CO2 Cystoscopy for Evaluation of Ureteral Patency

Publication date: Available online 27 August 2018Source: Journal of Minimally Invasive GynecologyAuthor(s): Marco Aurelio Pinho Oliveira, Thiers Soares Raymundo, Thiago Rodrigues Dantas Pereira, Felipe Vaz de Lima, Diogo Eugenio Abreu da SilvaABSTRACTGynecological surgeries are associated with various perioperative complications, especially urinary tract injuries. Intraoperative cystoscopy plays an important role in allowing the bladder to be assessed to ensure there are no injuries. The verification of the urinary jet from the ureters is a fundamental step but is not always easy to accomplish. Dyes are frequently used but they are not always available and are associated with adverse effects. Our study aims to demonstrate the use of CO2 as the medium of distension during cystoscopy. A total of 47 patients underwent CO2 cystoscopy after laparoscopic hysterectomy (26) or bladder endometriosis nodule resection (21). The ureteral jets were easily identified in all cases, leaving no doubt as to their patency. The median time between the onset of cystoscopy and the view of jetting from both ureteral ostia was 145 seconds (range 80-300 seconds). All cystoscopies were normal and no patient had any signs of accidental urinary tract injury in the follow-up period. Only two patients had a mild urinary tract infection. The cystoscopy technique using CO2 was fast, easy, safe and efficient. We recommend that bladder distension with CO2 should be a reasonable alternative when cystoscopy is ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research