ABSTRACT
This chapter describes key principles of cystourethroscopy as it pertains to various urologic conditions including vesicoureteric reflux, ureteral duplication anomalies, ureterocele, posterior urethral valves, genitourinary tumors, and urogenital sinus. It reviews the key principles of safe surgical practice of cystourethroscopy as well as various anatomic features of different conditions and their treatments. A voiding cystourethrogram will confirm the diagnosis, based on the appearance of a severely trabeculated bladder, thickened bladder neck, dilated posterior urethra, and an obstructive lumen change between the posterior and membranous urethra. The electrohydraulic lithotripsy involves generation of an electric spark that produces a shock wave and a cavitation bubble for stone fragmentation. Other lithotripsy devices include ultrasonic, ballistic, and various forms of laser. Incontinence secondary to anatomic abnormalities, such as congenital neuropathic conditions (spina bifida, sacral agenesis), exstrophy–epispadias complex, and bilateral ectopic ureters, requires intervention. Endoscopic implantation of bulking agents is a simple and logical attempt to increase outlet resistance with minimal morbidity.
