Endosee for Office Cystoscopy: A Single Site Experience

Abstract

Study Objective Demonstrate the safety and efficacy of an FDA approved handheld hysteroscope used as a newly FDA cleared handheld cystoscope in the office. Design Case series. Setting Busy outpatient urogynecology office private practice. Patients or Participants Thirty-nine consecutive women scheduled for office cystourethroscopy. Interventions Patients undergoing office cystourethroscopy in a single outpatient urogynecology office site were evaluated using the Endosee device with saline infusion without anesthesia. Measurements and Main Results Patient demographics, indications, findings, procedure length, volume of distention fluid, adequacy of the procedure and complications were analyzed. Digital images of all procedures were obtained and tabulated to illustrate the ability to diagnose a multitude of common bladder conditions in female patients with a variety common urogynecologic problems. 100% of procedures noted complete anatomic visualization and bilateral ureteral spillage. All patients were able to tolerate the procedure with no pre-procedure analgesia. Mean patient age 67.3 (SD=13.5, range 41-91), with common indications including hematuria (51.3%), urgency or incontinence (43.6%), recurrent UTI (20.5%), preoperative evaluation (10.3%). Average time of Endosee cystoscopy procedure was 206.5 seconds (SD=59.9) with average filling fluid volume 386.7 cc (SD=53.1). Procedure findings included trabeculations, hypervascularity, bladder stones, bladder and urethral polyps, hemangiomas, and cystitis cystica. One post-procedure day 2 fever was noted, culture negative who self-treated with Ciprofloxacin. Conclusion Endosee, which is FDA cleared for cystourethroscopy, is a safe, effective, well-tolerated alternative for office assessment of the bladder in female patients. The ability to portably perform office cystoscopy in flexible settings may make this modality more accessible to practitioners, without the need for a dedicated cystoscopy room or expensive tower. Further study may be warranted to determine whether Endosee may lead to earlier and more accurate diagnosis for a multitude of bladder problems.