Cystoscopy Instruments
Rainy Umbas
Department of Urology, Cipto Mangunkusumo Hospital
Faculty of Medicine, Universitas ndonesia
What is Cystoscope?
• Thin Telescope
• Insert into the
bladder through
urethra or
cystostomy
• 2 types:
– Flexible flexible,
fibre-optic scope
– Rigid solid, straight
scope
Cystoscopy instruments
During insertion ,
examination of the
urethra and prostate
could be done by
using 00 lens
(= urethro-cystoscopy
or pan-endoscopy)
Cystoscopy instruments
• Fill the bladder with irrigant (water/normal saline)
until all of the bladder wall become visible
Rigid Cystoscope
Basic components
• Sheath & obturator
• Telescope lens
• Cystoscope bridge
• Albarran lever
Lens
• 0O for urethroscopy
• 30O visualization of the base and
anterolateral aspect of the bladder
• 70-90O to view the bladder dome
• Retrograde lenses with an angle of view >
90O visualize the anterior bladder neck
Rigid instruments
History of Urology
ALBARRAN, J
Country: Cuba
Year : 1860-1912
.
Instrument
• Telescope adapter
• Alligator Forceps
• Biopsy Forceps
• Scissor
• Hook Scissor
Flexible instruments
Flexible Cystoscopes
• Diameter (at the tip): 14F-15F
• Contain fiberoptic bundles for illumination
and visualization
• Has an irrigating channel and a working
channel for passage of instruments
• Can be deflected 180-220o
• Digital Flexible cystoscopes eliminate the
need for fiber bundles and the honeycomb
pattern of the image
What to choose?
• Advantages of rigid endoscope:
– Better optics
– Larger working channel allows greater versatility in passage of
instruments
– Larger lumen for water flow, thus improving visualization
– Ease of manipulation and maintaining orientation during
inspection within the bladder
– Better for evacuating blood clots
• Advantages of flexible endoscope:
– Greater comfort for the patient
– Ability to perform the procedure with the patient in the supine
position
– Ease of passing the instrument over an elevated bladder neck
– Ability to inspect at any angle with deflection of the tip of the
instrument
References:
1. University college hospital at Westmoreland street. Cystoscopy: urology
[Link] colleg London Hospital. NHS foundation trust.
2. Chancellor MB, Steers WD. Cystoscopy and ureteroscopy. NIH publication. 2014
3. Narance D. Urology Overview: part II. Cystoscope processing and handling
procedures. CIS self study lesson plan. Med Central Health System.
4. M. Ihmeidan (Slide Share, 2018).