Interpretation of cystoscope:

Vaginal vestibule:

The appearance of the normal vaginal vestibule when distended with fluid. The vagina is located at the top of the screen, the cingulum is the band of tissue between the vagina and the urethra and the external urethral orifice is the opening in the middle of the image.

Urethra:

The normal female urethra is characterized by smooth, pale pink mucosa and a dorsal urethral membrane. The male urethra appears similar, but the urethral lumen is smaller and less distensible. Normal location of the ureters within the bladder:

The ureters are located just inside the bladder neck in the trigone. They are c-shaped and the open areas of the c’s face each other; both ureters are located in the same plane within the bladder. The right ureter is located on the right side of the screen and the left ureter on the left side of the screen.

Normal vagina:

The caudal female reproductive tract can be examined via cystoscope from the vagina to an area just caudal to the cervix called the pseudocervix. The vagina has numerous mucosal folds and with distension, a dorsal membrane similar to that seen in the urethra, may be appreciated. The appearance of the mucosa changes during the estrus cycle.

When is Cystoscopy Indicated??

Cystoscopy can be used to help identify ectopic ureters in dogs, a common reason many young dogs present with urinary incontinence. We can also use cystoscopy to less invasively obtain biopsies of the lower urinary tract if mass lesions such as polyps or tumors are suspected.

ECTOPIC URETERS

Oftentimes, we use this technique to evaluate dogs and cats that present with recurrent urinary tract infections; if no underlying cause is found, biopsy forceps can be inserted through the scope and small samples of the bladder wall can be obtained and submitted for histopathology and culture analysis.

Finally, the cystoscope can be used as a treatment option for stones ectopic ureters, as well as sub mucosal urethral collagen injections for treatment of urinary incontinence.

Why It Is Done??

Cystoscopy may be done to:

Find the cause of symptoms such as blood in the urine (hematuria), Painful urination (dysuria), urinary incontinence, urinary frequency or hesitancy, an inability to pass urine (retention), Or a sudden and overwhelming need to urinate (urgency). Find the cause of problems of the urinary tract, such as frequent, repeated urinary tract infections or urinary tract infections that do not respond to treatment. Look for problems in the urinary tract, such as blockage in the urethra caused by an enlarged prostate, kidney stones, or tumors. Evaluate problems that cannot be seen on X-ray or to further investigate problems detected by ultrasound or during intravenous pyelography, such as kidney stones or tumors. Remove tissue samples for biopsy. Remove foreign objects. Place ureteral catheters (stents) to help urine flow from the kidneys to the bladder. Treat urinary tract problems. For example, cystoscopy can be done to remove urinary tract stones or growths, treat bleeding in the bladder, relieve blockages in the urethra, or treat or remove tumors.

Place a catheter in the ureters for an X-ray test called retrograde pyelography. A dye that shows up on an X-ray picture is injected through the catheter to fill and outline the ureter and the inside of the kidney.

Limitation of Cystoscope:

ü  Invasive.

ü  Time-consuming.

ü  Expensive.

ü  The mucosa at the bladder neck and within bladder diverticula is not accessible.

ü  Need sedation.

ü  Susceptibility to infection or injury

Complications and Sequelae of Cystoscope

ü  Cystoscopy generally is a very safe test.

ü  If a general anesthetic is used, there are some risks of general anesthesia.

ü  There is no risk of loss of sexual function.

ü  Profuse bleeding.

ü  Damaged urethra(swelling).

ü  Perforated bladder.

ü  Urinary tract infection.

ü  Injured penis.                                               

ü  scar tissue.

CYSTOSCOPY

Normal:	The urethra, bladder, and ureters are normal.
	There are no polyps or other abnormal tissues, swelling, bleeding, narrow areas (strictures), or structural abnormalities.
Abnormal:	There is swelling or narrowing of the urethra because of previous infections or an enlarged prostate gland.
	There are bladder tumors (cancerous or benign), polyps, ulcers, urinary stones, or inflammation of the bladder walls.
	Abnormalities in the structure of the urinary tract present since birth (congenital) are seen.
	Pelvic organ prolapse is present in a woman.

What Affects the Test (contraindication) ??

A cystoscopy is usually not done if you have an infection of the bladder, prostate gland, or urethra.