Do we need to perform cystoscopy on all adults attending urology centres as outpatients?

• Published in: Urologia internationalis Vol. 73; no. 3; p. 198
• Main Authors: Kumar, V, Patel, H R, Nathan, S M, Miller, R A, Lawson, A H
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2004
• Subjects: Adult; Ambulatory Care Facilities - statistics & numerical data; Cystoscopy - utilization; Hospitals, District - statistics & numerical data; Humans; Medical Audit - statistics & numerical data; Retrospective Studies; United Kingdom - epidemiology; Urologic Diseases - diagnosis; Urologic Diseases - therapy; Urology Department, Hospital - statistics & numerical data
• ISSN: 0042-1138
• DOI: 10.1159/000080827

There has been considerable expansion in the use of flexible cystoscopy (FC) and people who can perform the procedure. Hence, there is a criticism that this procedure is being overused with no management benefit.
We audited the use of FC in a district hospital for a period of 1 year. The results of FC for non-standard indications (other than haematuria and check cystoscopy) were analysed for their diagnostic yield.
Of the 1,390 FCs performed, 295 were done for non-standard indications. 46.14% of these cystoscopies had positive findings. Cancer detection rate was 6.10%. Cystoscopy altered the management in 14.08% of patients and was supportive to diagnosis and management in 32.06%.
This procedure is certainly not overused and the ever-increasing requirement of this simple procedure has serious resource implications for the National Health Service.