Answer
Answer
Complications of surveillance cystoscopy are as follows:
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Urinary tract infection (10%) [12]
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Dysuria
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Hematuria
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Urethral stricture
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Pain
In a patient with spinal cord injury, autonomic dysreflexia can occur as a response to bladder distention, leading to potentially life-threatening hypertension. This may be prevented with nifedipine or terazosin in some cases, but careful monitoring is requisite. Any signs of headache, tremors, or hypertension should lead to immediate cessation of the procedure and emptying of the distended bladder. For this reason, most patients with spinal cord injury should probably undergo cystoscopy in the operating room with anesthesia monitoring.
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Media Gallery
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The classic appearance of carcinoma in situ as a flat, velvety patch. However, using special staining techniques such as 5-aminolevulinic acid, it has been shown that significant areas of carcinoma in situ are easily overlooked by conventional cystoscopy. Courtesy of Abbott and Vysis Inc.
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Papillary bladder tumors such as this one are typically of low stage and grade (Ta-G1). Courtesy of Abbott and Vysis Inc.
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Sessile lesions as shown usually invade muscle, although occasionally a tumor is detected at the T1-G3 stage prior to muscle invasion. Courtesy of Abbott and Vysis Inc.
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Flexible cystoscopes such as this one facilitate endoscopic tumor surveillance with minimal morbidity and excellent visualization of the urothelium. Courtesy of Olympus America Inc.
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The latest development in surveillance involves advances that integrate video chip technology on to the end of flexible cystoscopes. Courtesy of Olympus America Inc.
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Rigid cystoscopes such as this one allow biopsy collection via in-office fulguration of small tumors. Such fulguration may be performed using electrocautery or laser. Courtesy of Olympus America Inc.
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Resection of all visible tumors is possible using modern resectoscopes. Courtesy of Olympus America Inc.
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Photograph in which fluorescence in situ hybridization centromere staining identifies aneuploidy of chromosome 3. Multiple instances of overexpression of the chromosome (note the multiple red dots, which identify centromeres of this chromosome) prove aneuploidy.
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