Cystoscopy Cystoscopy and Stent Removal Cystoscopy and Biopsy

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CystoscopyCystoscopy and Stent
RemovalCystoscopy and Biopsy

• PATIENT INSTRUCTIONS and CONSENT FORM

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Appointment
You Have Been Scheduled For A Cystoscopy
__________________________at ____________________
_____a.m/p.m. In our office located at
Avon, 120 Simsbury Road Farmington 399
Farmington Ave. Glastonbury 330 Western
Blvd. Meriden 455 Lewis Ave.
Hartford 85 Seymour Street, Suite 416
Enfield 100 Hazard Avenue
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Lets Get You Ready
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First The Terminology

• Cystoscopy A Procedure For Viewing The Urethra
  And Entire Interior Of The Bladder
• Cystoscope The Telescope And Tube Inserted Into
  The Bladder
• Stent A Small Tube Inserted Into The Ureter
  (Tube Connecting The Bladder With The Kidney)
• Biopsy The Term Used To Clip A Small Piece Of
  Tissue For Pathological Analysis

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The Goal of A Cystoscopy

• To Determine The Health Of The Urethra, And
  Bladder
• Blood In Urine, Frequent Urinary Tract Infections
  
• Bladder Stones
• Cystitis (Bladder Inflammation)
• Suspicious Tissues
• Biopsy Suspicious Tissues For Pathological
  Analysis
• To Remove A Previously Inserted Stent

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Cystoscopy3 Different Procedures

• Cystoscopy Procedure
• Viewing of the Bladder Only
• Cystoscopy with Biopsy
• Viewing of the Bladder
• Biopsy of Suspicious Tissues
• Cystoscopy with Stent Removal
• Viewing of the Bladder
• Removal of the Stent

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Cystoscopy Male
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Cystoscopy Female
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Purpose of a Cystoscopy

• Assist In Obtaining Biopsies (Bx)
• Targeting Of Suspicious Areas
• Guidance For Systematic Biopsies
• Collect A Urine Sample From The Bladder
• Remove A Previously Inserted Stent
• Treat Certain Bladder Conditions

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Cystoscopy Procedure

• Using A Small Flexible Cystoscope With A Light
• Local Anesthetic With Lubricant Is Used For Ease
  Of Entry Into Urethra
• Inserted Up To The Bladder
• Water Or Saline Infused Into Bladder
• Physician Looks Through Telescope For
  Abnormalities
• May Biopsy Suspicious Tissues
• May Remove A Previously Inserted Stent
• Total Time 10 Minutes

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Tissue and Cell Analysis

• Tissues from Biopsies and Cells in the Urine are
  sent for Pathological Analysis
• To Determine
• Inflammation
• Cancerous Tissues
• Cancerous Cells
• Type and Categorization

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Preparation for Cystoscopy

• Let Your Urologist Know The Medications You Take
• Blood Thinner Medicines Coumadin, Plavix,
  Aspirin
• Over-the-counter
• Vitamin E
• Glucosamine
• Let Your Urologist Know
• If You Are Allergic To Local Anesthesia
• Novocaine
• Xylocaine
• Let Your Urologist Know If You Are Allergic To
• Latex Or Iodine Type Compounds

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PreparationThe Day of the Cystoscopy

• You May Drive Before And After The Procedure
• Empty Your Bladder Just Before The Procedure
• Total Time Of Procedure Is 10 Minutes
• Complete Consent Form Upon Arrival

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How is the Cystoscopy is Done

• Office Procedure
• You May Drive Yourself To The Appointment
• Local Anesthesia (Lidocaine) Desensitizes The
  Urethra. Time 5 Minutes
• Actual Cystoscopy 3-4 Minutes
• Removal of Stent or Biopsy. 1-2 minutes
• Time From Beginning To End Is About 10 Minutes

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What to Expect During the Cystoscopy

• Mild Abdominal Discomfort
• Strong Sense Of Urgency To Void
• If A Biopsy Is Taken, A Momentary Twinge
• Then A Slight Burn Sensation If The Site Of The
  Biopsy Is Cauterized
• If A Stent Is Removed,
• A Momentary Feeling Near The Kidney. It Normally
  Takes 1-2 Seconds To Remove The Stent.

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How Painful Will The Procedure Be?

• The Procedure Will Be Uncomfortable
• Pain Will Be Minimal
• Lubricant With Anesthetic Is Used To Desensitize
  The Urethra
• The Vast Majority Of Patients Can Tolerate This
  In An Office Setting And Thereby Avoid
  Hospitalization
• Anxiety Heightens The Pain Response

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What To Expect After the Cystoscopy

• Blood In The Urine
• Typically Resolves Within 8-12 Hours
• More Frequent In Men Than Women
• Burning Sensation During Urination
• More Frequent Urination During The Next Day Or Two

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Blood In Urine What to Look For

• Look At Your Urine In A Clear Glass If You Are
  Worried About The Amount Of Blood You See.
• Red, But Clear Ok (Like Diluted Red Punch)
• This Is Expected
• Drink More Water
• Thick And Dark Red Too Bloody
• Rest And Drink More Water

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What to Call Us About
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Complications

• Cystoscopy Carries Rare Risk Of Complications
• There Is A 1 Chance Of An Infection
• Less Than 1 Chance Of More Serious Bleeding
• Men With Large Prostates May Develop Urine
  Retention And Require Catheters To Drain The
  Urine
• Cystoscopy May Not Be Performed On Men With
  Narrowing Of The Urethra (Urethral Stricture)

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Please Call

• Fever Higher Than 100 Degrees
• Dark, Thick Red Urine That Does Not Clear With
  Increased Fluid Intake And Rest
• Pain Of Burning During Urination That Last More
  Than Two Days

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Bladder and Urine Tissue Pathology Results

• Typically, Results Are Back Within 10 Working
  Days.
• Special Staining And Second Reviews May Take
  Longer.
• Your Results Will Be Given To You By Phone
• If You Have Not Heard From Our Office Within
  10-14 Days, Please Call

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Consent Form

• Please Thoroughly Read The Consent Form
• It Explains In More Detail The Cystoscopy
  Procedure
• Ask Yourself
• Are You Comfortable With Knowing About The
  Procedure?
• Have All Your Questions Been Answered?
• When Complete, Please Sign The Consent Form
  Indicating You Have Read And Understand The
  Procedure. Bring It With You To Your Appointment

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Billing

• Your Insurance Will Be Billed For
• The Procedure by Hartford Clinical Associates
• A Laboratory Will Bill For The Pathological
  Analysis.
• A Reference Laboratory May Bill For The Technical
  Preparation Of The Slides For The Pathologist.
• Number of Bills You May Receive
• Hartford Clinical Associates for the Procedure
• A Pathologist Group for the Pathological Analysis
• Another Laboratory for the Technical Preparation
  of Slides