Contraindications. Avoid instrumental study in patients who are weakened by prolonged illnesses, or decrepit old men who have cystoscopy may cause severe complications. However, if severe the condition of the patient, especially when there are high temperatures, can be caused by diseases of urinary system, special urologic research (cystoscopy, pielografia) shows that despite the severity of the disease. Contraindicated cystoscopy in acute inflammatory processes in the gallbladder wall, acute epididymitis and purulent prostatitis.
Stricture of the urethra before it expands bagirovym.
Complications after cystoscopy are the same as those observed after administration in the urethra metal Buga and catheters (see Catheterization). Purulent prostatitis, epididymitis and orchitis after cystoscopy are the result of coarse, clumsy use of the cystoscope.
To prevent complications in patients with high temperature, you should to prepare them for cystoscopy within 2-3 days techniques inside disinfectants (syntomycin, furadonin, resultan), immediately before the study intramuscularly to enter penicillin (200 000-300 000 IU), and after the study to intravenous injection, 5 ml of 40% hexamethylenetetramine. Good protivosudorojnam means after zitostaticescoe research, including when the urethral fever, is the administration per os 0.25 g quinine or 0.5 g of aspirin. In these cases it is shown and shared a warm bath.
Normal mucous membrane of the bubble appears in the cystoscope is whitish-yellow or light-pink, its surface is smooth and slightly lustrous. The mucosa in the area of the triangle is always more red, often visible separate artery and vein, peaking through the mucous membranes. The greatest attention of the researcher should be focused on areas exit the bladder and the area of holes ureters. For inspection of the cervix of the cystoscope to slowly under the supervision of view pull out of the bubble, while the field of view will not be divided into two parts: one will be visible to the conventional picture of the mucous membrane of the bubble, on the other appears as dark red paluluna that as pull-out of the cystoscope will increase (the sphincter of the bladder). The edge of the sphincter smooth, flat; sometimes it is covered with transverse folds. To find the triangle should pay cystoscope strictly on the middle line beak down, and then, slowly pushing and sdviga it, rotated 45 degrees to the left to find the right ureter, and Vice versa. The mouth of the ureters are presented in the form of cracks or round holes of various sizes. Watching them in the cystoscope, you can see the process of allocation of urine them to watch their movements. Thus the wall of the bubble in the field ureter vents comes into a state of peristaltic contractions, then the opening of the urethra suddenly stuck out, opens it with the power stands out a stream of urine, which dissolves in the wash fluid that fills the bladder.
The coloration of the mucous membrane of the patient bubble changed, you may receive more or less dramatic focal hyperemia, which can sometimes take the entire inner surface of the bubble.
Cystoscopy is the main method of diagnosis of bladder stones. Stones should be sought on the back, resp. the lower surface of the bubble. The presence of rocks on the side or the front walls says on their location in the diverticula. It is recommended if in doubt, always knock the rock bill of cystoscope. Cystoscopy plays a crucial role in the diagnosis of tumors of the bladder. Malignant tumors bumpy, infiltrate the wall of the bubble, dark red colour, covered with white dense bloom, in the centre of the wounded and bleeding. Cystoscopy with adenoma of the prostate, long existing stricture of the urethra, and in various diseases of the spinal cord gives a picture of the so-called trabecular bubble. Due to the influence of a number of gynecological diseases on the condition of the walls of the bladder cystoscopy women should be made after a gynecological examination. Male cystoscopy should always be preceded by an examination of the prostate gland per rectum. In recognition of surgical diseases of the kidney plays an important role in the appearance of the gallbladder holes ureters and urine of them. In the cystoscope you can see the selection of blood out of the holes of the ureters, muddy, purulent urine, thick pus. In some cases, shows individual hairs tumors, leading down into the hole of the ureter in the periods of its disclosure, semushina "born" stone. Cystoscopies you can find the so called hernia ureter (ureterocele) in the form of spherical protrusion of the bladder wall with point-hole. If finding the holes of the ureter in pathological processes in the kidneys and bladder difficult, resort to chromolithography. Atony ureters cystoscopies is determined by their gaping holes and slow reductions.