Suprapubic Endoscopy and Local-Anesthetic Rigid Cystoscopy: Two New Endourologic Techniques

This paper details two new techniques that have evolved from our experience of endourology in the upper tracts. Suprapubic endoscopy is achieved by percutaneous puncture and dilatation of a tract into the bladder. The technique may be used to pass an endoscope into the bladder where urethral access is denied by an impassable stricture or obstruction or where suprapubic access might be preferable. Based on nephroscope design technology, we have created a new rigid cystoscope that has been used for rigid transurethral cystoscopy under local anesthesia in conjunction with premedication. Despite its small diameter (17.5F), it has the operating capability of the larger (24F) rigid cystoscopes. We believe this Integrated Cystoscope (Genito-Urinary Manufacturing Company Ltd; UK), by virtue of its superior rod lens optics, irrigating facility, strength, price, and operating potential, may become the best way of performing routine cystoscopy.