Technique

• Inspection of the urethra requires a 0°, 12° or 30° telescope

• Careful attention must be paid to the following areas —the external urethral meatus

—anterior (penile) urethra —external urethral sphincter

—prostatic urethra (occlusion, length, vascularity) —bladder neck (open or tight/high)

• Upon entry into the bladder the residual urine volume is noted

• A systematic examination of the entire bladder is performed using either a 30° or 70° telescope, including—

—state of the urothelium —degree of trabeculation —ureteric orifices

—bladder neck (may require a 90° or 120° telescope if using a rigid instrument) —abnormalities (e.g., tumor, stones, diverticula, flat urothelial abnormalities)

• The bladder is emptied at the completion of the procedure Complications

Complications can be significantly minimized by proper technique and avoiding cystoscopy in patients suspected of having an active UTI. The more frequent complications include—

• Hematuria (usually clears within 3 voids)

• UTI (<5% with prophylaxis, up to 38% without)

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