CystoscopyCystoscopyCystoscopy and Stent RemovalCystoscopy and Stent Removal

Cystoscopy and BiopsyCystoscopy and Biopsy

PATIENT INSTRUCTIONS and PATIENT INSTRUCTIONS and CONSENT FORMCONSENT FORM

AppointmentAppointmentYou 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

Let’s Get You ReadyLet’s Get You Ready

First: The TerminologyFirst: The Terminology

Cystoscopy: A Procedure For Viewing The Cystoscopy: A Procedure For Viewing The Urethra And Entire Interior Of The BladderUrethra And Entire Interior Of The Bladder

Cystoscope: The Telescope And Tube Inserted Cystoscope: The Telescope And Tube Inserted Into The Bladder Into The Bladder

Stent: A Small Tube Inserted Into The Ureter Stent: A Small Tube Inserted Into The Ureter (Tube Connecting The Bladder With The Kidney)(Tube Connecting The Bladder With The Kidney)

Biopsy: The Term Used To Clip A Small Piece Biopsy: The Term Used To Clip A Small Piece Of Tissue For Pathological AnalysisOf Tissue For Pathological Analysis

The Goal of A CystoscopyThe Goal of A Cystoscopy

To Determine The Health Of The Urethra, And BladderTo Determine The Health Of The Urethra, And Bladder Blood In Urine, Frequent Urinary Tract Infections Blood In Urine, Frequent Urinary Tract Infections Bladder StonesBladder Stones Cystitis (Bladder Inflammation)Cystitis (Bladder Inflammation) Suspicious TissuesSuspicious Tissues

• Biopsy Suspicious Tissues For Pathological AnalysisBiopsy Suspicious Tissues For Pathological Analysis To Remove A Previously Inserted StentTo Remove A Previously Inserted Stent

CystoscopyCystoscopy3 Different Procedures3 Different Procedures

Cystoscopy ProcedureCystoscopy Procedure Viewing of the Bladder OnlyViewing of the Bladder Only

Cystoscopy with BiopsyCystoscopy with Biopsy Viewing of the BladderViewing of the Bladder Biopsy of Suspicious TissuesBiopsy of Suspicious Tissues

Cystoscopy with Stent RemovalCystoscopy with Stent Removal Viewing of the BladderViewing of the Bladder Removal of the StentRemoval of the Stent

Cystoscopy: MaleCystoscopy: Male

Cystoscopy: FemaleCystoscopy: Female

Purpose of a CystoscopyPurpose of a Cystoscopy

Assist In Obtaining Biopsies (“Bx”)Assist In Obtaining Biopsies (“Bx”) Targeting Of Suspicious AreasTargeting Of Suspicious Areas Guidance For Systematic BiopsiesGuidance For Systematic Biopsies

Collect A Urine Sample From The BladderCollect A Urine Sample From The Bladder Remove A Previously Inserted StentRemove A Previously Inserted Stent Treat Certain Bladder ConditionsTreat Certain Bladder Conditions

Cystoscopy ProcedureCystoscopy Procedure

Using A Small Flexible Cystoscope With A Using A Small Flexible Cystoscope With A LightLight

Local Anesthetic With Lubricant Is Used For Ease Local Anesthetic With Lubricant Is Used For Ease Of Entry Into UrethraOf Entry Into Urethra

Inserted Up To The BladderInserted Up To The Bladder Water Or Saline Infused Into BladderWater Or Saline Infused Into Bladder Physician Looks Through Telescope For Physician Looks Through Telescope For

AbnormalitiesAbnormalities• May Biopsy Suspicious TissuesMay Biopsy Suspicious Tissues• May Remove A Previously Inserted StentMay Remove A Previously Inserted Stent

Total Time: 10 MinutesTotal Time: 10 Minutes

Tissue and Cell Analysis Tissue and Cell Analysis Tissues from Biopsies and Cells in Tissues from Biopsies and Cells in

the Urine are sent for Pathological the Urine are sent for Pathological AnalysisAnalysis To Determine:To Determine:

• InflammationInflammation• Cancerous TissuesCancerous Tissues• Cancerous CellsCancerous Cells

Type and CategorizationType and Categorization

Preparation for CystoscopyPreparation for Cystoscopy Let Your Urologist Know The MedicationsLet Your Urologist Know The Medications You Take You Take

• Blood Thinner Medicines: Coumadin, Plavix, AspirinBlood Thinner Medicines: Coumadin, Plavix, Aspirin• Over-the-counterOver-the-counter• Vitamin EVitamin E• GlucosamineGlucosamine

Let Your Urologist KnowLet Your Urologist Know• If You Are Allergic To Local AnesthesiaIf You Are Allergic To Local Anesthesia

NovocaineNovocaine XylocaineXylocaine

Let Your Urologist Know If You Are AllergicLet Your Urologist Know If You Are Allergic To To• Latex Or Iodine Type CompoundsLatex Or Iodine Type Compounds

PreparationPreparationThe Day of the CystoscopyThe Day of the Cystoscopy

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

How is the Cystoscopy is DoneHow is the Cystoscopy is Done

Office ProcedureOffice Procedure You May Drive Yourself To The AppointmentYou May Drive Yourself To The Appointment

Local Anesthesia (Lidocaine) Desensitizes Local Anesthesia (Lidocaine) Desensitizes The Urethra. Time 5 MinutesThe Urethra. Time 5 Minutes

Actual Cystoscopy: 3-4 MinutesActual Cystoscopy: 3-4 Minutes Removal of Stent or Biopsy. 1-2 minutesRemoval of Stent or Biopsy. 1-2 minutes Time From Beginning To End Is About 10 Time From Beginning To End Is About 10

MinutesMinutes

What to Expect During the What to Expect During the CystoscopyCystoscopy

Mild Abdominal DiscomfortMild Abdominal Discomfort Strong Sense Of Urgency To VoidStrong Sense Of Urgency To Void If A Biopsy Is Taken, A Momentary Twinge If A Biopsy Is Taken, A Momentary Twinge

Then A Slight Burn Sensation If The Site Of Then A Slight Burn Sensation If The Site Of The Biopsy Is CauterizedThe Biopsy Is Cauterized

If A Stent Is Removed, If A Stent Is Removed, A Momentary Feeling Near The Kidney. It A Momentary Feeling Near The Kidney. It

Normally Takes 1-2 Seconds To Remove The Normally Takes 1-2 Seconds To Remove The Stent.Stent.

How Painful Will The Procedure How Painful Will The Procedure Be?Be?

The Procedure Will Be UncomfortableThe Procedure Will Be Uncomfortable Pain Will Be MinimalPain Will Be Minimal

Lubricant With Anesthetic Is Used To Lubricant With Anesthetic Is Used To Desensitize The UrethraDesensitize The Urethra

The Vast Majority Of Patients Can Tolerate This The Vast Majority Of Patients Can Tolerate This In An Office Setting And Thereby Avoid In An Office Setting And Thereby Avoid HospitalizationHospitalization

• Anxiety Heightens The Pain ResponseAnxiety Heightens The Pain Response

What To Expect After the What To Expect After the CystoscopyCystoscopy

Blood In The UrineBlood In The Urine Typically Resolves Within 8-12 HoursTypically Resolves Within 8-12 Hours

• More Frequent In Men Than WomenMore Frequent In Men Than Women

Burning Sensation During UrinationBurning Sensation During Urination More Frequent Urination During The Next More Frequent Urination During The Next

Day Or TwoDay Or Two

Blood In Urine – What to Look ForBlood In Urine – What to Look For

Look At Your Urine In A Clear Glass If Look At Your Urine In A Clear Glass If You Are Worried About The Amount You Are Worried About The Amount Of Blood You See.Of Blood You See.

Red, But Clear = Ok (Like Diluted Red Red, But Clear = Ok (Like Diluted Red Punch)Punch) This Is ExpectedThis Is Expected Drink More WaterDrink More Water

Thick And Dark Red = Too BloodyThick And Dark Red = Too Bloody Rest And Drink More WaterRest And Drink More Water

What to Call Us AboutWhat to Call Us About

ComplicationsComplications

Cystoscopy Carries Rare Risk Of ComplicationsCystoscopy Carries Rare Risk Of Complications There Is A 1% Chance Of An InfectionThere Is A 1% Chance Of An Infection Less Than 1% Chance Of More Serious Less Than 1% Chance Of More Serious

BleedingBleeding Men With Large Prostates May Develop Urine Men With Large Prostates May Develop Urine

Retention And Require Catheters To Drain Retention And Require Catheters To Drain The UrineThe Urine

Cystoscopy May Not Be Performed On Men Cystoscopy May Not Be Performed On Men With Narrowing Of The Urethra (Urethral With Narrowing Of The Urethra (Urethral StrictureStricture))

Please CallPlease Call

Fever Higher Than 100 Degrees Fever Higher Than 100 Degrees Dark, Thick Red Urine That Does Not Dark, Thick Red Urine That Does Not

Clear With Increased Fluid Intake And Clear With Increased Fluid Intake And RestRest

Pain Of Burning During Urination That Pain Of Burning During Urination That Last More Than Two DaysLast More Than Two Days

Bladder and Urine Tissue Bladder and Urine Tissue Pathology ResultsPathology Results

Typically, Results Are Back Within 10 Working Days.Typically, Results Are Back Within 10 Working Days. Special Staining And Second Reviews May Take Longer.Special Staining And Second Reviews May Take Longer.

Your Results Will Be Given To You By PhoneYour Results Will Be Given To You By Phone If You Have Not Heard From Our Office Within 10-14 Days, If You Have Not Heard From Our Office Within 10-14 Days,

Please CallPlease Call

Consent FormConsent Form Please Thoroughly Read The Consent FormPlease Thoroughly Read The Consent Form It Explains In More Detail The Cystoscopy It Explains In More Detail The Cystoscopy

ProcedureProcedure Ask Yourself: Ask Yourself:

Are You Comfortable With Knowing About The Are You Comfortable With Knowing About The Procedure? Procedure?

Have All Your Questions Been Answered?Have All Your Questions Been Answered? When Complete, Please Sign The Consent When Complete, Please Sign The Consent

Form Indicating You Have Read And Form Indicating You Have Read And Understand The Procedure. Bring It With You Understand The Procedure. Bring It With You To Your AppointmentTo Your Appointment

BillingBilling

Your Insurance Will Be Billed For:Your Insurance Will Be Billed For: The Procedure by Hartford Clinical AssociatesThe Procedure by Hartford Clinical Associates A LaboratoryA Laboratory Will Bill For The Pathological Analysis.Will Bill For The Pathological Analysis.

• A Reference Laboratory May Bill For The Technical A Reference Laboratory May Bill For The Technical Preparation Of The Slides For The Pathologist.Preparation Of The Slides For The Pathologist.

Number of Bills You May ReceiveNumber of Bills You May Receive• Hartford Clinical Associates for the ProcedureHartford Clinical Associates for the Procedure• A Pathologist Group for the Pathological AnalysisA Pathologist Group for the Pathological Analysis• Another Laboratory for the Technical Preparation of SlidesAnother Laboratory for the Technical Preparation of Slides