Bladder reflexion (cystoscopy)

Already in ancient Egypt, catheters of bronze or tin were introduced into the bladder 3000 years before Christ, Hippocrates used around 400 BC. rigid tubes to look into the mouth or rectum. At the beginning of the 19th century, the German physician Bozzoni came up with the idea of ​​using candlelight in addition to a two-part tube - his "light guide" was the original form of endoscopy with which body cavities can be examined. The first "modern" cystoscope was presented by the Dresden urologist Nitze 70 years later.

Definition: What is an endoscopy?

The look inside the body without hurting it: an ancient dream of the doctors. Reflections of body cavities, endoscopy (endo = inside, skopie = Umherschauen) - in addition to X-ray and ultrasound examinations - have offered this possibility for more than 100 years.

They have the advantage that the organ can not only be viewed directly from the inside, but that the examiner can simultaneously take tissue samples, take measurements and even perform therapeutic interventions.

How does the bladder mirroring work?

When mirroring the bladder (Cystis), the endoscope is inserted through the urethra (urethra) and these are usually examined simultaneously - the procedure is therefore also referred to as urethrocystoscopy. If the examination is extended to the ureter and renal pelvis, it is called ureterorenoscopy.

The endoscope (cystoscope) is a tubular, depending on the question rigid or flexible device with a diameter of three to four millimeters, which includes a light source and a photoconductive cable (with a small camera at the end), which is inserted through a channel. An additional channel is used for rinsing and aspirating, by another, for example, rinsing fluids, auxiliary instruments or ureteral splints (stents, for bridging constrictions) can be introduced and tissue samples or stones are taken out.

In addition, an X-ray contrast medium can also be filled into the ureter and thus visualized together with the renal pelvis in the X-ray image (retrograde urography).

When is the cystoscopy performed?

There are a number of reasons for cystoscopy:

  • Blood in the urine (hematuria)
  • Suspected tumor, stone or foreign body
  • Suspected strictures of the urethra
  • Follow-up after removal of bladder cancer
  • Recurring urinary tract infections
  • Unclear pain when urinating
  • Voiding disorders.

However, for some of these indications, other tests will be performed first, such as urinalysis, blood tests and kidney and urinary tract examinations, X-ray. In any case, a blood test is made beforehand to rule out coagulation disorders.

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