Operative note 02 Core

Flexible cystoscopy

What it does: bladder check with a bendy scope, awake patient.

Gel in, as for a catheter. Water on.
At the sphincter, hold the scope back. Ask the patient to breathe out slowly or try to void. It relaxes and opens. It hurts less. Never push.
Quick look on the way in. Full check of urethra and prostate on the way out.
Survey the bladder half full, in a set order: trigone, right orifice, right wall, dome, left wall, left orifice, back wall, front wall. Watch each orifice jet. Scope bends better one way? Turn it 180 degrees.
"J move" for the bladder neck: bend the tip fully, push to the dome, pull back. Straighten the tip before moving on or coming out.
Stent out: check the register first (side, date, why). Graspers through the channel, closed on the curl. Scope and stent out together. Resists or encrusted: stop, do not pull.

From the UroRef Operative Quick Guide.