Cystoscopy Cystoscopy and Stent Removal Cystoscopy and Biopsy PATIENT INSTRUCTIONS and CONSENT FORM

Appointment You Have Been Scheduled For A Cystoscopy __________________________at _________________________a.m/p.m. In our office located at [ ] Avon, 120 Simsbury Road [ ] Farmington: 399 Farmington Ave. [ ] Glastonbury: 330 Western Blvd. [ ] Meriden: 455 Lewis Ave. [ ] Hartford: 85 Seymour Street, Suite 416 [ ] Enfield: 100 Hazard Avenue

Let’s Get You Ready

First: The Terminology  Cystoscopy: A Procedure For Viewing The Urethra And Entire Interior Of The Bladder  Cystoscope: The Telescope And Tube Inserted Into The Bladder  Stent: A Small Tube Inserted Into The Ureter (Tube Connecting The Bladder With The Kidney)  Biopsy: The Term Used To Clip A Small Piece Of Tissue For Pathological Analysis

The Goal of A Cystoscopy  To Determine The Health Of The Urethra, And Bladder Blood In Urine, Frequent Urinary Tract Infections Blood In Urine, Frequent Urinary Tract Infections Bladder Stones Bladder Stones Cystitis (Bladder Inflammation) Cystitis (Bladder Inflammation) Suspicious Tissues Suspicious Tissues Biopsy Suspicious Tissues For Pathological AnalysisBiopsy Suspicious Tissues For Pathological Analysis  To Remove A Previously Inserted Stent

Cystoscopy 3 Different Procedures  Cystoscopy Procedure Viewing of the Bladder Only Viewing of the Bladder Only  Cystoscopy with Biopsy Viewing of the Bladder Viewing of the Bladder Biopsy of Suspicious Tissues Biopsy of Suspicious Tissues  Cystoscopy with Stent Removal Viewing of the Bladder Viewing of the Bladder Removal of the Stent Removal of the Stent

Cystoscopy: Male

Cystoscopy: Female

Purpose of a Cystoscopy  Assist In Obtaining Biopsies (“Bx”) Targeting Of Suspicious Areas Targeting Of Suspicious Areas Guidance For Systematic Biopsies Guidance For Systematic Biopsies  Collect A Urine Sample From The Bladder  Remove A Previously Inserted Stent  Treat Certain Bladder Conditions

Cystoscopy Procedure  Using A Small Flexible Cystoscope With A Light Local Anesthetic With Lubricant Is Used For Ease Of Entry Into Urethra Local Anesthetic With Lubricant Is Used For Ease Of Entry Into Urethra Inserted Up To The Bladder Inserted Up To The Bladder Water Or Saline Infused Into Bladder Water Or Saline Infused Into Bladder Physician Looks Through Telescope For Abnormalities Physician Looks Through Telescope For Abnormalities May Biopsy Suspicious TissuesMay Biopsy Suspicious Tissues May Remove A Previously Inserted StentMay Remove A Previously Inserted Stent Total Time: 10 Minutes Total Time: 10 Minutes

Tissue and Cell Analysis  Tissues from Biopsies and Cells in the Urine are sent for Pathological Analysis To Determine: To Determine: InflammationInflammation Cancerous TissuesCancerous Tissues Cancerous CellsCancerous Cells Type and Categorization Type and Categorization

Preparation for Cystoscopy Let Your Urologist Know The Medications You Take Let Your Urologist Know The Medications You Take Blood Thinner Medicines: Coumadin, Plavix, AspirinBlood Thinner Medicines: Coumadin, Plavix, Aspirin Over-the-counterOver-the-counter Vitamin EVitamin E GlucosamineGlucosamine Let Your Urologist Know Let Your Urologist Know If You Are Allergic To Local AnesthesiaIf You Are Allergic To Local Anesthesia Novocaine Novocaine Xylocaine Xylocaine Let Your Urologist Know If You Are Allergic To Let Your Urologist Know If You Are Allergic To Latex Or Iodine Type CompoundsLatex Or Iodine Type Compounds

Preparation The Day of the Cystoscopy  You May Drive Before And After The Procedure  Empty Your Bladder Just Before The Procedure  Total Time Of Procedure Is 10 Minutes  Complete Consent Form Upon Arrival

How is the Cystoscopy is Done  Office Procedure You May Drive Yourself To The Appointment You May Drive Yourself To The Appointment  Local Anesthesia (Lidocaine) Desensitizes The Urethra. Time 5 Minutes  Actual Cystoscopy: 3-4 Minutes  Removal of Stent or Biopsy. 1-2 minutes  Time From Beginning To End Is About 10 Minutes

What to Expect During the Cystoscopy  Mild Abdominal Discomfort  Strong Sense Of Urgency To Void  If A Biopsy Is Taken, A Momentary Twinge Then A Slight Burn Sensation If The Site Of The Biopsy Is Cauterized Then A Slight Burn Sensation If The Site Of The Biopsy Is Cauterized  If A Stent Is Removed, A Momentary Feeling Near The Kidney. It Normally Takes 1-2 Seconds To Remove The Stent. A Momentary Feeling Near The Kidney. It Normally Takes 1-2 Seconds To Remove The Stent.

How Painful Will The Procedure Be?  The Procedure Will Be Uncomfortable  Pain Will Be Minimal Lubricant With Anesthetic Is Used To Desensitize The Urethra Lubricant With Anesthetic Is Used To Desensitize The Urethra The Vast Majority Of Patients Can Tolerate This In An Office Setting And Thereby Avoid Hospitalization The Vast Majority Of Patients Can Tolerate This In An Office Setting And Thereby Avoid Hospitalization Anxiety Heightens The Pain ResponseAnxiety Heightens The Pain Response

What To Expect After the Cystoscopy  Blood In The Urine Typically Resolves Within 8-12 Hours Typically Resolves Within 8-12 Hours More Frequent In Men Than WomenMore Frequent In Men Than Women  Burning Sensation During Urination  More Frequent Urination During The Next Day Or Two

Blood In Urine – What to Look For  Look At Your Urine In A Clear Glass If You Are Worried About The Amount Of Blood You See.  Red, But Clear = Ok (Like Diluted Red Punch) This Is Expected This Is Expected Drink More Water Drink More Water  Thick And Dark Red = Too Bloody Rest And Drink More Water Rest And Drink More Water

What to Call Us About

Complications  Cystoscopy Carries Rare Risk Of Complications There Is A 1% Chance Of An Infection There Is A 1% Chance Of An Infection Less Than 1% Chance Of More Serious Bleeding Less Than 1% Chance Of More Serious Bleeding Men With Large Prostates May Develop Urine Retention And Require Catheters To Drain The Urine Men With Large Prostates May Develop Urine Retention And Require Catheters To Drain The Urine Cystoscopy May Not Be Performed On Men With Narrowing Of The Urethra (Urethral Stricture ) Cystoscopy May Not Be Performed On Men With Narrowing Of The Urethra (Urethral Stricture )

Please Call  Fever Higher Than 100 Degrees  Dark, Thick Red Urine That Does Not Clear With Increased Fluid Intake And Rest  Pain Of Burning During Urination That Last More Than Two Days

Bladder and Urine Tissue Pathology Results  Typically, Results Are Back Within 10 Working Days. Special Staining And Second Reviews May Take Longer. Special Staining And Second Reviews May Take Longer.  Your Results Will Be Given To You By Phone  If You Have Not Heard From Our Office Within Days, Please Call

Consent Form  Please Thoroughly Read The Consent Form  It Explains In More Detail The Cystoscopy Procedure  Ask Yourself: Are You Comfortable With Knowing About The Procedure? Are You Comfortable With Knowing About The Procedure? Have All Your Questions Been Answered? Have All Your Questions Been Answered?  When Complete, Please Sign The Consent Form Indicating You Have Read And Understand The Procedure. Bring It With You To Your Appointment

Billing  Your Insurance Will Be Billed For: The Procedure by Hartford Clinical Associates The Procedure by Hartford Clinical Associates A Laboratory Will Bill For The Pathological Analysis. A Laboratory Will Bill For The Pathological Analysis. A Reference Laboratory May Bill For The Technical Preparation Of The Slides For The Pathologist.A Reference Laboratory May Bill For The Technical Preparation Of The Slides For The Pathologist.  Number of Bills You May Receive Hartford Clinical Associates for the ProcedureHartford Clinical Associates for the Procedure A Pathologist Group for the Pathological AnalysisA Pathologist Group for the Pathological Analysis Another Laboratory for the Technical Preparation of SlidesAnother Laboratory for the Technical Preparation of Slides