Uses of cystoscopy in small animals

Introduction:

Cystoscopy is the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery). 

Areas that can be examined include the following: 

Urethra or urinary channel, Bladder, which collects and stores urine, The 2 ureters, which are small internal tubes that conduct the urine made by each kidney into the bladder. Cystoscopy is a powerful tool for characterization of lower urinary tract disease in dogs and cats.  Current applications of cystoscopy include diagnostic and interventional techniques. 

Cystoscopy equipment:

Rigid cystoscopes are used for females and male cats with perineal urethrostomies. It is important to match the size of cystoscope to the size of the patient.  The best image will be obtained with the largest cystoscope that can be easily passed through the urethra.

Light sources:

Many different light sources are available for use in cystoscopy. Xenon light sources are generally considered optimal and are available from several different companies. Some newer light sources have automatic light adjustment, but most require that an assistant adjust the light level throughout the examination.

 Image capture:

Images of the lower urinary tract may be viewed through the eyepiece of the cystoscope or via camera equipment attached to the cystoscope eyepiece.  Still images or video images may be captured in a variety of formats depending on the equipment used.

Biopsy instruments:

Most cystoscope’s have an instrument channel that will accommodate a biopsy instrument. The cystoscope can be used to select an optimal location for biopsy and to direct the biopsy instrument.

CYSTOSCOPY PROCEDURES

Male dog cystoscopy procedures:

In the male dog, the penis is extruded from the prepuce by an assistant while the examiner passes the cystoscope up the urethra. Fluid is injected through the instrument port to distend the urethra and ease the passage of the cystoscope.  The instrument is manipulated to keep the image of the urethral lumen in the center of the screen.

Male cat cystoscopy procedures:

Just as in the male dog, the male cat penis is extruded from the prepuce and the flexible cystoscope is directed up the urethra while fluid is simultaneously infused to distend the urethra and ease the passage of the cystoscope. A mosquito hemostat or stay sutures secured to the prepuce may be necessary to maintain extrusion of the penis throughout the examination.

Female cystoscopy procedures:

The cystoscope is directed slightly dorsally to enter the vaginal vestibule. The vulvar labia are pressed firmly closed and retracted slightly to form a chamber that is distended with irrigation fluid.