Inserting the instrument:
™ Calibrate external urethral meatus.
™ Introduce the cystoscope blindly or under direct vision.
™ Procedure should be pain free.
™ Never use pressure or force.
™ Gently introduce the sheath without mucosal injury to avoid possible urethral strictures.
™ Blind introduction in men: ™ Straighten the penis. ™ Use excessive lubricating gel. ™ Introduce the sheath, closed with the obturator.
™ In the bulbar part, the urethra turns from an almost horizontal direction to a steep rise behind the symphysis towards the bladder neck. The curvature at the bulb is easily to overcome by lowering the instrument.
™ Curvature due to a large endovesical median lobe: this change in direction must be compensated for by lowering the eyepiece of the instrument, a possibly painful procedure in patients without anaesthesia.
™ Introduction under direct vision in men: ™ Straighten the penis. ™ Use excessive lubricating gel. ™ Introduce the sheath over the external meatus closed with the obturator. ™ Remove the obturator and use the 0° telescope.
™ With continuous flow irrigation and straightened urethra, gently move towards the bladder.
Was this article helpful?