Year: 2024 | Month: November | Volume: 14 | Issue: 11 | Pages: 269-272
DOI: https://doi.org/10.52403/ijhsr.20241130
Advancing Patient Care: The Use of Flexible Cystoscopy for Bedside Procedures in Severely Ill Patients
Dr. Shrenik J. Shah1, Dr Pratik Chaudhary2, Dr. Kapil Kachhadiya3, Dr Nirav Agrawal4, Dr Piyush Baraiya5
1,2,3,4,5Department of Urology, B.J Medical College, Gujarat University, Ahmedabad, Gujarat, India
Corresponding Author: Dr Pratik Chaudhary
ABSTRACT
Introduction: Flexible cystoscopy has emerged as an essential tool in the management of urological conditions, particularly in critically ill patients where traditional cystoscopy may pose significant risks. The bedside application of flexible cystoscopy offers a minimally invasive, practical solution, allowing for prompt evaluation and intervention without the need to transfer unstable patients to the operating room. This study aims to assess the efficacy, safety, and outcomes of bedside flexible cystoscopy in critically ill patients, focusing on its utility in diagnosing and managing hematuria, catheter-related complications, and lower urinary tract injuries.
Methods: A retrospective analysis was conducted on critically ill patients who underwent flexible cystoscopy at the bedside in an intensive care unit (ICU) setting in the past one year. The indications for cystoscopy included persistent hematuria, suspected bladder injuries, and catheter-related issues. Data were collected on patient demographics, indications for the procedure, procedural success rates, complications, and the impact on subsequent clinical management. The flexible cystoscopy was performed using a portable cystoscope under local anaesthesia or sedation, depending on the patient's condition.
Results: A total of 158 flexible cystoscopy procedures were performed at the bedside on 142 critically ill patients. The most common indications were hematuria (45%), catheter malfunctions (32%), and suspected bladder injuries (23%). Procedural success was achieved in 94% of cases, with immediate diagnostic findings in 82% of patients. Interventions based on cystoscopic findings included catheter adjustments, clot evacuation, and, in some cases, stent placement. The complication rate was low (4%), with no major adverse events reported. The bedside procedure eliminated the need for patient transfer to the operating room in 89% of cases, significantly reducing the risk of transportation-related complications.
Conclusion: Bedside flexible cystoscopy is a safe, effective, and practical approach for the evaluation and management of urological issues in critically ill patients. It allows for immediate diagnostic and therapeutic interventions with a minimal complication profile. The ability to perform this procedure at the bedside not only improves patient safety by avoiding transport but also enhances clinical outcomes by facilitating timely and targeted treatment. These findings support the routine use of flexible cystoscopy in the ICU setting as an invaluable tool for managing urological emergencies in critically ill patients.
Key words: flexible cystoscopy, in critically ill patients, diagnostic, bedside, ICU, emergencies