection. Results: The study included 69 patients, with a mean age of 70 years (range 33 -89 years) and a mean duration since NMIBC diagnosis of 8 years. Most patients had high-grade cancer at initial diagnosis (52/69) and were at high risk of recurrence (48/69). Two patients per hour could be assessed using outpatient BLFC. Preparation and instillation of hexaminolevulinate took less than 10 minutes per patient, and patients had an additional waiting time of 45 60 minutes following instillation, while the hexaminolevulinate solution was retained in the bladder before examination. Eleven patients had histologically confirmed tumors that were identified using both white light flexible cystoscopy and BLFC. An additional three patients had tumors that were identified by BLFC only: two with Ta tumors and one with carcinoma in situ. Of the 14 patients with confirmed tumors, 11 could be managed on site with fulguration, whereas three were referred to the operating room. No adverse events attributable to BLFC were reported. Conclusion: Routine outpatient management of patients with NMIBC using BLFC and onsite biopsy/fulguration is feasible, despite the additional time required for hexaminolevulinate instillation, and appears to allow early detection of recurrent lesions, which can be fulgurated without more...
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- 2018
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162. AB066. The diagnostic value of narrow-band imaging for flat bladder lesions
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Chuanliang Xu, Weidong Xu, Yifan Chang, Meimian Hua, Aiguo Wang, Zhensheng Zhang, Maoyu Wang, and Yinghao Sun
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Physics ,Nuclear magnetic resonance ,Narrow-band imaging ,Reproductive Medicine ,Urology ,Bladder tumors ,flat bladder lesions ,urologic and male genital diseases ,Value (mathematics) ,female genital diseases and pregnancy complications ,Printed Abstract ,flexible cystoscopy ,narrow-band imaging - Abstract
Background To investigate the diagnostic value of narrow-band imaging for flat bladder lesions. Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included. The diagnostic value of narrow-band imaging was compared with postoperative pathological results. Results A total of 59 flat lesions were identified, in which 8 were normal urothelium, 3 were chronic inflammation, 1 was papillary urothelial neoplasm of low malignant potential, 2 were mild dysplasia, 1 was moderate dysplasia, 1 was severe dysplasia, 3 were carcinoma in situ, 16 were low-grade papillary urothelial carcinoma, 16 were high-grade papillary urothelial carcinoma, and 8 were invasive papillary urothelial carcinoma. For narrow-band imaging, the sensitivity was 86.7% (39/45), specificity was 57.1% (8/14), diagnostic accuracy was 79.7% (47/59), false-positive rate was 42.9% (6/14), positive predictive value was 86.7% (39/45), negative predictive value was 57.1% (8/14), area under receiver operating characteristic (ROC) curve was 0.719. Among these lesions, the sensitivity and specificity for postoperative recurrent lesions were 100% (3/3) and 40% (2/5), respectively, and those for erythematous patch-like lesions were 90% (9/10) and 100% (4/4), respectively. Conclusions Narrow-band imaging can improve the detection rate for flat bladder tumor lesions, and reduce the risk for missed diagnosis under white light cystoscopy, especially for otherwise indistinguishable erythematous patch-like lesions. more...
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- 2018
163. Surveillance of the Upper Tract After Conservative Treatment
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Majid Eshghi and Joel Hillelsohn
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,Upper endoscopy ,Flexible cystoscopy ,Cystoscopies ,Conservative treatment ,Upper tract ,medicine ,Ureteroscopy ,business ,Endoscopic treatment ,Urothelial carcinoma - Abstract
Surveillance is essential following endoscopic treatment for upper tract urothelial carcinoma. However unlike lower tract disease, surveillance cannot be performed in an outpatient basis. It is therefore critical to have a multidisciplinary approach to ensure follow-up. Conservative treatment which involves multiple invasive procedures can be cumbersome, for the patient and constant physician–patient dialogue must be maintained. We will outline the optimal approach in explaining to a patient and their families, what surveillance entails. Our surveillance protocol involves flexible cystoscopy, CT or MR urogram, and upper endoscopy in first 3 months. This is followed by repeat ureteroscopy, cytologies, cystoscopies, and imaging in 3–6 month intervals. more...
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- 2018
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164. Outpatient photodynamic-guided diagnosis of carcinoma in situ with flexible cystoscopy: an alternative to conventional inpatient photodynamic-guided bladder biopsies in the operating theatre?
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Thomas H. Scheike, Birgitte Grønkær Toft, Anders Glenthøj, Karin Mogensen, and Gregers G. Hermann
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Image-Guided Biopsy ,medicine.medical_specialty ,Biopsy ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Photodynamic diagnosis ,Pain ,Flexible cystoscopy ,Anesthesia, General ,Fluorescence ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Ambulatory Care ,Humans ,General anaesthesia ,Prospective Studies ,Aged ,CIS ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Carcinoma in situ ,Cystoscopy ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Resectoscopes ,Urinary Bladder Neoplasms ,Nephrology ,030220 oncology & carcinogenesis ,outpatient ,business ,Carcinoma in Situ ,photodynamic diagnosis - Abstract
Objective: The aim of this prospective open comparative study was to establish whether conventional photodynamic-guided bladder biopsies using general anaesthesia and rigid resectoscopes (inpatient) can be replaced with less traumatic flexible cystoscopy in non-sedated patients (outpatient), without compromising the diagnosis of carcinoma in situ (CIS). Materials and methods: Thirty-one patients were included. After BCG instillation for CIS, bladder biopsies were obtained using photodynamic-guided flexible cystoscopy. Two weeks later, patients underwent the conventional inpatient procedure. An external pathologist reviewed the biopsy samples. Pain and quality of life (QoL) symptom score were recorded. Results: Post-BCG biopsies showed only CIS in 10 patients; high-grade Ta or T1 tumour in three patients, who were referred for cystectomy; and normal or low-grade tumour tissue in 18 patients. There was a high agreement of identification of high-grade disease in biopsies and cytology using the two methods (κ = 0.93, 95% confidence interval 0.8–1.0). The outpatient procedure identified four high-grade patients diagnosed as ‘normal/low-grade’ in the inpatient procedure. The opposite was observed in two patients. Quality of biopsies did not differ between the two procedures. Pain scores for outpatients were low, and median QoL symptom score was significantly lower than for inpatients (24 vs 33, p = 0.02). Hospital length of stay was significantly longer for inpatients. Conclusions: Outpatient photodynamic-guided flexible cystoscopy is less traumatic than the conventional inpatient procedure in the diagnosis of CIS. It is safe and cost-effective, and may be an alternative to conventional inpatient biopsy procedures in patients with malignant urine cytology and normal white-light cystoscopy. more...
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- 2017
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165. PPTLBA-02 BLUE LIGHT FLEXIBLE CYSTOSCOPY (BLFC) WITH HEXAMINOLEVULINATE (HAL) AND WHITE LIGHT FLEXIBLE CYSTOSCOPY: A PROSPECTIVE, COMPARATIVE, WITHIN-PATIENT CONTROLLED MULTI-CENTER PHASE 3 STUDY IN THE DETECTION OF BLADDER CANCER DURING SURVEILLANCE
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Kamal S. Pohar, Sanjay Patel, Tracy M. Downs, Michael A. O’Donnell, Edouard J. Trabulsi, Matthew J. Resnick, William J.S. Huang, Yair Lotan, Badrinath R. Konety, Trinity J. Bivalacqua, Jennifer M. Taylor, Mark P. Schoenberg, Stephen E. Jones, Ashish M. Kamat, Siamak Daneshmand, Michael Woods, Gary D. Steinberg, and Joel DeCastro more...
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medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,030232 urology & nephrology ,Phases of clinical research ,Flexible cystoscopy ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Hexaminolevulinate ,medicine ,White light ,Radiology ,business ,Blue light - Published
- 2017
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166. Psychological distress in out-patients undergoing flexible cystoscopy for the investigation of bladder cancer
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S Pridgeon, Ellis G, NS Awsare, Thomas McNicholas, Jsa Green, S Osaghae, Benjamin W. Lamb, and Samuel G. Smith
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Funding Agency ,medicine.medical_specialty ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Urology ,General surgery ,Cancer ,Psychological distress ,Flexible cystoscopy ,Cystoscopy ,medicine.disease ,Out patients ,Surgery ,medicine ,Anxiety ,medicine.symptom ,business - Abstract
Objectives: Flexible cystoscopy can cause patients significant psychological distress, especially when utilised in the diagnostic pathway for suspected bladder cancer. We aimed to assess the prevalence of general anxiety and depression, as well as procedure-related worry and pain in patients undergoing local anaesthetic flexible cystoscopy and to determine whether these conditions occur more frequently in subsets of the population. Patients and methods: Patients referred for flexible cystoscopy were invited to participate. Patients were asked to complete a questionnaire containing the Hospital Anxiety and Depression Scale (HADS), a worry score and a question regarding the most stressful event in the diagnostic pathway. Following the procedure patients were also asked to complete a pain score. Results: A total of 175 patients participated in the study. The prevalence of significant anxiety was 15% and depression 3.5%. This was higher in younger, female and unmarried patients. Procedure-related worry and pain were generally low. Conclusions: We found the prevalence of anxiety and depression in patients undergoing flexible cystoscopy to be raised compared to a similar cohort of patients undergoing TRUS-guided prostate biopsy. We have identified subgroups more likely to experience these symptoms and have also identified the sections of the diagnostic pathway that are most likely to cause anxiety and depression. By doing this we can target those patients who are more likely to suffer during the diagnostic process and aim to improve their experience. We can also implement targeted changes to the pathway to reduce the impact it may have on patients’ mental health. more...
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- 2014
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167. Outpatient rigid cystoscopy: Is it acceptable to women?
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Sambita Basak, Helen Johnson, and Ashish Pradhan
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medicine.medical_specialty ,Rigid cystoscopy ,Patient satisfaction ,Outpatient procedure ,business.industry ,Urology ,Patient experience ,medicine ,Surgery ,General anaesthesia ,Flexible cystoscopy ,business - Abstract
Objective: Flexible cystoscopy is commonly performed as an outpatient procedure whereas rigid cystoscopy is performed under general anaesthesia by urogynaecologists because of a perception that it is painful. The aim of this study is to assess women’s experience of outpatient cystoscopy (OC) with rigid cystoscope. Materials and methods: The first 56 women who attended our newly established OC service with rigid cystoscope were recruited prospectively for the study. They were requested to complete a questionnaire (with visual analogue scale) based on their expectations prior to the procedure. A post-procedure questionnaire was given to quantify their experience after the OC. Two patients were excluded from the study as they did not complete the questionnaire appropriately. Wilcoxon signed ranks test was used to compare the scores for comfort, pain and anxiety in the pre- and post-procedure questionnaires. Results: A total of 52/54 patients (96.3%) were fully satisfied at the end of the procedure as indicated in their visual analogue scale score of 10/10. Most patients found the procedure more comfortable and less painful than expected. There were no post-operative complications. Conclusion: OC with a rigid cystoscope is a well-tolerated, safe, cost-effective ambulatory service resulting in good patient experience. more...
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- 2014
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168. Recurrent UTIs in women: What is the evidence for investigating with flexible cystoscopy, imaging and urodynamics?
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Omar M. Aboumarzouk, F. Rodger, N. Santoni, and A. Ng
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medicine.medical_specialty ,business.industry ,medicine ,Surgery ,General Medicine ,Flexible cystoscopy ,Radiology ,business - Published
- 2018
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169. Does postal consent for flexible cystoscopy work?
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L. Yap, B. Creavin, D.P. McNicholas, L. McLornan, and B. Barea
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medicine.medical_specialty ,Work (electrical) ,business.industry ,Medicine ,Surgery ,Medical physics ,General Medicine ,Flexible cystoscopy ,business - Published
- 2018
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170. Long term outcomes of re-do urethroplasty: Outcome evaluation through flexible cystoscopy
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Nadir I. Osman, Marta Barretta, Christopher R. Chapple, Joon Jae Park, Richard D. Inman, and Francesco Esperto
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medicine.medical_specialty ,business.industry ,Urology ,General surgery ,Urethroplasty ,medicine.medical_treatment ,Long term outcomes ,Medicine ,Flexible cystoscopy ,business ,Outcome (game theory) - Published
- 2018
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171. Pain Reduction and Mood Improvement Using Supplementary Music Therapy Intervention During Flexible Cystoscopy under Local Anesthesia: A Prospective, Single-Blinded, Randomized Controlled Study
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Wan Zain Wan Zainira and Ilias Aizat Sabri
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medicine.medical_specialty ,Music therapy ,business.industry ,Flexible cystoscopy ,law.invention ,Mood ,Pain reduction ,Randomized controlled trial ,law ,Intervention (counseling) ,Physical therapy ,Medicine ,Surgery ,Local anesthesia ,business - Published
- 2019
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172. Diffuse melanosis cutis
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Sibel Demirel and Bruce Sizer
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medicine.medical_specialty ,business.industry ,Skin hyperpigmentation ,Bladder tumour ,Cutis ,Medicine ,General Medicine ,Flexible cystoscopy ,business ,Dermatology ,Resection ,Dark urine ,Diffuse Melanosis - Abstract
A 64 year old white man underwent flexible cystoscopy after reporting a three month history of progressive skin hyperpigmentation (figure) and passing dark urine. His history included resection of a papillary bladder tumour and complete excision … more...
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- 2019
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173. The Psychological Impact of Flexible Cystoscopy
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N. Hegarty, S. Mulhern, S. O’Meara, K.J. O’Malley, S. Connolly, and D. Galvin
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Medical physics ,Flexible cystoscopy ,business - Published
- 2019
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174. Assessment of acute male urethral catheterisation problems in a tertiary centre and usefulness of a new catheterisation protocol using portable flexible cystoscopy with disposable sterile sheets
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S. Zubillaga Guerrero, J.L. Gutiérrez Baños, E. Alonso Mediavilla, E. Herrero Blanco, M.A. Correas Gómez, Felix Campos-Juanatey, E. Fernández Guzmán, P. Calleja Hermosa, J.A. Portillo Martín, and R. Varea Malo more...
- Subjects
Protocol (science) ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Flexible cystoscopy ,Urethral catheterisation ,business ,Surgery - Published
- 2019
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175. Impact of patient’s real-time visualization of flexible cystoscopy finding on pain in a randomized controlled trial
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T. Prachapinyo, P. Prasanchaimontri, and S. Tritipwanit
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Real time visualization ,medicine.medical_specialty ,Randomized controlled trial ,business.industry ,law ,Urology ,medicine ,Medical physics ,Flexible cystoscopy ,business ,law.invention - Published
- 2019
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176. When Does It Hurt? Pain during Flexible Cystoscopy in Men.
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Taghizadeh, A. K., El Madani, A., Gard, P. R., Li, C.-Y., Thomas, P. J., and Denyer, S. P.
- Subjects
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PAIN , *CYSTOSCOPY , *PATIENTS , *URETHRA , *LIDOCAINE - Abstract
Introduction: In this observational study, pain was measured continuously in men undergoing flexible cystoscopy, in order to help to identify which parts of the procedure were the most painful. Patients and Methods: Men who were to undergo flexible cystoscopy were recruited. Pain was measured continuously throughout flexible cystoscopy by asking the subject to squeeze a pressure-sensing rubber bulb in proportion to the amount of discomfort experienced giving a score of 0–10. Results: The most painful part of the procedure was as the cystoscope passed through the membranous urethra with a median pain score of 2.82. The initial lidocaine administration gives a median pain score of 0.84. The other parts of the cystoscopy produced median scores of between 0.14 and 0.33. The difference in the pain scores was significant (p = 0.03). There was no statistically significant difference in the pain scores between those who were having their first cystoscopy and those who were having repeat cystoscopy. The subjects’ age did not influence the degree of pain experienced. Conclusion: This study gives further understanding of how pain is experienced during flexible cystoscopy. It may help explain why previous studies have not reached a clear consensus on the value of lidocaine during flexible cystoscopy. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] more...
- Published
- 2006
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177. Do We Need to Perform Cystoscopy on All Adults Attending Urology Centres as Outpatients?
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Kumar, V., Patel, H. R., Nathan, S. M., Miller, R. A., and Lawson, A. H.
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CYSTOSCOPY , *ENDOSCOPY , *BLADDER examination , *UROLOGY , *MEDICINE - Abstract
Introduction: There has been considerable expansion in the use of flexible cystoscopy (FC) and people who can perform the procedure. Hence, there is a criticism that this procedure is being overused with no management benefit. Materials and Methods: We audited the use of FC in a district hospital for a period of 1 year. The results of FC for non-standard indications (other than haematuria and check cystoscopy) were analysed for their diagnostic yield. Results: Of the 1,390 FCs performed, 295 were done for non-standard indications. 46.14% of these cystoscopies had positive findings. Cancer detection rate was 6.10%. Cystoscopy altered the management in 14.08% of patients and was supportive to diagnosis and management in 32.06%. Conclusion: This procedure is certainly not overused and the ever-increasing requirement of this simple procedure has serious resource implications for the National Health Service. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] more...
- Published
- 2004
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178. Validation of a flexible cystoscopy course.
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Shah, J., Montgomery, B., Langley, S., and Darzi, A.
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CYSTOSCOPY , *NURSE practitioners , *VIRTUAL reality in medicine , *TRAINING - Abstract
Objective To examine the instructional effectiveness of a course for nurses wishing to learn flexible cystoscopy, using a virtual reality flexible cystoscopy simulator to measure the outcome. Subjects and methods Fourteen urology nurse practitioners with no previous experience of cystoscopy were taught the basic techniques of flexible cystoscopy. They then had supervised group instruction during which they practised flexible cystoscopy on an inanimate latex model, and were taught how to handle the cystoscope, followed by unsupervised practice, including use of the virtual reality (VR) simulator (URO Mentor, Simbionix, Israel). They then undertook a cystoscopy task on the simulator; within the bladder there were 10 flags (numbered 1–10) at key positions. By visualizing and photographing each of the flags the subject would have visualized the entire bladder mucosa. The number of flags seen was thus used as a measure of how much of the bladder mucosa was examined. The VR simulator also measured the total procedure time. After a day of training the subjects were reassessed and the changes in performance evaluated. Subjects were also asked their opinion of the use of VR for flexible cystoscopy. Results The median (range) time to complete the procedure before the course was 3.33 (2–5.5) min and the number of flags seen 7 (6–9). After the course, the median time decreased to 2.85 (1.5–4.42) min and the number of flags seen increased to 8 (6–9). The change in time was significant (P = 0.03) but the difference in the number of flags was not ( P = 0.12). All 14 subjects enjoyed the use of VR for learning flexible cystoscopy; they all reported that they were more confident in handling a flexible cystoscope and in undertaking flexible cystoscopy. Conclusion The virtual reality simulator was an effecctive tool for teaching flexible cystoscopy. [ABSTRACT FROM AUTHOR] more...
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- 2002
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179. The community-based morbidity of flexible cystoscopy.
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Burke, D.M., Shackley, D.C., and O'Reilly, P.H.
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CYSTOSCOPY , *URINARY tract infections , *ANTIBIOTICS - Abstract
Objective To evaluate patients' experience after flexible cystoscopy (FC), particularly concentrating on the prevalence and degree of symptoms, the frequency of visits to their General Practitioner (GP), subsequent antibiotic rates and the actual incidence of urinary tract infection (UTI). Patients and methods Consecutive patients (420) presenting for FC were audited prospectively. A pain score for the procedure was recorded immediately afterward (linear scale 0–10) and a self-administered questionnaire completed at 7 days, to assess the objective and subjective symptoms and their duration, and the incidence of GP visits and subsequent antibiotic provision noted. An interim analysis was conducted on the initial 274 datasets received. To estimate the incidence of FC-induced UTI, the final 110 patients were asked not to consult their GP but to present to the urology department at 3 days after FC (or the emergency department if clinically necessary). These patients had initially provided a mid-stream urine (MSU) sample before FC and were assessed symptomatically with a subsequent sample obtained if a urinary dipstick test 3-days after FC was abnormal. Results In all, 384 (91%) evaluable forms were returned. The median (range) pain score for FC was 1.1 (0–8.5), with seven patients (1.8%) recording a pain score of > 5 (all men); 382 patients (99.5%) declared they would be happy to undergo an identical procedure in the future if medically indicated. Pain on voiding was reported in 190 patients (50%), urinary frequency in 142 (37%) and gross haematuria in 73 (19%). Eighteen of the initial 274 patients (6.6%) visited their GP, with 15 (5.5%) of these receiving antibiotics. The MSU data from the final 110 patients showed a FC-mediated infection in three (2.7%). Conclusion Although FC is well tolerated, gross haematuria, urinary frequency and dysuria occur afterward much more frequently than expected. Patients should be thoroughly counselled before FC about... [ABSTRACT FROM AUTHOR] more...
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- 2002
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180. A new small-calibre diagnostic flexible cystoscope.
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Dryhurst, D.J. and Fowler, C.G.
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CYSTOSCOPY , *CYSTOSCOPES - Abstract
Objective To determine whether flexible cystoscopy with a prototype slim flexible instrument is less uncomfortable than flexible cystoscopy using a standard flexible cystoscope. Patients and methods In all, 200 men scheduled to undergo flexible cystoscopy for the follow-up of transitional cell carcinoma of the bladder were randomized in equal groups to flexible cystoscopy using the standard instrument or using the prototype slim-scope. Each patient had 11 mL of 2% lignocaine gel instilled intraurethrally 5 min before the procedure. At the end of the procedure the patient was asked to complete a 100-mm non-graphical visual analogue scale to rate how uncomfortable the procedure was. Results The slim-scope was very significantly less uncomfortable than the conventional instrument (anovaP < 0.001). The ease of use and views of the bladder were similar to those obtained with the conventional cystoscope. Conclusion The slim-scope offers a significant benefit in patient comfort, with little loss of image quality or ease of use. [ABSTRACT FROM AUTHOR] more...
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- 2002
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181. Nurse-led one stop hematuria clinic: Outcomes from 2,714 patients.
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Madaan A, Kuusk T, Hamdoon M, Elliott A, Pearce D, and Madaan S
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Objectives: Objective of this study is to report the results of nurse led hematuria clinic service outcome of 2,714 patients., Subjects and Methods: We conducted a retrospective, single center review of 2714 patients with visible and nonvisible hematuria managed by a well-trained nurse specialist in a rapid access clinic (RAC) between 2014 and 2020. All patients received a full review, flexible cystoscopy performed by a nurse, and ultrasound of urinary tracts. After investigations, patients were reassured and discharged or referred for rigid cystoscopy, TURBT, and CT urography., Results: In total, 2714 patients attended the RAC between October 2014 and March 2020. Of these, 1684 (62%) were males and 1030 (38%) females. The median age of patients was 68.3 (IQR 58-79). Of the 1030 females, 500 (48.5%) presented with nonvisible hematuria (NVH), and 530 (51.5%) presented with visible hematuria (VH). The median age was 66 (IQR 56-76). The number of females diagnosed with any form of malignancy was 72 (7% of all females). Of the 1684 males, 288 (17.1%) presented with NVH, and 1396 (82.9%) presented with VH. The median age was 72 (IQR 59-81). The number of males diagnosed with some form of malignancy was 258 (15.3% of all males). Overall, 1926 patients presented with VH and 788 patients presented with NVH. After investigations, 290 patients (15.1%) with VH and 40 (5.1%) patients with NVH had some form of malignancy. The highest number of malignancies found in VH was bladder cancer (n = 222, 11.5%), followed by prostate (n = 28, 1%), renal (n = 23, 0.8%), UT urothelial (n = 17, 0.6%), gynaecological (n = 7, 0.3%), and gastrointestinal (n = 5, 0.2%) cancer. The highest number of pathologies found in NVH was infection (n = 44, 5.6%). Cancer detection rate for symptomatic NVH was more than double that of asymptomatic NVH, 6.5% versus 3.1%, respectively., Conclusion: Overall, 15.1% with VH and 5.1% with NVH present with malignancy. Nurse-led rapid access hematuria clinic and flexible cystoscopy investigation by trained nurse is safe and feasible., Competing Interests: All authors have nothing to disclose., (© 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.) more...
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- 2021
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182. Flexible cystoscopy can improve anxiety and subjective feelings of bladder cancer patients during follow-up.
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Gao J, Tian DW, Zhou DS, and Wu CL
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Introduction: The effect of repeated cystoscopy on bladder cancer (BC) patient anxiety and feelings is rarely evaluated., Aim: To compare the difference of patients' anxiety and subjective feelings caused by different cystoscopes., Material and Methods: We prospectively included 192 BC patients who accepted regular cystoscopy follow-up after transurethral resection of bladder tumor (TURBT): 93 in the flexible group and 99 in the rigid group. The method of anesthesia and the order of examinations were consistent between different groups. We analyzed the anxiety level before cystoscopy, the maximum pain during the examination and the change of lower urinary tract symptoms (LUTS) before and after cystoscopy. Meanwhile, we analyzed the rate of gross hematuria and pyuria after cystoscopy. The anxiety and pain levels were evaluated by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and visual analogue scale (VAS). LUTS was reflected by the Core Lower Urinary Tract Symptom Score (CLSS). We distinguished gender during analysis., Results: The median APAIS score of male patients undergoing flexible or rigid cystoscopy was 8 vs. 12 (p < 0.01), and this result for females was 8 vs. 9 (p = 0.048). The median pain scores for men in the two groups was 1 vs. 2 (p < 0.01), respectively, and this outcome in female patients was 0 vs. 1 (p < 0.01). Patients in the rigid group had more CLSS change (0 vs. 1, p < 0.01). There was no difference in pyuria or gross hematuria rate after examination. Analysis in respective groups showed that men have more severe pain than women, 1 vs. 0 (p = 0.001) in the flexible group and 2 vs. 1 (p = 0.009) in the rigid group., Conclusions: A flexible cystoscope can improve anxiety and subjective feelings of BC patients during cystoscopy follow-up., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Fundacja Videochirurgii.) more...
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- 2021
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183. Inspection of Ureteral Orifices: The Pearl of Flexible Cystoscopy
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Seshikanth Middela, Hamid Bushra, Bo Pettersson, Sanjay Das, and Charmaine Matthews
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Case Report ,Flexible cystoscopy ,Cystoscopy ,Surgery ,Imaging modalities ,Ureter ,medicine.anatomical_structure ,Rare case ,medicine ,Examination technique ,Radiology ,business - Abstract
Cystoscopy is most common diagnostic investigation. The examination technique and the findings, both normal and pathological, were well described described a hundred years ago. With technological advances, there has been over-emphasis on imaging modalities for diagnostic purposes. A basic maneuver of examining the ureteral orifices is sometimes rushed through when in fact careful examination can clinch the diagnosis. The importance is exemplified by two cases, one of which is a rare case of Xanthoma of the ureter. more...
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- 2015
184. Is a Retention Time After the Instillation of Anesthetic Lubricant Necessary When Performing Male Flexible Cystoscopy?
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José María Martínez-Jabaloyas and Jorge Panach-Navarrete
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Administration, Topical ,Urology ,Treatment outcome ,Pain ,Flexible cystoscopy ,Preoperative Care ,Humans ,Medicine ,Prospective Studies ,Anesthetics, Local ,Lubricant ,Aged ,Lubricants ,Pain Measurement ,Aged, 80 and over ,business.industry ,Local anesthetic ,Lidocaine ,Cystoscopy ,Middle Aged ,Surgery ,Treatment Outcome ,Anesthesia ,Anesthetic ,Clinical Competence ,Clinical competence ,business ,Retention time ,medicine.drug - Abstract
Flexible cystoscopy is a common practice in urology. We wanted to determine whether a retention time of 5 minutes between the administration of a local anesthetic lubricant and flexible cystoscope insertion decreased the degree of discomfort or pain in the patient.Males who underwent flexible cystoscopy during 5 months were randomized in a prospective study. They were divided into two groups. In the first one, the Cathejell lubricant with lidocaine 12.5 g was administered and cystoscopy was performed immediately. In the second one, the same lubricant was maintained in the urethra for 5 minutes before the performance of cystoscopy. After scanning, all the patients were requested to indicate the degree of perceived pain on a visual pain scale from 0 to 10, with 0 being no discomfort and 10 being the maximum degree of pain bearable. As a secondary objective, the relationship of pain to age and to the type of cystoscopist (urologist/resident doctor) was studied. For statistical analysis, a Student's t-test for independent samples and correlation analysis were used.A total of 242 patients were studied, 110 in the immediate group and 132 in the 5-minute delay group, with samples being homogeneous for the age and type of cystoscopist. The mean in the pain scale in the immediate group was 2.41, and in the 5-minute delay group was 2.04, with no significant differences between them (p=0.175). There was no relationship with age (r=-0.061, p=0.348) or with the type of cystoscopist (2.06 of average pain in the associate group, 2.35 in the resident, p=0.28).There is no benefit in waiting a short time after the administration of intraurethral lubrication with a local anesthetic in flexible cystoscopy in men. There is also no relationship between the patient age or the type of cystoscopist (urologist/resident doctor) and perceived pain. more...
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- 2015
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185. Intraurethral Prilocaine Provides Efficient Anesthesia during Flexible Cystoscopy in Male Patients: A Prospective Randomized Clinical Study
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Alpaslan Yuksel, Derya Balbay, M. Murad Başar, Oguz Ozkanli, and Erdal Alkan
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Clinical study ,medicine.medical_specialty ,business.industry ,Male patient ,Anesthesia ,Medicine ,Flexible cystoscopy ,business ,Prilocaine ,Surgery ,medicine.drug - Published
- 2014
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186. Urinary tract infection following flexible cystoscopy: a comparison between sterilised cystoscopes and disposable sterile sheaths
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S. Wood, Jack P Carmichael, Srijit Banerjee, and Steve P McCombie
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Incidence (epidemiology) ,Urinary system ,Signs and symptoms ,Flexible cystoscopy ,Cystoscopy ,Cystoscopes ,Surgery ,medicine ,business - Abstract
Objective: The objective of this article is to compare the incidence of post-cystoscopy urinary tract infections (UTIs) between cystoscopes sterilised between patients and cystoscopes that use removable sterile sheath technology. Patients and methods: A total of 200 patients undergoing flexible cystoscopy at the Norfolk and Norwich Hospital (Norwich, UK) between November 2011 and March 2012 were identified prospectively as part of an ongoing audit of the department’s services. One hundred patients were recruited from day procedure lists, using KeyMed® cystoscopes sterilised between patients (sterilised scope, SS); 100 patients were recruited from a ‘one-stop’ urology clinic, using a Vision Sciences® CST-5000 cystoscope with disposable sterile Endosheath® technology (removable sheath, RS). Mid-stream urine (MSUs) samples and patient symptoms were recorded prior to the cystoscopy and at least three days following the cystoscopy. Results: No significant difference was found in the incidence of new MSU-confirmed UTI (2.7% (SS) vs. 2.0% (RS)). In those undergoing their first cystoscopy, no significant differences were found in either new symptoms (34.1% (SS) vs. 36.7% (RS)) or requirement for antibiotics (13.6% (SS) vs. 13.0% (RS)). Conclusion: Flexible cystoscopy using removable sterile sheath technology does not have a higher incidence of UTI compared to a cystoscope sterilised between patients. The introduction of cystoscopes using this technology can therefore safely transform flexible cystoscopy into an outpatient clinic procedure. more...
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- 2013
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187. Role of flexible cystoscopy and ultrasound in the detection of recurrent Bladder Tumour
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Saiful Islam, M. A. Uddin, and Anwarul Islam
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medicine.medical_specialty ,Urinary bladder ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Bladder tumour ,Flexible cystoscopy ,medicine.disease ,Cystoscopies ,Surgery ,medicine.anatomical_structure ,Transitional cell carcinoma ,Biopsy ,medicine ,Stage (cooking) ,business - Abstract
Background: Rigid cystoscopy under anaesthesia for the surveillance of recurrent bladder tumour creates a large urological workload. Recently, flexible cystoscopy became a popular alternative and an easy, safe and effective means of check cystoscopy in following-up patients of superficial transitional cell carcinoma (TCC) of the urinary bladder. Because of the frequency of tumor recurrences and the necessity of finding, whether a less invasive, easily repeatable investigation is capable of providing precise information about the bladder cavity, and, could decrease the frequency of repeated rigid cystoscopy under anaesthesia and inpatient admission; we have decided to perform this study. Methods: This is a prospective comparative study that involved 85 patients (70 male and 15 female) with a mean age of 61 years (41-80 years), who had undergone one or more transurethral resections for TCC of bladder (stage pTa and pT1; grade I and II.) in the department of Urology, BSMMU between July 2005 -Feb 2007. Ultrasonography(USG) of the bladder was performed one week before check cystoscopy. We have calculated sensitivity and accuracy of USG and flexible in comparison to rigid cystoscopy.Results: Eighty five (85) sessions of follow-up investigations- Ultrasound and flexible cystoscopy showed 31 recurrences confirmed by rigid cystoscopy and biopsy. In over 85 rigid cystoscopies, 54 were negative and 31 were positive for tumour. Sensitivity, the most important parameter, was 97% for the two examinations together. Each method separately had the following sensitivity: ultrasound 77%; flexible cystoscopy 90%.Conclusion: Considering that there was only one false-negative result of combined abdominal ultrasound and flexible cystoscopy; with this follow-up scheme we could have saved our patient from rigid cystoscopies, reducing the cost of in-patient admission and anaesthesia.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13655 KYAMC Journal Vol. 3, No.-1, June 2012 pp.214-219 more...
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- 2013
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188. Flexible Endoscopy of the Upper and Lower Urinary Tract
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Babayan, R. K., Jonas, Udo, editor, Dabhoiwala, N. F., editor, and Debruyne, Frans M. J., editor
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- 1988
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189. Identifying content for simulation-based curricula in urology:a national needs assessment
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Charlotte Paltved, Karen Lindorff-Larsen, Lars Konge, Rikke Bølling Hansen, Bjørn Ulrik Nielsen, and Leizl Joy Nayahangan
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medicine.medical_specialty ,VIRTUAL-REALITY SIMULATOR ,Delphi Technique ,ENDOUROLOGICAL SIMULATOR ,SURGERY ,simulation-based training ,Urology ,education ,030232 urology & nephrology ,MEDLINE ,Delphi method ,VALIDATION ,Simulation training ,Urologic Surgical Procedures/education ,03 medical and health sciences ,0302 clinical medicine ,needs assessment ,Curriculum development ,Journal Article ,Medicine ,Humans ,FLEXIBLE CYSTOSCOPY ,Curriculum ,Simulation based ,Simulation Training ,Ultrasonography ,Medical education ,ACQUISITION ,business.industry ,Internship and Residency ,EDUCATION ,simulation ,Urological surgery ,Urology/education ,TECHNICAL PROCEDURES ,Nephrology ,030220 oncology & carcinogenesis ,Needs assessment ,SKILLS ,Urologic Surgical Procedures ,urology training ,business ,Urinary Catheterization ,Needs Assessment - Abstract
OBJECTIVE: Simulation-based training is well recognized in the transforming field of urological surgery; however, integration into the curriculum is often unstructured. Development of simulation-based curricula should follow a stepwise approach starting with a needs assessment. This study aimed to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training.MATERIALS AND METHODS: A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists. Round 1 identified technical procedures that newly qualified urologists should perform. Round 2 included a survey using an established needs assessment formula to explore: the frequency of procedures; the number of physicians who should be able to perform the procedure; the risk and/or discomfort to patients when a procedure is performed by an inexperienced physician; and the feasibility of simulation training. Round 3 involved elimination and reranking of procedures according to priority.RESULTS: The response rates for the three Delphi rounds were 70%, 55% and 67%, respectively. The 34 procedures identified in Round 1 were reduced to a final prioritized list of 18 technical procedures for simulation-based training. The five procedures that reached the highest prioritization were cystoscopy, transrectal ultrasound-guided biopsy of the prostate, placement of ureteral stent, insertion of urethral and suprapubic catheter, and transurethral resection of the bladder.CONCLUSION: The prioritized list of technical procedures in urology that were identified as highly suitable for simulation can be used as an aid in the planning and development of simulation-based training programs. more...
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- 2017
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190. Cystoscopy in Non-Muscle-Invasive Bladder Cancer: When and how (Rigid or Flexible)
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Antonio Cicione, Rocco Damiano, and Francesco Cantiello
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Rigid cystoscopy ,medicine.medical_specialty ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Cystoscopy ,Equipment Design ,General Medicine ,Flexible cystoscopy ,medicine.disease ,Recurrence risk ,Urinary Bladder Neoplasms ,Neoplasm Invasiveness ,medicine ,Humans ,High incidence ,Radiology ,Non muscle invasive ,business - Abstract
Cystoscopy is a common procedure in the urological practice due to its ability to survey the bladder for a variety of indications. It is the principal means of diagnosis and surveillance of bladder tumors. Hematuria is the most common finding of non-muscle-invasive bladder cancer (NMIBC), as a consequence of that it is one of the most frequent reasons to perform cystoscopy. The follow-up of patients treated for NMIBC is of great importance because of the high incidence of recurrence and progression of the disease, whereby patients with NMIBC undergo cystoscopy repeatedly (every three months generally). At present, the schedule and methods of follow-up is a sign of patient's progression and recurrence risk, which has to be rated for each patient when follow-up begins. Moreover, before the development of flexible cystoscopy, patients underwent rigid cystoscopy with greater discomfort. The advance of flexible cystoscopy has significantly decreased the pain and discomfort associated with the procedure, and the flexible instrument is currently considered the standard tool to perform cystoscopy. However, controversies exist about the use of anesthetic gel during cystoscopy. The aim of this study is to report some short evidence about cystoscopy in particularly about the follow-up timing for NMIBC and the use of rigid or flexible cystoscopy. more...
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- 2013
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191. Use of Canine-Assisted Therapy in Office-Based Flexible Cystoscopy
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auren Folgosa Cooley, Sarah Caulkins, Rebecca Holloway, Sandra Barker, and Lance Hampton
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medicine.medical_specialty ,Office based ,business.industry ,Medicine ,Medical physics ,Flexible cystoscopy ,business ,Assisted therapy - Published
- 2016
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192. An emergency back-up light source for flexible cystoscopy can be found in most of our pockets
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N Arumainayagam, B Lovell-Viggers, and A Robinson
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business.industry ,General Medicine ,Flexible cystoscopy ,Cystoscopy ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Light source ,Embedded system ,030221 ophthalmology & optometry ,Medicine ,Humans ,Surgery ,Emergencies ,business ,Computer hardware ,Cell Phone ,Lighting ,Technical Section - Published
- 2016
193. Flexible cystoscopy findings in patients investigated for profound lower urinary tract symptoms, recurrent urinary tract infection, and pain
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Richard J. Bryant, Sarah A. Howles, Jeremy G. Noble, Gemina Doolub, Freddie C. Hamdy, Stéphane Larré, and Heidi Tempest
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Urology ,Urinary system ,Pain ,Context (language use) ,Flexible cystoscopy ,Young Adult ,Lower Urinary Tract Symptoms ,Recurrence ,Lower urinary tract symptoms ,Internal medicine ,Humans ,Medicine ,In patient ,Young adult ,Pliability ,Aged ,Demography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Cystoscopy ,Middle Aged ,medicine.disease ,Surgery ,Urinary Tract Infections ,Female ,business - Abstract
BACKGROUND AND PURPOSE: The National Institute of Clinical Excellence published guidelines in 2010 recommending the use of cystoscopy to investigate profound lower urinary tract symptoms (pLUTS), recurrent urinary tract infection (rUTI), and pain in men. Currently, there are no equivalent guidelines for women. We aimed to examine the diagnostic performance of flexible cystoscopy (FC) when it is used in this context in both men and women. PATIENTS AND METHODS: Results of all outpatient FCs undertaken in our department between April 2009 and March 2010 were examined retrospectively. Patients undergoing FC for the investigation of pLUTS, rUTI, or pain were included. Diagnostic performance was calculated, which was defined as the number of patients receiving a diagnosis of a clinically relevant abnormality at FC divided by the total number of patients undergoing FC for this indication. RESULTS: Of the 1809 patients who underwent FC during the study period, 113 underwent FC to investigate pLUTS, rUTI, or pain. Diagnostic performance was 11.5% (n=13), being 11.4%, 19.2%, and 0% in those with pLUTS, rUTI, and pain, respectively. Bladder cancer was diagnosed in one (0.9%) patient who underwent FC to investigate pLUTS but also had nonvisible hematuria. Urethral stricture was diagnosed in nine (8.0%) cases and intravesical calculi in four (3.5%) cases. CONCLUSION: Clinically relevant abnormalities were found in 11.5% of patients with pLUTS, rUTI, or pain, supporting recently published NICE guidelines recommending cystoscopy in patients with pLUTS or rUTI. Of the 17 patients who were investigated for pain, none was found to have clinically relevant abnormalities; further studies are needed to define the clinical utility of FC in these cases. more...
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- 2016
194. Defining competency in flexible cystoscopy: a novel approach using cumulative Sum analysis
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Kenneth R. MacKenzie and Jonathan Aning
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Cumulative sum ,Urology ,030232 urology & nephrology ,Prospective data ,CUSUM ,Flexible cystoscopy ,Objective assessment ,CUSUM analysis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Humans ,Medicine ,Medical physics ,Prospective Studies ,Learning curve ,Competence (human resources) ,Aged ,Aged, 80 and over ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Cystoscopy ,General Medicine ,Middle Aged ,Surgery ,Reproductive Medicine ,Female ,Clinical Competence ,Erratum ,Clinical competence ,business ,Research Article - Abstract
Background Flexible cystoscopy (FC) is one of the most frequently performed urological intervention. Cumulative sum analysis (CUSUM) allows objective assessment of a proceduralist’s performance to ensure acceptable outcomes. This study investigated the application of CUSUM to assess a trainee’s learning curve and maintenance of competence in performing FC. Methods A single urology trainee, with no previous experience of FC, performed FCs between August 2013 and February 2014. For assessment FC was divided into 5 steps. Each step was assigned a CUSUM completion score. The primary outcome measure was successful performance of a complete FC. Prospective data were collected and analysed using CUSUM. Results In total, 419 FCs were performed. Acceptable performance of FC was achieved by the 122nd procedure. Complete assessment of the ureteric orifices and trigone was the most difficult step of FC to achieve consistently. Competence for complete FC was achieved following 289 procedures. Conclusion CUSUM analysis objectively assesses acquisition of competence in flexible cystoscopy. Recommended indicative numbers may underestimate the number of FCs trainees require to achieve, and maintain, competency. Validation of CUSUM method in a larger cohort of trainees should be considered. Electronic supplementary material The online version of this article (doi:10.1186/s12894-016-0143-9) contains supplementary material, which is available to authorized users. more...
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- 2016
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195. Re: Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way
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David S. Wang
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Male ,Pleasure ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Flexible cystoscope ,Lidocaine ,Medical assistant ,Cystoscopy ,Flexible cystoscopy ,Surgery ,Urethra ,medicine.anatomical_structure ,Male patient ,medicine ,Pressure ,Humans ,Patient Comfort ,business ,Saline - Abstract
available at http://www.ncbi.nlm.nih.gov/pubmed/25603481 Editorial Comment: It has always been my observation that increasing the irrigation pressure during office flexible cystoscopy facilitates male flexible cystoscopy, as the irrigation fluid may distend the urethra and/or sphincter to allow for easier passage of the flexible cystoscope. I will routinely ask my medical assistant to manually squeeze the saline bag during cystoscopy. In this nice randomized study the authors examined whether increasing the irrigation pressure during flexible cystoscopy resulted in decreased discomfort for male patients undergoing flexible cystoscopy. The height of the saline bag was randomized to 80, 100 and 150 cm above the examination table, and visual analogue scales were recorded. The group with the highest irrigation pressure (150 cm) had significantly less discomfort during cystoscopy. Thus, this simple modification seems to decrease discomfort for males undergoing office flexible cystoscopy. more...
- Published
- 2016
196. Nurse-led flexible cystoscopy in Australia: initial experience and early results
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E Hayes, Niall M. Corcoran, Anthony J. Costello, Pat Bugeja, Nikhil Sapre, and Paul Anderson
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Psychological intervention ,MEDLINE ,Retrospective cohort study ,Audit ,Flexible cystoscopy ,Cystoscopy ,Surgery ,Nurse led ,Early results ,Physical therapy ,medicine ,business - Abstract
What's known on the subject? and What does the study add? Nurse-led flexible cystoscopy (NLFC) has developed over the past decade in the UK with reports suggesting that adequately trained nurses can undertake FC competently. However, this is a relatively new concept in Australia and the feasibility and efficacy of this initiative in Australia has not yet been reported. We describe the various aspects that need to be addressed to implement a NLFC service in Australia. We have shown that NLFC is a safe and feasible option when established with strong departmental support, training, supervision and adherence to established guidelines. NLFC clinics can provide an efficient service and excellent continuity of care for patients with bladder cancer. Objective • To present our initial experience implementing a nurse-led flexible cystoscopy (NLFC) service in a Victorian tertiary hospital and our initial results from that service, as NLFC has developed over the past decade with reports suggesting that adequately trained nurses can undertake FC competently. Patients and methods • We describe the implementation of a NLFC service including approval, funding, nurses' training, and protocols. • Outcomes of all patients having a NLFC or subsequent interventions were recorded prospectively and analysed retrospectively. • To gauge patients' response to NLFC, an anonymous feedback questionnaire was administered to 60 consecutive participating patients in the recovery unit. • The effect of NLFC on waiting times was determined from surgical scheduling records. Results • In all, 272 patients had 720 NLFC done over a 2-year period. In all, 150 (21%) FCs had a suspected bladder cancer recurrence and were referred for a rigid cystoscopy. Of those, 83 (58%) revealed a recurrence comprising of 14 (17%) high-grade lesions, 45 (54%) low-grade lesions and 24 (29%) were diathermied without a biopsy. In all, 41 (27%) had benign pathology on biopsy and 21 (14%) had normal rigid cystoscopy. • There were two significant adverse events. • There was a 65% reduction in the waiting list for surveillance FC after introduction of the service. • Of 60 patients who completed the feedback questionnaire, 95% reported that they were given enough information by the nurses, 92% had all their questions answered satisfactorily and 97% had enough confidence and trust in the nurse. In all, 90% had a positive perception of the service overall and 93% were happy to have a FC performed by a nurse rather than a doctor. Conclusions • Results from our NLFC audit compare favourably with other published reports. NLFC is a safe and feasible option when established alongside strong departmental support, comprehensive nurses' training according to established guidelines, service supervision by a designated consultant and regular audits. • NLFC clinics can provide an efficient service and excellent continuity of care for patients with non-muscle-invasive bladder cancer. more...
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- 2012
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197. Flexible Cystoscope for Evaluating Pelvic Fracture Urethral Distraction Defects
- Author
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Yue Min Xu, Jiong Zhang, Qiang Fu, Ying Long Sa, and Xu Li
- Subjects
Adult ,Urethral Stricture ,medicine.medical_specialty ,Adolescent ,business.industry ,Urology ,Flexible cystoscope ,Cystoscopy ,Equipment Design ,Flexible cystoscopy ,Cystoscopes ,Middle Aged ,medicine.disease ,Fractures, Bone ,Young Adult ,Cystourethrography ,Urethra ,Distraction ,Pelvic fracture ,Humans ,Medicine ,Radiology ,Pelvic Bones ,business - Abstract
Objective: To describe the value of flexible cystoscopy versus conventional urethrography (retrograde urethrography and cystourethrography) in diagnosing pelvic fracture urethral distraction defects (PFUDDs). Patients and Methods: Between May 2010 and June 2011, 120 male patients with PFUDDs were evaluated. In this study, all patients underwent conventional urethrography after admission. Flexible cystoscopy was also used for comparison, followed by conventional urethrography. The flexible cystoscope was introduced into the posterior urethra and the area was evaluated for the length of the proximal urethra and any possible fistulas, false passages, calculi or displacement of the posterior urethra. Results: Severe allergic reaction or obvious discomfort did not occur in any patients after conventional urethrography or flexible cystoscopy. By comparing the data obtained from flexible cystoscopy to those from conventional urethrography, no statistical difference was found in the measured length of the proximal posterior urethra (4.31 ± 2.28 vs. 4.02 ± 3.12, p > 0.05). However, the rate of detection in other abnormalities was higher in flexible cystoscopy than in conventional urethrography (48.3 vs. 10.8%, p < 0.05). Seventeen (14.2%), 9 (7.5%) and 32 (26.7%) patients were detected with fistula, false passage and calculus, respectively, according to flexible cystoscopy. In comparison, fistula, false passage and calculus were only observed in 2 (1.7%), 7 (5.8%) and 4 (3.3%) patients, respectively, through conventional urethrography imaging. Conclusions: Flexible cystoscopy is a valuable procedure in the evaluation of the posterior urethra and bladder neck, and in patients with urethral distraction defects before surgery. More details about fistulas, false passages, calculi and urethral defects could be obtained through this method. more...
- Published
- 2012
- Full Text
- View/download PDF
198. Efficacy of antibiotic prophilaxis and cleaning/disinfection devices in flexible cystoscopy to prevent positive urinary culture after procedure
- Author
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E. Felip, N. Juventeny, L. Ibarz Servio, M. Arzoz Fabregas, and R. Martinez Rodriguez
- Subjects
medicine.medical_specialty ,business.industry ,medicine.drug_class ,Urology ,Urinary system ,Antibiotics ,Flexible cystoscopy ,Surgery ,Toxicology ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,030212 general & internal medicine ,business ,030217 neurology & neurosurgery - Published
- 2017
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199. Outpatient diagnostic of bladder tumours in flexible cystoscopes: Evaluation of fluorescence-guided flexible cystoscopy and bladder biopsies
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Gregers G. Hermann, Helle M Pedersen, Karin Mogensen, Birgitte Grønkær Toft, and Anders Glenthøj
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Adult ,medicine.medical_specialty ,Light ,Biopsy ,Urology ,Urinary Bladder ,Flexible cystoscopy ,behavioral disciplines and activities ,Fluorescence ,Outpatients ,mental disorders ,medicine ,Humans ,Outpatient clinic ,False Positive Reactions ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Urinary bladder ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Carcinoma in situ ,Reproducibility of Results ,Cystoscopy ,Cystoscopes ,Middle Aged ,medicine.disease ,nervous system diseases ,Surgery ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,Nephrology ,Radiology ,Neoplasm Recurrence, Local ,business ,Carcinoma in Situ - Abstract
The aim of this study was to evaluate photodynamic diagnosis (PDD) in flexible cystoscopes and the diagnostic quality of biopsies for diagnosis of non-muscle-invasive bladder cancer in the outpatients department (OPD).Seventy-three patients (aged 36-91 years) with recurrent non-muscle-invasive bladder cancer and a medium to high risk of recurrence had a flexible PDD cystoscopy performed in the OPD. The bladder was first examined in standard white light followed by PDD.PDD was superior to white light diagnosis; PDD was positive in 16 patients (22%) where white light showed a normal bladder mucosa. Four of these patients had bladder tumour [4/73, 6%; two carcinoma in situ (CIS), two Ta]. The diagnosis was verified by transurethral resection of the bladder tumour in the operating room. In 20 patients (20/73, 27%) PDD identified additional tumour lesions that were not identified in white light (five CIS, 15 Ta). The false-positive detection rate of PDD was 0.41. False positivity was significantly reduced by simultaneous flex biopsies disproving malignancy. Biopsies were obtained from 57 patients and diagnosis of stage and grade were possible in 55 of these (97%). In two patients (4%) the tissue material was too small for diagnostic evaluation. Biopsies from 47 patients (83%) included muscularis mucosa and from 20 patients (35%) muscularis propria. In 30 patients all but one diagnosis from the OPD was confirmed by biopsy in rigid scopes in the operating room.PDD-guided cystoscopy and bladder biopsy in flexible cystoscopes can be performed in an OPD setting and with reliable results for diagnosis of tumour stage Ta, CIS and T1a bladder cancer. more...
- Published
- 2011
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200. ABC of flexible cystoscopy for junior trainee and general practitioner
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Pravin Menezes and Nourdin Kadi
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Subject (documents) ,General Medicine ,Cystoscopy ,Flexible cystoscopy ,Review ,clinical practice ,Clinical Practice ,Ophthalmology ,fiberscope ,medicine ,Outpatient setting ,Medical physics ,business ,urology ,urethrocystoscopy - Abstract
Introduction: Flexible cystoscopy is a diagnostic procedure usually performed under local anesthesia and has been used in the outpatient setting since the 1980s. Methods: We performed an electronic search of MEDLINE® and the Cochrane Central Search Library between 1990 and 2010. Duplicate references were removed. One reviewer extracted the publications relevant to general clinical practice. Results: MEDLINE search using the MeSH (Medical Subject Headings) words “flexible” and “cystoscopy” revealed 274 titles, and there were 42 titles in the Cochrane Central Search Library. However, interestingly, only 13 published papers addressing the clinical practice of flexible cystoscopy in the English literature were identified. Conclusions: Flexible cystoscopy is a real revolution in the field of diagnostic urology. more...
- Published
- 2011
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