ABSTRACT
Urethrocystoscopy is very instrumental in the assessment of lower urinary tract anatomy, helping in the appraisal of urethral and bladder anatomic anomalies, most of the time secondary to complications such as urethral strictures, trabeculations, bladder stones, and diverticula. Flexible cystoscopes are mainly used in men with preserved sensitivity, and the test is usually much less painful than with a rigid instrument. Indwelling catheters, multiple endoscopic manipulations, intermittent catheterizations, and neurogenic trophicity changes lead to frequent urethral strictures and false passages. The degree of opening of the neurogenic bladder neck cannot be adequately evaluated by cystoscopy. There is no consensus in the literature regarding the significance of bladder wall trabeculations. O'Donnell suggested that they could be related to high bladder pressure. High bladder pressure, recurrent infections, and changes in bladder wall thickness may provoke alterations in the shape of the ureteral orifices. Usually secondary to infections, bladder stones are frequent findings in neurogenic patients.
