Cystoscopy, Right Ureteroscopy, and Ureteral Stent Insertion with Aborted Biopsy and Potential Laser Ablation of a Right Renal Mass
Ryan A. Hankins, MD
MedStar Georgetown University Hospital
This article describes a case of a 58-year-old male patient with a renal mass, which was incidentally discovered on an imaging of chest CT scan, without any signs and symptoms indicative for renal masses. The patient has no history of ureteroscopy before, and no prior history of urolithiasis. The multiphasic, contrast-enhanced abdominal CT scan shows 2.5-cm hyperattenuating enhancing mass in the upper pole of the right kidney. Transverse unenhanced CT image shows hyperattenuating mass with no evidence of fat. Transverse CT image shows enhancement of the mass from 60 HU to 116 HU. The chest CT scan showed no abnormalities. This video describes a complex urological procedure that initially aimed to perform diagnostic and potentially therapeutic intervention but was modified due to anatomical constraints. The procedure demonstrates the importance of surgical adaptability and the role of staged approaches in urological surgery.
Cystoscopy and Transurethral Resection of Bladder Tumors with Stent and Foley Catheter Placement
Austin Bramwell, MD; Tullika Garg, MD, MPH, FACS
Penn State Health Milton S. Hershey Medical Center
Bladder cancer is the sixth most common cancer in the United States. Transurethral resection of bladder tumor (TURBT) is a common urologic surgical procedure used to diagnose, stage, and treat bladder cancer. This article presents a patient who had multiple episodes of gross hematuria and was found to have multifocal bladder tumors. In this case, TURBT was performed to confirm the diagnosis of bladder cancer, remove all visible bladder tumors, and prevent further episodes of gross hematuria.
Cystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC Surgery
Francis McGovern, MD
Massachusetts General Hospital
This video provides a comprehensive overview of the prophylactic ureteral stenting and cystoscopy performed on a patient with advanced metastases of appendiceal cancer who is scheduled for cytoreduction and hyperthermic intraperitoneal chemotherapy. The video focuses on urethral instrumentation, identification of ureteral orifices, stent placement, and subsequent bladder inspection. The patient’s preoperative evaluation had revealed no evidence of ureteral involvement with the tumor.
The cystoscopic technique employed in this case allowed the surgeons to visualize the bulbar urethra, sphincter, and prostatic urethra, illustrating the step-by-step process of advancing into the bladder. Next, the vesical trigone is identified, aiding in the visualization of the ureteral orifices. The careful placement of stents into both ureters is demonstrated. No resistance was encountered in the process of stent placement, suggesting no involvement of the ureters with the tumor. A thorough bladder inspection revealed no unusual findings such as abnormal lesions, masses, or other pathology. The stents were secured with silk sutures to prevent inadvertent dislodgement.
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