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Thread: How often for cystoscopy?

  1. #1
    Senior Member
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    How often for cystoscopy?

    I have MS and have had my SP cath now for a little more than 4 years. Other than what I feel are "typical" issues with it - UTIs, and once had it pushed in too far and the tip embedded into bladder wall, causing it to irritate and block up - it has been relatively uneventful. I had a cystoscopy back when it blocked up, and it has been a little over 2 years since. I had the scope repeated a few months later to make sure everything healed alright, and to just double check that the irritation of the bladder lining was just temporary due to the misplacement of the catheter (versus being due to something more serious like the beginning of a tumor forming). Everything looked great.

    As I said before, I haven't really had any other atypical issues. The only other minor issue I can think of is that I had to have some extra flap of skin burned off that was overgrowing near the stoma and causing problems during cath changes. It healed nicely and the extra skin only grew back minimally, not causing enough problems to warrant another visit.

    I've heard some discussion about people with SP caths, and I seem to recall that it is recommended to have occasional cystoscopies to check things out. How often should that be, especially if a person isn't having obvious problems? And what exactly are they checking for - the beginnings of cancer?

  2. #2
    I don't have a supra pubic any more but my urologist does a scope every 18 months and an ultra sound of the bladder every year.

    Good luck.

    Millard
    ''Life's tough... it's even tougher if you're stupid!'' -- John Wayne


  3. #3
    If everything is going well, we don't do routine cystoscopies on people with any type of indwelling catheter until 10 years of indwelling use. Things that may prompt a cystoscopy include an abnormal annual bladder ultrasound, frank hematuria (heavy blood in the urine), or "sand" or other indications of possible stones in the bladder. After 5 years we do 3 annual urine cytologies (a lab test of your urine), and will scope if these are abnormal too. Starting at 10 years we do the annual cystoscopies with random biopsies.

    I would recommend talking with your urologist about the criteria they use for doing cystoscopies on their indwelling catheter patients, and the rational for doing it that way.

    (KLD)

  4. #4
    I am adding this to the thread because I had never heard the term "urine cystology."
    Urine cystology is a test to look for abnormal cells in your urine. Urine cytology is used along with other tests and procedures to diagnose urinary tract cancers. Urine cytology is most often used to diagnose bladder cancer, though the test may also detect kidney cancer, prostate cancer, ureter cancer and urethra cancer. The test uses a urine sample that is obtained by clean catch or catheter sample. The urine is sent to a lab to be analyzed by a pathologist for evidence of abnormal and/or suspicious cells that require further testing usually with a cystoscopy.

    I have a couple questions about this test for those who use a suprapubic catheters to manage their bladders. Is the urine sample taken through the suprapubic catheter tubing or would a urethral catheter sample be required? I read that first urine of the day is not acceptable for urine cystology studies. What would be the appropriate time of day to get a sample for this test?

    All the best,
    GJ

  5. #5
    I get a cystoscopy every 2 years. SP for almost 3 years.

  6. #6
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    SCI Nurse - My urologist is not one who specializes in SCI or MS issues. The clinic's waiting room is mostly filled with older folks who have prostate issues. However, there aren't really any other choices for urologists in the immediate area, and I like this guy's personality and how he has handled some of my issues in the past (I've had a few horrible uros in the past). But, I have a feeling he isn't up-to-date on issues that might be most relevant to my medical situation. Quite honestly, I learn a lot about what to ask my doctor from groups such as this - the help is absolutely invaluable (and much appreciated!!!)

    What is the purpose of the annual bladder ultrasound, and what is it looking for?

    Would someone know if they had sand in their urine or possible stones? Meaning, if it was sand would it be painful or readily visible to me?

    What are the three cytologies that your clinics do on their indwelling cath patients?

    If I know this, then I can ask more direct questions of my urologist and perhaps avoid unnecessary procedures (or request ones that ARE necessary)!

    Thanks again for all of the time and help you provide, nurses and fellow members of the forum!! I love being able to be a more well-informed advocate for myself

  7. #7
    Quote Originally Posted by retto76 View Post
    SCI Nurse - My urologist is not one who specializes in SCI or MS issues. The clinic's waiting room is mostly filled with older folks who have prostate issues. However, there aren't really any other choices for urologists in the immediate area, and I like this guy's personality and how he has handled some of my issues in the past (I've had a few horrible uros in the past). But, I have a feeling he isn't up-to-date on issues that might be most relevant to my medical situation. Quite honestly, I learn a lot about what to ask my doctor from groups such as this - the help is absolutely invaluable (and much appreciated!!!)

    What is the purpose of the annual bladder ultrasound, and what is it looking for?

    Would someone know if they had sand in their urine or possible stones? Meaning, if it was sand would it be painful or readily visible to me?

    What are the three cytologies that your clinics do on their indwelling cath patients?

    If I know this, then I can ask more direct questions of my urologist and perhaps avoid unnecessary procedures (or request ones that ARE necessary)!

    Thanks again for all of the time and help you provide, nurses and fellow members of the forum!! I love being able to be a more well-informed advocate for myself
    The renal/bladder ultrasound looks for:
    * kidney infection (pyelonephritis) or injury.
    * kidney tumors such as renal cell cancer, angiomyolipoma.
    * Evaluate the kidney for disease and failure.
    * Evaluate the kidney for stones that can cause flank (side) pain or blood in the urine.
    * ureteral blockages from stones, tumors or scarring.
    *bladder stones, tumors, or infection that can cause pain and blood in the urine.

    Sand in the urine, in medical terms, means small calculous particles passed in the urine. These particles are usually small enough not to cause any significant discomfort, but they can be seen as sediment in the expelled urine.

    You may have misunderstood the comment about cystologies. As I understand the comment, it is recommended that someone managing their bladder with a suprapubic catheter (and probably an indwelling urethral catheter) should start getting a test called urine cystology at 5 years post placement of the suprapubic catheter. The recommendation is to have 3 tests (presumably, one every 4 months) annually.
    See my post above for the a descripton of urine cystology.

    Hope this helps.

    All the best,
    GJ

  8. #8
    Cytology (not cystology) test are done on your urine. The urine is mixed with a preservative, spun down in a centrifuge, and any cells in the urine are stained and examined through a microscope. Nearly always, urinary cancers (esp. bladder cancers) will shed cells from the bladder wall into the urine, and these are the cells we are looking for. Pre-cancerous cells may show up in the test results as "metaplasia" and that should prompt a cystoscopy and biopsy.

    The urine cytologies are all done at the time of the annual. We collect a fresh dilute urine specimen from the indwelling catheter (not from the bag) three days in a row, mix in the preservative, and send or deliver to the pathology lab for examination. It is done 3 times (each at least 24 hours apart) as this has been shown to be the best at catching any abnormal cells.

    Bladder, ureter and kidney ultrasound also is used to look for hydronephrosis (dilation of the ureter and kidney drainage system), in addition to the reasons that are listed above. It is recommended annually for someone with a SCI, regardless of their bladder management method. We also include the gall bladder in this scan, since people with SCI are also at higher risk for gall bladder stones.

    You may want to download this clinical practice guideline and share it with your urologist or PCP:

    Bladder Management for Adults with Spinal Cord Injury

    It includes some guidelines for annual urinary "surveillance".


    (KLD)

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    Cytology (not cystology) test are done on your urine. The urine is mixed with a preservative, spun down in a centrifuge, and any cells in the urine are stained and examined through a microscope. Nearly always, urinary cancers (esp. bladder cancers) will shed cells from the bladder wall into the urine, and these are the cells we are looking for. Pre-cancerous cells may show up in the test results as "metaplasia" and that should prompt a cystoscopy and biopsy.

    The urine cytologies are all done at the time of the annual. We collect a fresh dilute urine specimen from the indwelling catheter (not from the bag) three days in a row, mix in the preservative, and send or deliver to the pathology lab for examination. It is done 3 times (each at least 24 hours apart) as this has been shown to be the best at catching any abnormal cells.
    (KLD)
    My apologies to "retto76" that I misinterpreted "KLD's comments and spelling regarding the Cytology test. Clearly there was a disconnect with the explanation and my understanding.

    Now a couple more questions for clarificatoin.
    Outside of the hospital setting how is the urine for this test collected, i.e., three specimens, each 24 hours apart...preservative added...

    And then to clarify my other assumption from your post. This is not a test done 3 times a year (every 4 months). Cytology is a single test that includes 3 urine samples collected every 24 hours (72 hours). This test is recommended every year post 5 years of a suprapubic placement. Is this the proper understanding and interpretation of your explanation?

    Is there a single reference that you think is a good one for this test. As I said in my first post, I have never heard of this test, and obviously there is some need for definitive information for those of us who want to speak with our urologists about this.

    All the best,
    GJ

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