Ultrasonography

The imaging of deep structures of the body by recording the echoes of pulses ofultrasoni
c waves directed into the tissues and reflected by tissue planes where there is a change i
n density. Diagnostic ultrasonography
uses 110 megahertz waves.
a radiologic technique in which deep structures of the body are visualized by recording th
e reflections (echoes) of ultrasonic waves directed into the tissue.
A particularly important use of ultrasonography is in the field of obstetrics and gynecolog
y, where ionizing radiation is to be avoidedwhenever possible. The technique can evaluat
e fetal size and maturity and fetal and placental position. It is a fast, relatively safe, andr
eliable technique for diagnosing multiple pregnancies. Uterine tumors and other pelvic m
asses, including abscesses, can beidentified by ultrasonography.
Amode ultrasonography that in which on the cathoderay tube display one axis represe
nts the time required for the return of the echoand the other corresponds to the strength
of the echo.
Bmode ultrasonography that in which the position of a spot on the CRT display corresp
onds to the time elapsed and the brightness of the spot to the strength of the echo; mov
ement of the transducer produces asweep of the ultrasound beam and a tomographic sc
an of a cross section of the body.
Doppler ultrasonography that in which measurement and a visual record are made of
the shift in frequency of a continuous ultrasonicwave proportional to the blood-flow veloc
ity in underlying vessels; used in diagnosis of extracranial occlusive vascular disease. It i
s alsoused in detection of the fetal heart beat or of the velocity of movement of a structu
re, such as the beating heart.
Gray-scale ultrasonography B-mode ultrasonography in which the strength of echoes
is indicated by a proportional brightness of the displayed dots.
Real-time ultrasonography B-mode ultrasonography using an array of detectors so
that scans can be made electronically at a rate of 30 frames a second.
Cystoscopy
A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, this
tube is inserted through your urethra and into your bladder so the doctor can see inside.
Your urethra is the tube that carries urine out of your bladder. Images from the camera
are displayed on a screen where your doctor can see them.
Reasons for Having a Cystoscopy
Your doctor might order this test if you have urinary problems, such as a constant need
to urinate or if you find urination painful. Your doctor might also order the procedure to
investigate reasons for blood in your urine, frequent urinary tract infections (UTIs),
an overactive bladder, or pelvic pain.
A cystoscopy can reveal several conditions, including bladder tumors, stones, or cancer.
Your doctor can also use this procedure to diagnose:

blockages

enlarged prostrate

noncancerous growths

problems with the ureters (tubes) connecting your bladder to your kidneys

Cystoscopy can also be used to treat bladder conditions. Your doctor can pass tiny
surgical tools through the scope to remove small bladder tumors and stones or to take a
sample of bladder tissue. Other uses include:

taking a urine sample to check for tumors or infection

inserting a small tube to assist urine flow

injecting dye so kidney problems can be identified on an X-ray.

Preparing for a Cystoscopy
Your doctor might prescribe antibiotics before and after the procedure if you have a UTI
or a weak immune system. You may also need to give a urine sample before the test. If
your doctor plans to give you general anesthesia, youll feel groggy afterward and youll
need to arrange a ride home. Plan to take time to rest after the procedure at home.
Ask your doctor if you can continue any regular medications. Certain medications can
cause excessive bleeding during the procedure.
Anesthesia During a Cystoscopy
The procedure might be performed in a hospital or doctors office and you will need
some form of anesthesia, so be prepared for that. Talk to your doctor about your options
before the procedure.
Outpatients will be given local anesthesia. You can drink and eat normally on your
appointment day and go home immediately after the procedure.
With general anesthesia, you may need to fast for a certain number of hours ahead of
time. General anesthesia means youll be unconscious during the cystoscopy.
Regional anesthesia involves an injection in your back. This will numb you below the
waist. You might feel a sting from the shot.
With either regional or general anesthesia, you will probably need to stay in the hospital
for a few hours following the procedure.
The Cystoscopy Procedure
Just before the cystoscopy, youll go to the bathroom to empty your bladder. Youll
change into a surgical gown and lie down on your back on a treatment table. Your feet
may be positioned in stirrups. The nurse may provide you with antibiotics to help prevent
a bladder infection.
At this point, youll be given anesthesia. If you get general anesthesia, this will be all that
you are conscious of until you wake up. If youre getting a local or regional anesthetic,
you may be given a sedative to relax you. Your urethra will be numbed with an
anesthetic spray or gel. Youll still feel some sensations, but the gel makes the procedure
less painful. The doctor will lubricate the scope with gel and carefully insert it into the
urethra. This may burn slightly, and it may feel like urinating.

If the procedure is investigatory, your doctor will use a flexible scope. Biopsies or other
surgical procedures require a slightly thicker rigid scope. The bigger scope allows
surgical instruments to pass through it.
Your doctor looks through a lens as the scope enters your bladder. A sterile solution will
flow through to flood your bladder. This makes it easier for your doctor to see whats
going on. The fluid might give you an uncomfortable feeling of needing to urinate.
With local anesthetic, your cystoscopy may take less than five minutes. If youre sedated
or given general anesthesia, the entire procedure may take 10 to 30 minutes.
Potential Risks of a Cystoscopy
Its normal to have a burning sensation while urinating for a few days after the
procedure. You may need to urinate more frequently than usual. Dont try to hold it, as
the blood in your bladder could clot and create a blockage. Blood in the urine is also
common, especially if you had a biopsy. Drinking lots of water helps ease the burning
and bleeding.
Some people develop more serious complications, including:

Swollen urethra: This is the most common complication. It makes urination

difficult. If you arent able to urinate for more than eight hours after the procedure,
contact your doctor.

Infection: In rare cases, germs enter your urinary tract and cause infection. Fever,
strange smelling urine, nausea, and lower back pain are all symptoms. You might need
antibiotics.

Bleeding: A few people suffer from more serious bleeding.

Recovering After a Cystoscopy

Give yourself time to rest. Drink lots of fluids and stay close to the bathroom. Holding a
damp, warm washcloth over your urethra can help relieve any pain.
If you were under general anesthesia, have someone stay with you. You may feel sleepy
ordizzy. Dont drink alcohol, drive, or operate complex machinery for the rest of the day.
If you had a biopsy, youll need time to heal. Avoid heavy lifting for the next two weeks.
Ask your doctor when its safe to have sexual intercourse.