Actively deflectable, flexible cystoscopes: no longer solely a diagnostic instrument

Area of Science:

• Urology
• Endourology
• Minimally Invasive Surgery

Background:

• Advancements in actively deflectable, flexible endoscopes have led to the development of the flexible cystoscope.
• Key improvements include enhanced optics, deflectability, and optimized sheath/working channel dimensions for broader instrument compatibility.

Purpose of the Study:

• To evaluate the clinical utility and therapeutic applications of a superior flexible cystoscope in managing diverse urologic conditions.
• To assess the feasibility of bedside treatments using flexible cystoscopy under local anesthesia.

Main Methods:

• A cohort of 55 patients with urethral, bladder, or upper urinary tract lesions underwent bedside treatment using a flexible cystoscope.
• Procedures included urethral stricture treatment, bladder neck contracture management, ureteral catheter placement, stent removal, foreign body retrieval, laser treatment of bladder tumors (Nd:YAG), and laser lithotripsy (pulsed-dye laser).
• A dedicated treatment cart facilitated efficient bedside procedures.

Main Results:

• Flexible cystoscopy enabled successful bedside treatment for a range of urologic pathologies in 55 patients.
• Therapeutic applications included stricture repair, tumor ablation, stone fragmentation, and foreign body removal.
• Procedures were typically performed under local anesthesia, highlighting the minimally invasive nature of the technique.

Conclusions:

• The flexible cystoscope is a versatile and effective tool for a variety of urologic treatments, adaptable to diverse clinical settings.
• Its application extends from diagnostic consultations to therapeutic interventions, including laser therapies and foreign body retrieval.
• The development of a superior flexible cystoscope with specific features facilitates efficient and minimally invasive patient care.