Cystoscope is one of the most commonly used inspection tools in urology. Up to now, metal rigid cystoscope is basically used in clinical practice. With the development of endourology, flexible cystoscopes have come out and have been used clinically.
The difference between flexible cystoscopy and rigid cystoscopy:
The flexible cystoscope has a soft body, a small diameter and can be bent. The diameter of the rigid cystoscope for adults is generally F19.5~21, while the diameter of the flexible cystoscope is generally less than or equal to F16. Due to the smaller diameter, the pain of the patient is reduced. During the entire inspection process, no matter how the mirror body is rotated, lifted and inserted, there is no discomfort. The vast majority of patients had no pain when urinating immediately after the examination, and a small number of patients had mild gross hematuria after examination, and the rest of the urine color was normal.
With rigid cystoscopy, patients can only use the lithotomy position. In the application of flexible cystoscopy, in addition to the lithotomy position, the patient can also use the lateral or supine position. This is convenient for patients with quadriplegia, paraplegia, and patients with severe arthritis. Because the flexible cystoscope enters the bladder through the urethra under direct vision, and can bend with the normal physiological curvature of the urethra, the damage to the urethra is reduced. Examination of patients with semi-rigid penile prostheses with rigid cystoscopes is difficult and often unsuccessful, whereas the increased length and maneuverability of flexible cystoscopes makes this examination easily accomplished.
Generally, a 0° direct-view mirror is used when examining the urethra, and a 30°-120° side-view mirror is required when examining the bladder. Therefore, when using a rigid cystoscope to examine the bladder and urethra, it is often necessary to disassemble and assemble the components, and replace the observation mirror with different angles to Observation of various parts of the bladder and intraluminal manipulation; the use of a flexible cystoscope does not have these shortcomings. The rigid cystoscope has a certain blind spot in the bladder due to the limitation of the observation angle; the flexible cystoscope overcomes this shortcoming, and can observe the urethra when inserted under direct vision. , bent down 90°, increasing the observation range. It has been reported that the missed diagnosis rate of flexible cystoscopy is no higher than that of rigid cystoscopy.
Although flexible cystoscopy has many advantages over rigid cystoscopy, it also
There are some deficiencies. If the lumen is thin, the perfusion fluid enters and exits slowly, and the blood in the bladder cannot be quickly cleared, so it should not be used in patients with acute bleeding and blood clots in the bladder. Due to the difficulty of intravesical orientation of flexible cystoscopes, a process of proficiency and adaptation is required. The price of the flexible cystoscope is higher than that of the rigid cystoscope with the same performance and the service life is shorter than that of the rigid cystoscope, thus increasing the inspection cost.
Flexible cystoscope is very suitable for intrarenal application due to its thin, flexible and long scope, especially for the treatment of secondary renal stones caused by ureteral obstruction and postoperative renal residual stones.
Disclaimer: This article focuses on the popularization of medical knowledge and does not seek any economic benefits. If there is any infringement, please contact us in time.
