Patients will have to remove their clothing covering the lower part of the body, although some physicians may prefer if the patient wears a hospital gown for the examination and covers the lower part of the body with a sterile drape.
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These patients should ensure that they do not urinate for a sufficient period of time, such that they are able to urinate prior to this part of the test. Patients are sometimes asked to give a urine sample before the test to check for infection. Physicians may have special instructions, but in most cases, patients are able to eat normally and return to normal activities after the test.
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For larger stones, the physician may also use the extra tube in the ureteroscope to extend a flexible fiber that carries a laser beam to break the stone into smaller pieces that can then pass out of the body in the urine. (The ureter is the tube that carries urine from the kidney to the bladder.) The physician can then see the stone and remove it with a small basket at the end of a wire that is inserted through an extra tube in the ureteroscope. If a patient has a stone lodged higher in the urinary tract, the physician may use a much finer calibre scope called a ureteroscope through the bladder and up into the ureter. The bottom two images show an inflamed urethra. In the top-right image, the cystoscope has been bent within the bladder to look back on itself. The top two images show the interior of the bladder of a male patient. The sizes of the sheath of the rigid cystoscope are 17 French gauge (5.7 mm diameter), 19 Fr gauge (6.3 mm diameter), and 22 Fr gauge (7.3 mm diameter). Rigid cystoscopy can be performed under the same conditions, but is generally carried out under general anesthesia, particularly in male subjects, due to the pain caused by the probe. The medication is instilled into the urethra via the urinary meatus five to ten minutes prior to the beginning of the procedure. Typically, a topical anesthetic, most often xylocaine gel (common brand names are Anestacon and Instillagel) is employed. Flexible cystoscopy is carried out with local anaesthesia on both sexes. There are two main types of cystoscopy-flexible and rigid-differing in the flexibility of the cystoscope. Many cystoscopes have extra tubes to guide other instruments for surgical procedures to treat urinary problems. Cystoscopes range from pediatric to adult and from the thickness of a pencil up to approximately 9 mm and have a light at the tip. Some cystoscopes use optical fibres (flexible glass fibres) that carry an image from the tip of the instrument to a viewing piece at the other end. These lenses let the physician focus on the inner surfaces of the urinary tract.
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The cystoscope has lenses like a telescope or microscope. The urethra is the tube that carries urine from the bladder to the outside of the body. Cystoscopy is endoscopy of the urinary bladder via the urethra.