The flexible cystoscope is then inserted gently into the urethra up into the bladder. Only the soft tip actually goes into your bladder. Can you drive home after a cystoscopy? After a rigid cystoscopy You can go home once you're feeling better and you've emptied your bladder. Most people leave hospital the same day, but sometimes an overnight stay might be needed. You'll need to arrange for someone to take you home as you won't be able to drive for at least 24 hours. What are the complications of a cystoscopy?
Complications of cystoscopy may include: Infection. Urinary retention due to irritation and swelling from the procedure. Is a cystoscopy considered surgery? A urologic surgeon, or urologist, performs cystoscopy. The procedure involves looking at the urinary tract from the inside. Abnormalities can be detected in this manner, and surgical procedures can be performed.
You would commonly have cystoscopy for the evaluation of blood in the urine. How long do I need to take off work after a Ureteroscopy? Your Recovery For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. You may have a mild burning feeling when you urinate, and you may see small amounts of blood in your urine. These problems should not last more than 24 hours. Tell your doctor if bleeding or pain is severe or if problems last more than a couple of days.
To relieve discomfort, drink two 8-ounce glasses of water each hour for 2 hours. Ask your doctor if you can take a warm bath to relieve the burning feeling. If not, you may be able to hold a warm, damp washcloth over the urethral opening. Your doctor may give you an antibiotic to take for 1 or 2 days to prevent an infection. If you have signs of infection—including pain, chills, or fever—call your doctor.
Female Urology. Cystoscopy and Ureteroscopy When you have a urinary problem, your doctor may use a cystoscope to see inside your bladder and urethra. Your doctor may recommend cystoscopy for any of the following conditions: frequent urinary tract infections blood in your urine hematuria loss of bladder control incontinence or overactive bladder unusual cells found in urine sample need for a bladder catheter painful urination, chronic pelvic pain, or interstitial cystitis urinary blockage such as prostate enlargement, stricture, or narrowing of the urinary tract stone in the urinary tract unusual growth, polyp, tumor, or cancer If you have a stone lodged in your ureter or have an area that needs more study in your ureter, your doctor may recommend a ureteroscopy, usually with general or regional anesthesia.
Preparation Ask your doctor about any special instructions. Possible side effects You may have blood in your urine for a few days after the test. You may also have some soreness or mild pain when you pass urine and in your tummy area or back for 1 or 2 days. If these side effects do not get better or you feel unwell or feverish, contact the hospital for advice, as you may have an infection.
Having a retrograde pyelography Sometimes x-rays of the kidney and ureter are taken during a ureteroscopy. This is called retrograde pyelography. The doctor places a tube catheter into the ureter, then passes dye up the catheter to better show the ureter and renal pelvis on x-rays.
Print page. How we can help. The scores on the theoretical knowledge test were comparable among the training groups, and all students were able to perform ureteral stent insertion and removal. Simulator training allowed students to achieve higher ureteroscopic and cystoscopic proficiency, and transparent simulators were more effective than non-transparent simulators.
The use of simulators in medical education began in the s with devices for training resuscitation, anesthetic and clinical skills [ 1 , 2 ]. Numerous studies have confirmed that medical students can improve their skills and achieve proficiency through simulation training [ 3 — 7 ]. Ureteroscopy and cystoscopy are essential for the diagnosis and therapy of urological diseases, and repeated hands-on training and standardized learning are necessary for mastering the skills required.
However, due to ethical and fiscal concerns, traditional hands-on training of new practitioners with patients has been supplanted by methods that rely on endourological simulators [ 8 , 9 ]. Both virtual and physical ureteroscopic and cystoscopic simulators have been created, and their value for training new students in the required surgical skills has been demonstrated [ 6 , 10 , 11 ].
Virtual models include the virtual-reality simulator for ureteroscopy [ 10 ] and the virtual reality endourological simulator [ 6 ]. However, the popularity of virtual models is limited by their high cost and the lack of haptic feedback for the trainee that is provided by physical simulators and clinical experience [ 3 ]. Current physical simulators are primarily bench models, such as the Uro-Scopic Trainer [ 11 ] and the adult ureteroscopy and renoscopy simulator [ 3 ].
Despite the relative fidelity of these simulators, novices often report that they cannot successfully relate the computer display to actual conditions encountered during surgery. The disparity between the simulated experience and reality encountered in clinical practice translates into greater risk of surgical error and a longer training period.
It seems logical that simulators fabricated from transparent material could help alleviate the shortcomings of the training methods described above. A transparent model could allow trainees to more readily observe and correct their errors during the course of training and self-evaluate their skills.
To test this theory, we designed and fabricated both transparent and non-transparent ureteroscopy and cystoscopy simulators between October 1, and September 30, The present randomized, controlled trial study investigated the relative viability of these simulators as endourological training tools.
The physical dimensions of the simulator were chosen to conform to normal adult human anatomy Table 1. Adult kidneys are paired organs that are typically 10—12 cm long, 5—7 cm wide and 3 cm in the anteroposterior dimension [ 12 , 13 ].
The superior pole of the kidney is broader and thinner than the inferior pole [ 12 ] and the anterior surface is more convex than the posterior surface [ 14 ]. The thickness of the external renal cortex is 0. The ratio of papillae draining into minor calyces is — [ 15 ]. Humans have two ureters, thick-walled muscular tubes that each measure 25—30 cm in length [ 16 ] and 1—10 mm in diameter [ 12 ].
The ureteric openings are about 5 cm apart in the distended bladder of both genders [ 13 ]. The bladder is somewhat pyramidal in shape when empty [ 14 ].
The average thickness of the bladder wall is about 3. The mean capacity of the adult male bladder is slightly more than that of the female bladder at mL, and varies from to mL. The prostate is somewhat conical in shape, wider at the top and tapering towards the base with the urethra passing through the center, and measures approximately 4 cm transversely at the base, 2 cm at the anteroposterior end and 3 cm in vertical diameter [ 13 ].
The male urethra extends from the internal orifice of the urinary bladder to the external opening. It can be subdivided into the posterior and anterior urethra. The posterior urethra is 3—5 cm long, while the anterior urethra is 15—20 cm long [ 12 , 19 ]. The urethra has a double physiological curve. The first curve infrapubic is constant unless exposed to a strong force, and the second curve praepubic can be eliminated by a tiny force and vanishes naturally during an erection [ 12 , 16 ].
Ouattara [ 20 ] reported that the mean urethral diameter can reach 11 to 15 mm and that the average thickness of the periurethral tissue is 9 mm. Additionally, there is a narrowing of the urethra the penis neck at the base of the glans.
The female urethra is straight, about 4 cm long and 6 mm in diameter [ 16 ]. The simulator was designed in accordance with three criteria: its dimensions should conform to human anatomy; it should be composed of transparent materials; and it should be able to satisfy the requirements of typical ureteroscopy and cystoscopy training.
The equipment used in the design and fabrication of the transparent simulator consisted of UG NX software Version 7. The complete, assembled transparent simulator and the unassembled components of the simulator are pictured in Figs. All components of the transparent simulator: kidneys, ureters, bladder, urinary tracts, brackets and base.
To obtain a non-transparent simulator, a transparent simulator was spray-coated with a layer of black paint on its exterior surface.
Otherwise, the transparent and non-transparent simulators were identical in terms of structure, function and operational approaches. Ten urologists seven men and three women were selected from urologists affiliated with the Third Military Medical University through stratified sampling and were invited to evaluate the simulators. The urologists were given an introductory presentation of the simulator, including an explanation of its structure and operation.
They were then asked to use both the transparent and non-transparent simulators for about 30 min, to perform separate simulated cystoscopy, ureteral stent insertion and removal and removal of upper urinary tract stones. After this, each urologist was asked to complete a standard anonymous questionnaire assessing both simulators. Thirty-six first-year medical students were recruited from Third Military Medical University through a recruitment conference to assess the viability of the simulators for teaching endoscopic skills.
Each recruited student verbally consented to participate in the study and signed a consent form. All students attended the same 1-day didactic lecture given by an endourologist, and two six-hour days of video instruction encompassing genitourinary anatomy, cystoscopy, ureteroscopy and ureteroscopic procedures, ureteral stent insertion and removal by transurethral cystoscopy and stone extraction by transurethral cystoscopy or ureteroscopy.
The examination paper consisted of 50 multiple-choice questions, and each question on the exam had just one right answer.
The day after the exam, students were randomly assigned to three groups. Random assignment was conducted using a random number table, and each group had 12 participants. Students used the transparent simulator in the experimental group Group 1 and the non-transparent simulator in the experimental control group Group 2. Within each group, students were further separated into working pairs, with one student operating and the other assisting.
Under the supervision of an experienced instructor, students repeatedly practiced cystoscopy, guidewire insertion, ureteral stent insertion and removal, ureteroscopy and stone extraction using the simulator.
Each 2-person team spent approximately one hour per day training on the simulator. In both groups, each student participated in 12 one-hour training sessions. Ureteral stent insertion training and ureteral stent removal training are pictured in Figs. Students were also grouped into pairs in a control group Group 3 that received no simulator training.
Instead of simulator training, students were given verbal instruction concerning the proper performance of cystoscopy, ureteroscopy, guidewire insertion, stone extraction and ureteral stent insertion and removal.
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