Pediatric Cystoscopy & Transurethral Procedures Anesthesia - AnethAssist

Pediatric cystoscopy and transurethral procedures anesthesia reference sourced from Jaffe and created by AnethAssist. Check out the profile for more sets, and please leave a rating and share with your cohort if it helped!

Pediatric Cystoscopy and Transurethral Procedures — What it is

Diagnostic or therapeutic cystoscopy, vaginoscopy, foreign-body or stent removal, stricture incision, posterior-valve ablation, ureterocele incision, or urinary injection therapy.

Pediatric Cystoscopy and Transurethral Procedures — Common indications

Foreign body, bladder calculus, outlet obstruction, urethral stricture, ureterocele, hematuria, posterior urethral valves, urogenital sinus, or stent management.

Pediatric Cystoscopy and Transurethral Procedures — Position

Lithotomy, frog-leg at the distal bed, or supine with a flexible cystoscope.

Pediatric Cystoscopy and Transurethral Procedures — Surgical access

No incision; a lubricated 7-18 Fr cystoscope or resectoscope enters through the urethra.

Pediatric Cystoscopy and Transurethral Procedures — Typical duration

Cystoscopy about 10 min; therapeutic transurethral procedures about 1 h.

Pediatric Cystoscopy and Transurethral Procedures — Expected blood loss

Minimal.

Pediatric Cystoscopy and Transurethral Procedures — Pain and stimulation

Pain score 2.

Pediatric Cystoscopy and Transurethral Procedures — Anesthetic options

GA with ETT or LMA; maintain immobility for laser or upper-tract work and use culture-directed antibiotics for infected urine.

Pediatric Cystoscopy and Transurethral Procedures — Airway

Short cases often suit LMA; sepsis, aspiration risk, prolonged work, or required paralysis may favor ETT.

Pediatric Cystoscopy and Transurethral Procedures — IV and blood preparation

One 22-24 gauge pediatric IV; complex cases rarely require additional access or transfusion.

Pediatric Cystoscopy and Transurethral Procedures — Monitoring

Standard monitors; closely follow hemodynamics with obstructing ureterocele, pyelonephrosis, suspected urosepsis, significant irrigation absorption, or indigo carmine.

Pediatric Cystoscopy and Transurethral Procedures — Ventilation and physiology

Spontaneous or controlled ventilation is acceptable; paralysis may prevent movement-related ureteral injury during upper-tract or laser instrumentation.

Pediatric Cystoscopy and Transurethral Procedures — Regional options

No primary regional technique; transurethral lidocaine gel, phenazopyridine, or an antimuscarinic may reduce catheter irritation and bladder spasm.

Pediatric Cystoscopy and Transurethral Procedures — Positioning risks

Common peroneal nerve injury, foot drop, excessive hip flexion, pressure injury, and overdistention of an augmented bladder.

Pediatric Cystoscopy and Transurethral Procedures — Major intraoperative risks

Urosepsis, urethral, bladder, or ureteral perforation, fluid absorption, bleeding, laser injury, and indigo-carmine-related hypertension, bradycardia, hypotension, or bronchospasm.

Pediatric Cystoscopy and Transurethral Procedures — Major postoperative risks

Bleeding, urethral stricture, infection, urinary retention, bladder spasm, catheter irritation, and overdistention of an augmented bladder.

Pediatric Cystoscopy and Transurethral Procedures — Postoperative destination

PACU; most patients discharge after routine recovery with catheter, stent, antibiotic, and bladder-spasm instructions when applicable.

Pediatric Cystoscopy and Transurethral Procedures — Critical communication

Clarify diagnostic versus therapeutic work, laser, fluoroscopy, irrigation, infected urine, indigo carmine, stent or catheter plan, and augmented bladder.

Pediatric Cystoscopy and Transurethral Procedures — Fast pearl

Indigo carmine can increase blood pressure with reflex bradycardia and rarely cause severe hypotension or bronchospasm.