The Use of CystoSure to Enable Post-Hysterectomy Cystoscopic Evaluations: A Case Series [10E]

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INTRODUCTION:Cystoscopy can be used to diagnose some urologic injuries following hysterectomy. The objective of this study is to evaluate and report on our initial experience with CystoSure, a new device designed to facilitate peri-operative diagnostic cystoscopy. The CystoSure catheter is an 18-Fr quad-port silicone transurethral catheter with a central sealed port for the cystoscope and a side port that allows for bladder filling. The reusable scope has a 2.7 mm outer diameter with a 70 degree viewing angle.METHODS:A retrospective chart review was performed of women that underwent a benign hysterectomy with cystoscopy at Brigham and Women's Faulkner Hospital from May 1, 2015 to August 31, 2015.RESULTS:Thirty women underwent cystoscopy using the CystoSure device. The CystoSure catheter is placed at the beginning of the procedure. The mean patient age was 47.8 years. The mean body mass index was 28.3 kg/m2. Total laparoscopic hysterectomy was the most common procedure, 70% (21/30). Using the CystoSure system, full bladder survey and bilateral ureteral jets were easily evaluated in 90% (27/30) of the patients. One intra-vesical suture was diagnosed and was removed. In the remaining three patients, the 18-Fr CystoSure catheter was too large for the urethral orifice and a 16 or 14-Fr catheter was used for the case.CONCLUSION:Current cystoscopy setup involves removing the indwelling catheter placed for the procedure and assembling a multi-component cystoscope. The ease of this new setup can potentially lead to higher adoption of peri-operative cystoscopy for gynecologic surgery.

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