Skyworth Auto Manual (EN)

What does this procedure involve?

1 This leaflet contains evidence-based information about your proposed urological procedure. We have consulted specialist surgeons during its preparation, so that it represents best practice in UK urology. You should use it in addition to any advice already given to you. To view this leaflet online, scan the QR code (right) or type the short URL below it into your web browser: What does this procedure involve? This involves putting a telescope through your urethra (waterpipe) into your bladder to look at the lining of both. We normally remove any blood clots we see using suction but, occasionally, we need to use diathermy (electric current) to break up large clots.

If we find any abnormality in your bladder, we may biopsy the area, remove it completely using diathermy or cauterise it to stop the bleeding. What are the alternatives?

Irrigation & bladder washouts – usually performed through a large bladder catheter on the ward, with you awake; most people having a cystoscopy and bladder washout will already have had this done Information about your procedure from The British Association of Urological Surgeons (BAUS) KEY POINTS • Blood clots in the bladder can stop you passing urine normally; they may also irritate the bladder lining causing further bleeding • The aim of this procedure is to use a telescope to remove the clots and to look for a source of bleeding in your bladder • If any abnormalities in the bladder are found, we may remove the area or take a biopsy from it using diathermy (electric current) Published:

Jul 2023 Leaflet No: E23/009 Review due: Oct 2026 © British Association of Urological Surgeons Limited

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Details of the procedure

2 Open washout & packing of the bladder – only performed when telescopic inspection has been tried and has failed. What happens on the day of the procedure? Your urologist (or a member of their team) will briefly review your history and medications, and will discuss the surgery again with you to confirm your consent. An anaesthetist will see you to discuss the options of a general anaesthetic or spinal anaesthetic. The anaesthetist will also discuss pain relief after the procedure with you. We may provide you with a pair of TED stockings to wear, and we may give you a heparin injection to thin your blood. These help to prevent blood clots from developing and passing into your lungs.

Your medical team will decide whether you need to continue these after you go home. Details of the procedure we normally use a full general anaesthetic (where you will be asleep) or a spinal anaesthetic (when you will be numb from the waist down).

we usually give you an injection of antibiotics before the procedure, after you have been checked for any allergies we put a telescope into your bladder through your urethra (water pipe) to inspect the urethra and bladder if there are any clots in the bladder, we remove them using a suction evacuator (pictured); large clots may need breaking up with diathermy (electric current) before they can be removed if we find anything in the bladder that might be causing the bleeding, we will cauterise, biopsy or remove it with diathermy we usually put in a catheter at the end of the procedure that allows us to irrigate your bladder continuously you may need further irrigation and bladder washouts afterwards the procedure may take between 10 minutes and one hour or more Published:

Jul 2023 Leaflet No: E23/009 Review due: Oct 2026 © British Association of Urological Surgeons Limited

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Are there any after-effects?

3 the average stay in hospital for this procedure is five days Are there any after-effects? The possible after-effects and your risk of getting them are shown below. Some are self-limiting or reversible, but others are not. We have not listed very rare after-effects (occurring in less than 1 in 250 patients) individually. The impact of these after-effects can vary a lot from patient to patient; you should ask your surgeon’s advice about the risks and their impact on you as an individual:

After-effect Risk Mild burning or bleeding on passing urine for a short time after the procedure Almost all patients Temporary insertion of a bladder catheter which needs to be removed later Almost all patients Permission for telescopic removal/biopsy of an abnormality, if found Almost all patients Infection of the bladder requiring antibiotic treatment Between 1 in 10 & 1 in 50 patients Finding a cause for the bleeding, such as cancer, which requires further treatment at a later stage Between 1 in 10 & 1 in 50 patients Perforation of your bladder requiring a temporary catheter or open surgical repair Between 1 in 50 & 1 in 250 patients Delayed bleeding requiring removal of clots or further surgery Between 1 in 50 & 1 in 250 patients Published:

Jul 2023 Leaflet No: E23/009 Review due: Oct 2026 © British Association of Urological Surgeons Limited

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What can I expect when I get home?

4 What is my risk of a hospital-acquired infection? Your risk of getting an infection in hospital is between 4 & 6%; this includes getting MRSA or a Clostridium difficile bowel infection. This figure is higher if you are in a “high-risk” group of patients such as patients who have had: long-term drainage tubes (e.g. catheters); long hospital stays; or multiple hospital admissions. What can I expect when I get home?

you will be given advice about your recovery at home you will be given a copy of your discharge summary and a copy will also be sent to your GP any antibiotics or other tablets you may need will be arranged & dispensed from the hospital pharmacy you should drink twice as much fluid as you would normally for the first 24 to 48 hours, to flush your system through and reduce the risk of infection if you cannot pass urine after your bladder catheter is removed, you may be discharged with a catheter in; we will show you how to manage it at home and arrange for you to have it removed at an appropriate time if you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your GP immediately if you need a follow-up outpatient appointment or further investigations, we will arrange them for you, and tell you when they will take place you may return to work when you are comfortable enough and when your GP is satisfied with your progress.

Injury to the urethra (water pipe) causing delayed scar formation Between 1 in 50 & 1 in 250 patients Anaesthetic or cardiovascular problems possibly requiring intensive care (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death) Between 1 in 50 & 1 in 250 patients (your anaesthetist can estimate your individual risk) Published: Jul 2023 Leaflet No: E23/009 Review due: Oct 2026 © British Association of Urological Surgeons Limited

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