Catheters made of bronze or tin were inserted into the urinary bladder as early as 3,000 years before Christ in ancient Egypt, and Hippocrates used rigid tubes to look into the mouth or rectum around 400 before Christ. At the beginning of the 19th century, the German physician Bozzoni came up with the idea of using candlelight in addition to a two-part tube – his “light guide” was the archetype of endoscopy, which can be used to examine body cavities. The first “modern” cystoscope was introduced by Dresden urologist Nitze 70 years later.
Definition: what is endoscopy?
Looking inside the body without hurting it: an ancient dream of physicians. Reflections of body cavities, technically endoscopies (endo = inside, skopie = looking around) have offered this possibility – along with X-ray and ultrasound examinations – for a good 100 years now.
They have the advantage that the organ can not only be viewed directly from the inside, but the examiner can simultaneously take tissue samples, perform measurements and even perform therapeutic interventions.
How does cystoscopy work?
When the urinary bladder (cystis) is examined, the endoscope is inserted through the urethra and this is usually examined at the same time – the procedure is therefore also known as urethrocystoscopy. If the examination is extended to the ureter and the renal pelvis, it is called ureterorenoscopy.
The endoscope (cystoscope) is a tube-shaped device, rigid or flexible depending on the problem, with a diameter of three to four millimeters, which includes a light source and a light-conducting cable (with a small camera at the end), which is inserted through a channel. An additional channel is used for irrigation and suction, and through another, for example, irrigation fluids, auxiliary instruments or ureteral stents (stents; for bridging narrowings) can be inserted and tissue samples or stones extracted.
In addition, an X-ray contrast medium can also be filled into the ureters and thus these can be visualized together with the renal pelvis in the X-ray image (retrograde urography).
When is cystoscopy performed?
There are a number of reasons for cystoscopy:
- Blood in the urine (hematuria).
- Suspicion of a tumor, a stone or a foreign body
- Suspicion of narrowing of the urethra
- Follow-up after removal of bladder cancer.
- Recurrent urinary tract infections
- Unclear pain during urination
- Voiding disorders
However, in some of these indications, other tests are done first, for example, urine tests , blood tests and examinations of the kidney and urinary tract, X-ray. In any case, a blood test is done first to rule out clotting disorders.
