Flexible fiberoptic technology was first applied to cystoscopy in 1973, with greatly increased usage since 1982. Most procedures formerly performed with rigid cystoscopes can be done using flexible cystoscopes with minimal or no anesthesia. Patient positioning and precystocopy preparation and draping are simplified with the flexible fiberoptic instruments. Complete examination of the urethra and bladder can be performed with a single-lens system and with the patient in a variety of positions. Fiberoptic cystoscopy is limited in patients who are bleeding or have blood clots in their bladders. Withdrawal of irrigant or bladder drainage is cumbersome, and the fiberoptic image is currently not of the same caliber as that of the rigid-lens systems. Fiberoptic cystoscopy has become the procedure of choice for many urologists for ureteral stenting prior to extracorporeal shock-wave lithotripsy. With the advent of lithotripters that require no anesthesia, this application is likely to broaden. Future applications of flexible cystoscopy may include a flexible videocystoscope for use in diagnostic and therapeutic procedures.
Kennedy, TJ; Preminger, GM
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