Pediatric cystoscopy

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Information about Pediatric cystoscopy

Published on December 20, 2008

Author: azamahk2000


Pediatric cystoscopy Indications & Operative technique : Pediatric cystoscopy Indications & Operative technique Dr. Abdelazim Hussein .K R.U.H Armamentarium : Armamentarium Telescope Length ( cm) 18 Dam e t e r (mm) 19 Angle of e view 0º 15º 0º 70º 120º Cystourethroscopes sheath Length cm 11-14 Dam e t e r Fr 6- 12 Irrigating/working channels Fr 2.4-6.6 Armamentarium : Armamentarium Bridge Forcepes and working inturments Accessareis light source light cable camera moniter INTEGRAL CYSTOSCOPES : INTEGRAL CYSTOSCOPES E-line pediatric cystoscopy features integral sheaths with built-in bridges. Richard Wolf Stinger : Stinger 9.5 FR. OFFSET OPERATING URETHRO / CYSTOSCOPE for sub-trigone injections, also known as the “Stinger”, features an offset eyepiece for insertion of rigid instruments and accessories. Richard Wolf Indications : Indications Most common urological procedure minimal-invasive technique for a- Diagnosing and treating diseases of the lower urinary tract in pediatric. b- Diagnosing upper urinary tracts diseases in pediatric. (retrograde pyelography) Indications : Indications Diagnostic Indications Congenital anomalies (bladder diverticulum, ureterocele, posterior U.V.) Haematuria, BOO, Recurrent (UTI) incontinence (ureteral ectopy), Slide 8: Therapeutic Indication Posterior urethral valve, Urethral stricture. Reflux, Neurogenic bladder, Ureterocele, Contraindications : Contraindications Acute (febrile) UTI. Coagulopathy. Pre-operative assessment : Pre-operative assessment Routine investigations Informed Consent Rx UTI. Hip mobility Antibiotic prophylaxis Operative technique : Operative technique General anaesthesia Supine lithotomy position Clean the genital area. Remove the wet sheet &Warm the patient during the entire procedure Inspect the genital area for any pathology. Calibrate the meatus (narrowest point of the urethra). While standing hold penis with index finger and thumb pull the penis out straight Lubricate the instrument. Introduce cystoscope 30°lens & gradually sit down as cystoscope traverses bulbar urethra Slide 12: once enter , systematically examine A-Base of bladder 1-Trigone 2- ureteric orifices (location, number, shape) interureteric bar B-Side walls and dome Complications : Complications Operative false passage at bulbar urethra Haemorrhage Post- Operative UTI Septicaemia urinary retention Urethral stricture

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