Rigid Cystoscopy, Biopsy and Diathermy

Rigid Cystoscopy

Cystoscopy is a procedure performed to investigate the ureters, bladder and urethra (urinary system). A cystoscope, a flexible lighted tube, helps identify abnormal changes in the normal smooth pink lining of the bladder and urethra as well as identify tumours, bladder stones, and areas of narrowing, blockage or injury. A cystoscopy may be indicated when there is an obstruction in the flow of urine, painful urination, bleeding, incontinence and frequent urinary tract infections. It is also performed to examine the bladder after gynaecological surgery. Certain therapeutic procedures may also be performed during cystoscopy.

Procedure

Cystoscopy is usually done as an outpatient procedure. You may be required to fast or be on a special diet prior to the procedure. A sedative may be administered to help you relax. You will lie on your back with your knees up and spread. An anaesthetic gel is used to numb the urethra. Your doctor introduces the cystoscope through the urethra and gradually advances it up to the bladder, carefully examining the lining mucosa for abnormalities. Water or saline may be instilled through the cystoscope to expand the bladder, which gives your doctor a better view. The cystoscope may be used to irrigate and suction and instil substances into specific areas. Surgical instruments may be introduced through the cystoscope to remove stones, obtain tissue samples (biopsy) or perform other procedures.

Following the procedure, you may experience some burning sensation and bleed with urination for which increased fluid intake and a tub bath are recommended.

Your doctor will prescribe pain medication to make sure you are comfortable.

Diathermy

Diathermy is a therapy that uses shortwaves, microwaves or ultrasound to treat pain, inflammation and stiffness in joints by generating heat in the deep tissues. The waves cause heat to be generated from within target body tissues without directly applying heat. This heat promotes blood flow, enhances healing, reduces inflammation and improves flexibility. Diathermy may also be used in surgery to seal blood vessels (by coagulating the blood within) and to remove abnormal tissue such as tumours and warts.

Shortwave diathermy uses electromagnetic high-frequency waves in either pulsed or continuous form and is effective in treating pain and muscle spasms. Microwaves used in microwave diathermy lack deep penetration and are better suited for treating areas closer to the skin such as the shoulder. Ultrasound diathermy uses sound waves to vibrate deep tissues and produce heat. It is indicated for strains, sprains and fractures.

Prior to the treatment, you must remove any metal jewellery or accessories. Wet skin or perspiration should be wiped dry. Cream or gel may be applied to the area to be treated or wrapped to prevent directly with the electrodes. Two electrodes are positioned over the area or a wand is glided over the affected area. You may feel a warm or tingling sensation as the current is delivered. You must remain still for the entire procedure and avoid contact with any metal object.

Diathermy is avoided if you have implanted metal devices as this may burn the adjacent tissue. It is also avoided in areas of compromised blood supply, reduced sensation, cancer and peripheral vascular disease.