The Use of CystoSure to Enable Posthysterectomy Cystoscopic Evaluation: A Case Series

Abstract

Cystoscopy can be used to diagnose urologic injuries at the time of gynecologic surgery. Current cystoscopy setup involves removing the indwelling catheter placed for the procedure and assembling a multicomponent cystoscope. The objective of this study was to evaluate and report on our initial experience with CystoSure (Emmy Medical, Holliston, MA), a new Food and Drug Administration-approved device designed to facilitate perioperative diagnostic cystoscopy. The CystoSure catheter is an 18F quad-port silicone transurethral catheter with a central sealed port for the cystoscope and a side port that allows for bladder filling. A retrospective chart review was performed of women who underwent benign laparoscopic or robotic gynecologic surgery with cystoscopy at Brigham and Women's Faulkner Hospital, Boston, MA, from May 1, 2015, to August 31, 2015. Thirty women underwent cystoscopy during the study period. The CystoSure catheter is placed at the beginning of the procedure. Total laparoscopic hysterectomy was the most common procedure, representing 90% of cases (27/30). Using the CystoSure system, full bladder survey and bilateral ureteral jets were easily evaluated in 87% (26/30) of the patients. Of the 26 cystoscopies performed successfully, 1 intravesical suture was diagnosed and addressed. In the remaining 4 patients, the 18F CystoSure catheter was too large for the urethral orifice, and a 16F catheter was used for the case. The CystoSure device allows for minimal setup and efficient performance of diagnostic cystoscopy postgynecologic surgery.

Keywords: Cytoscopy; Hysterectomy; Urinary catheter.