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Digital atlas of cystoscopy.pdf

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drgayala

This document is the preface and table of contents for a digital atlas of cystoscopy images published by Dr. Jan Schönebeck and sponsored by Astra Tech AB. It provides an overview of the atlas, which contains approximately 800 cystoscopy photos illustrating the majority of findings that can be seen during cystoscopy exams. The photos are intended to help educate physicians and can be used for presentations, textbooks, articles and case reports. The preface describes how Dr. Schönebeck digitized his collection of over 1,500 cystoscopy slides in order to preserve them and make them more accessible for educational purposes.

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Jan Schönebeck Digital Atlas of Cystoscopy
This booklet and CD are published and sponsored by Astra Tech AB. This publication reflects Dr. Schönebeck’s findings during cystoscopy and not necessary the view of Astra Tech. Copyright of the concept “Digital Atlas of Cystoscopy” belongs to Astra Tech. Pictures on the CD are free to use, but please reference Dr. Jan Schönebeck.
C O N T E N T S Preface 4 Abnormal vessels. Bleeding 5 Bladder cancer Urothelial dysplasia Ureteral cancer 6 Bladder diverticulum + various 12 Bladder fistulas (colon – vagina – uterus) 13 Bladder septum or membrane. Züdler incontinence prosthesis 14 Bladder stones. Ureteral and urethral stones 15 Bricker conduit – coecocystoplasty 18 Clothes Line Man 18 Cystitis cystica + glandularis 19 Diseases of the prostate 20 Ectopic ureteral orifice 23 Indwelling catheter – complications 26 Internal urethrotomy 29 Interstitial (Hunner) – cystitis 29 Intrusion from outside the bladder 30 Large Bladder Bezoar 30 Litholapaxy 31 Non specific cystitis – inflammation 31 Normal anatomy + epithelial metaplasi + pseudopolyps 32 Penis + external urethral orifice 36 Resection of ureteral orifice 36 Suprapubic cystoscopy + ureteral stent 37 The Amazon River Fish 37 Trabeculation 38 Tuberculous cystitis – Bilharzia – Amyloidosis 38 TUR-P + complications 39 Ureteral cancer. Deep resection of ureteral orifice 42 Ureterocele A and B 43 Urethral diverticulum in male – operation of 44 Urethral stricture – fistulation – diverticulum 44
P R E F A C E In the beginning of the 80ies it was regarded as impossible to take good quality photos inside the urinary bladder due to insuf- ficient light conditions. Be- ing a urologist with an interest in photo docu- mentation I solved this problem. In 1984 I published a selec- tion of my photos in the book ”Atlas of cystoscopy” which was soon sold out. However, my interest continued. When I retired about 1500 slides rested in my boxes. After purging some about 800 remained. I realised that my heirs would have no interest in my slides. They were most likely to be destructed. Furthermore, the slides were fairly bulky. I decided to digi- talize them and by that I solved both problem, they now occupied only three DVDs and could be saved for long-term. However my wish is that my pic- tures should be made easily avail- able for education, making it pos- sible for young physicians to have the possibility to learn the spectrum of the cystoscopic appearance of bladder diseases. The photos could also, for educational purposes, be used in PowerPoint pre- sentations, in text-books, in scientific articles and case reports. To achieve this it was necessary to adapt the material to fit into one CD and to have the possibility to distribute it to as many hospitals as possible. I therefore contacted Astra Tech. The company immediately declared that they were willing to support the project. The result is now in your hands, a CD named ”Digital Atlas of Cystosopy” and which at no cost is distributed to a large number of urologists, surgeons and gynecolo- gists. I want to thank Astra Tech for their generous support which made creation of this CD possible. It con- tains about 800 cystoscopy photos illustrating a majority of all findings you might find with cystoscopy. Ljungby, Sweden, August 2007 Jan Schönebeck Associate professor of urology, retired
015. Varicose vessels of bladder wall 014. Slightly abnormal vessels - radiotherapy 013. Old clot (almost black) leaving right ureter 016. Haemangioma A - urinary bladder 017. Haemangioma A of urinary bladder - close-up 012. Fresh clot leaving right ureter 011. Clot leaving left ureter 010. Bleeding in bladder wall caused by bladder stone 009. Bleeding from bladder wall caused by rapid evacuation of urine retention 008. Bleeding from bladder wall caused by rapid emptying of urine retention 007. Abnormal vessels - radiotherapy 006. Abnormal vessels - radiotherapy 005. Abnormal vessels of bladder wall - radiotherapy 004. Abnormal vessels after radiotherapy 003. Abnormal vessels after radiotherapy 002. Abnormal vessels after radiotherapy 001. Abnormal vessels - radiotherapy 020. Biopsy - haemangioma B Haemangioma B + microscopic examination 018. Haemangioma B - urinary bladder 019. Haemangioma B - urinary bladder close-up Abnormal vessels. Bleeding
021. Abnormal blood vessels close to bladder tumour 026. Bladder biopsy 031. Large bladder cancer at i.v. urography 022. Abnormal large vessel feeding bladder tumour 027. Bladder cancer grade 1 after biopsy 032. Large vessel feeding the bladder cancer grade 2 023. Abnormal vessels close to bladder tumour 028. Bladder scar after TUR 033. Large vessels feeding bladder cancer 024. Abnormal vessels close to bladder tumour. TUR imminent 029. Bladder wall after TUR 034. Lower lip of urtereal orifice resected and healed 025. Bladder biopsy 030. Healed ureteral orifice after TUR for bladder cancer 035. Occluded ureter after resection. Dilated. 036. Radiotherapy cystitis and necrosis 041. Scars after earlier TURs 037. Recurrent bladder cancer. Biopsy ongoing 042. Small stones growing in TUR - scar 038. Resected ureteral orifice 039. Resected ureteral orifice 040. Scar after TUR Bladder cancer - various Bladder cancer Urothelial dysplasia Ureteral cancer
046. Ureteral splint after TUR close to orifice 048. Primary adenocarcinoma of the bladder 047. Urothelial cancer in TUR-P cavity 049. Primary adenocarcinoima of the bladder 043. Status post resection of bladder cancer 050. Primary adenocarcinoma of the bladder 044. TUR - scar 051. Primary adenocarcinoma of the bladder 045. Ureter occluded by bladder cancer. After TUR dilated ureter 052. Primary adenocarcinoma of the bladder 053. Bladder cancer - signetringcell 054. Signetringcell­ cancer 055. Signetringcell­ cancer 056. Signetringcell­ cancer Primary adenocarcinoma Signetringcell- cancer Squamous carcinoma 057. Bladder carcinoma - squamous 058. Bladder squamous carcinoma 059. Bladder cancer - squamous 060. Bladder squamous carcinoma 061. Squamous carcinoma of the bladder Ureteral cancer 062. EP. Resected ureteral cancer. Recurrence 063. EP. Ureteral cancer - recurrence puts out its tongue
068. Resection of uretral cancer - small tumour remnant 064. Ureteral cancer bulging into the bladder 065. Larger part of ureteral cancer resected 069. Ureteral cancer completely resected 066. Resection of ureteral cancer grade 2 070. Ureteral cancer grade 2 bulging into the bladder 067. Resection of ureteral cancer grade 2 071. Ureteral cancer grade 2 from left orifice 072. Bladder cancer grade 1 077. Urothelial cancer grade 1 079. Bladder cancer grade 2 084. Grade 2 cancer 073. Bladder cancer grade 1 - cloverleaf 078. Urothelial cancer grade 1 - coral like 080. Bladder cancer grade 2 074. Bladder cancer grade 1 - doomsday 082. Bladder cancer grade 2 - diverticulum 075. Urothelial cancer grade 1 081. Bladder cancer grade 2 - cluster of grapes 076. Urothelial cancer grade 1 083. Early grade 2 recurrence in scar close to orificium 085. Grade 2 cancer - Dooms day approaching 086. Grade 2 cancer - encrustations Urothelial cancer grade 1 Urothelial cancer grade 2
087. Grade 2 cancer in prostatic part of the urethra 088. Grade 2 cancer in prostatic part of urethra 089. Grade 2 cancer in prostatic urethra 090. Grade 2 cancer with blood clot 091. Grade 2 cancer with blood clot garland 096. Grade 2 cancer with plentiful vascular supply 092. Grade 2 cancer with calcification 097. Grade 2 cancer with small encrustation 093. Grade 2 cancer with encrustation 094. Grade 2 cancer with encrustations 095. Grade 2 cancer with feeding vessel 098. Grade 2 cancer with strange vessel 099. Grade 2 recurrences in old scar 100. Grade 2 urothelial cancer in prostatic part of urethra 101. Grade 2 recurrence in TUR scar 102. Large grade 2 cancer 103. Multiple recurrences grade 2 in scar 104. Some small grade 2 cancers 105. Two grade 2 tumours with feeding vessels 106. Urothelial cancer grade 2 107. Urothelial cancer grade 2 close to ureteral orifice 108. Urothelial cancer grade 2 in prostatic part of urethra 109. Urothelial cancer grade 2 in prostatic part of urethra. 110. X-ray. Bladder cancer with calcifications
10 111. Bladder cancer grade 3 in bladder roof 116. Bladder cancer grade 3 in diverticulum 121. Grade 3 cancer in bladder roof + gas bubbles 126. Grade 3 urothelial cancer 112. Bladder cancer grade 3 117. Flat, grade 3 cancer in bladder roof 122. Grade 3 cancer in diverticulum. Ca. in situ at diverticulum edge 127. Grade 3, encrusted cancer 113. Bladder cancer grade 3 118. Grade 3 cancer in bladder roof 123. Grade 3 cancer solid as well as ridged 128. Urothelial cancer grade 3 114. Bladder cancer grade 3 119. Grade 3 bladder cancer 124. Grade 3 recurrence in bladder scar 129. Urothelial cancer grade 3 115. Bladder cancer grade 3 facing Dooms Day 120. Grade 3 cancer in bladder roof 125. Grade 3 urothelial cancer 130. Carcinoma in situ at upper edge of diverticulum 132. Diverticulum A. Urothelial cancer grade 2 133. Diverticulum A after TUR 131. Diverticulum A. Urothelial cancer grade 2 Urothelial cancer in bladder diver- ticulum Urothelial cancer grade 3
11 135. Diverticulum B. Clot and urothelial cancer grade 2 140. Diverticulum D clotfilled and urothelial cancer 136. Diverticulum B. TUR has just started 141. Diverticulum D. Three months after TUR 137. Diverticulum B. Urothelial cancer grade 2 134. Diverticulum A after TUR for urothelial cancer grade 2 138. Diverticulum C. Urothelial cancer grade 2 139. Diverticulum C. Urothelial cancer grade 2 145. Urothelial cancer grade 2 on its way into diverticulum 142. Diverticulum. Urothelial cancer grade 3 143. Diverticulum. Urothelial cancer grade 3. Edge biopsy, ca. in situ 144. I.v. urography shows bladder diverticulum 146. Carcinoma in situ 147. Carcinoma in situ at upper edge of diverticulum 148. Diverticula bottom - epithelial dysplasia 149. Diverticulum. Epithelial dysplasia in bottom 150. Epithelial dysplasia in bottom of diverticulum Urothelial dysplasia - carcinoma in situ 151. Normal area in bladder A with epithelial dysplasia 152. Urothelial dysplasia bladder A 156. Urothelial dysplasia 155. Urothelial dysplasia 153. Urothelial dysplasia bladder A 154. Urothelial dysplasia bladder A
12 157. Rottening sutur keeping splint in place 158. Biopsy from nonspecific ulceration in diverticulum bottom 159. Bladder diverticulum 160. Bladder diverticulum 161. Bladder diverticulum 162. Bladder diverticulum 167. Large bladder diverticulum 172. Ureteral orifice cut open 163. Bladder roof dipping into prostatic urethra. Atonic bladder 168. Nonspecific ulceration in bladder diverticulum 173. Ureteral splint 164. Bladder trabeculation 169. Small bladder diverticulum 165. Catgut sutur cutting through bladder wall 170. Stent in ureter after operation according to Boari 166. Diverticulum. Epithelial dysplasia at bottom 171. Suture holding splint in place but cutting through bladder wall 174. Bladder cancer grade 2 growing into a diverticulum A 179. Diverticulum A. Urothelial cancer grade 2 175. Bladder diverti­ culum - urothelial cancer grade 3 176. Bladder diverticulum at i.v. urography 177. Diverticulum A after TUR 178. Diverticulum A and bladder cancer grade 2 after TUR Bladder diverticulum + various
13 180. Diverticulum B, grade 2 tumour, TUR instituted 181. Diverticulum B. Close up cancer grade 2 182. Diverticulum C, cancer grade 2 183. Diverticulum C, cancer grade 2 184. Diverticulum cancer grade 3. Ca. in situ in edge biopsy 189. Urothelial cancer grade 2 growing into diverticulum A 185. Diverticulum D clot-filled, urothelia cancer grade 2 186. Diverticulum D three months after TUR 187. Diverticulum with septum. Ca. in situ in upper edge 188. Diverticulum, blood clot, cancer grade 2 190. Vesicointestinal fistula - colonic cancer 191. Vesicointestinal fistula - sigmoiditis 192. Vesicointestinal fistula - sigmoiditis 193. Vesicointestinal fistula - sigmoiditis 195. Vesicointestinal fistula - sigmoiditis 196. Vesicointestinal fistula - vegetable remnants in the bladder 194. Vesicointestinal fistula - sigmoiditis Vesico-­intestinal fistula Bladder fistulas (colon - vagina - uterus) 197. Vesicointestinal fistula with fecal intrusion - sigmoiditis 198. Vesicosigmoidal fistula B - sigmoiditis 199. Vesicosigmoidal fistula B - sigmoiditis 200. Vesico-uterine fistula in middle of period Vesico-uterine fistula caused by sectio cesarea
14 201. Vesico-uterine fistula - menstruation 203. Vesicovaginal fistula A 204. Vesicovaginal fistula A 206. Vesicovaginal fistula B after hysterectomi 208. Bladder membrane B 214. Bladder membrane 205. Vesicovaginal fistula A 215. Bladder membrane 202. Vesico-vaginal fistula A after hysterectomi 210. Bladder membrane B 207. Vesicovaginal fistula B 211. Bladder membrane B 212. Bladder membrane seen from above 216. Züdler sling has cut through the bladder 213. Bladder membrane seen from above 217. Züdler sling has perforated the bladder wall 209. Bladder membrane B sideways view Züdlerprosthesis penetrating ­ bladder wall Vesico-vaginal fistula Bladder septum or membrane. Züdler incontinence prosthesis Bladder membrane Bladder septum or membrane
15 218. Züdlersling halfway cut through 229. Bladder stone - coral like 230. Bladder stone - coral like 231. Bladder stone - coral- or minelike 219. Birth of a ureteric stone 224. Bladder stone with blood clot 220. Birth of a ureteric stone - close up 225. Bladder stone with foot 221. Bladder stone 226. Bladder stone, mine- or corallike 222. Bladder stone 227. Bladder stone - asteroidlike 223. Bladder stone with blod clot 228. Bladder stone - carafe corkformed Bladder stones. Ureteral and urethral stones The Züdler urine incontinence sling 236. Bladder stones - geometrical, darkened background 232. Bladder stone - jellyfishlike 234. Bladder stone - mulberrylike 235. Bladder stone - olivelike 233. Bladder stone - minelike
16 241. Bladder stones - Barbarafamily like 246. Corallike bladderstone 250. Many small bladder stones 242. Bladder stones - X-ray 247. Dull bladder stone at right ureterial orifice 251. Marblelike bladder stones 243. Bladderstone 238. Geometrical bladder stones 252. Minelike bladder stone + catheter balloon. Suprapubic cystoscopy 244. Bladderstone - like black and white patterned cow 248. Irregular bladder stone 253. Multiple marblelike bladder stones 245. Corallike bladderstone 249. Large bladder stones 254. Painful delivery of bladder stone 256. Painful delivery of ureteric stone into the bladder 260. Stones in prostatic part of the urethra 239. Pyramidal bladderstone 261. Stratified bladder stone after partial lithotripsy 257. Razorsharp bladder stone 258. Razorsharp bladder stone 259. Sharp bloodstained bladder stone 240. Bladder stones - different 237. Bladder stones, geometrical 255. Concrements proximal to urethral stricture in female with MS
17 272. Catheter balloon with incrustation 277. Small bladder stone + fibrin. Patient with indwelling catheter 273. Catheter balloon - incrustation 270. Soup plate stone 274. Lithotripsy- curette 275. Old balloon shell-stone 276. Shell stone from bladder catheter balloon 264. Articulated bladder stones 266. Old and fairly fresh casts of catheter balloon + catheter tip 265. Articulated bladder stones 267. Cast of catheter balloon in urinary bladder 268. Catheter balloon shell-stones 269. Catheter balloon stones - soup- platestones 271. Catheter balloon with incrustation 262. Three dull bladder stones 263. Ureteral stone in left orifice. Incision of the orificium to begin Extraction of urethral stone Bladder stones and indwelling catheter Articulated bladder stones 278. Urethral stone stuck in urethra 280. Stone powder after ESVL leaving ureter 281. Stone powder after ESVL leaving ureter 282. Stone powder after ESVL leaving ureter Stone powder leaving ureter after ESVL 279. Stone extraction with biopsy forceps
18 283. Cutting open too narrow ureteral orifice at stone extraction 288. Extracted stone 284. Cutting open too narrow ureteral orifice 289. Extracted stone in bladder 285. Cutting open too narrow ureteral orifice 290. Ureteral orifice after stone extraction 286. Dormia basket catheter on its way into ureter 287. Dormia basket with stone 291. Bricker conduit 292. Bricker conduit with ureteral opening 293. Bricker conduit with ureteral orifice 294. Coecocystoplasty 296. Coecocystoplasty - colonic part 297. Coecocystoplasty - border coecum - bladder 298. Coecocystoplasty - coecal part 295. Coecocystoplasty - border coecum - bladder 299. Clothes line man 300. Clothes line, suprapubic cystoscopy 301. Clothes line - the intravesical knot - suprapubic cystoscopy Transurethral ureteric stone extraktion Clothes Line Man Bricker conduit - coecocystoplasty
19 303. Clothes line 302. Clothes line in the bladder. Sectio alta 304. Cystitis cystica 305. Cystitis cystica 306. Cystitis cystica 307. Cystitis cystica 309. Cystitis cystica and non-specific cystitis 310. Cystitis cystica at bladder neck 308. Cystitis cystica - widely spread 311. Cystitis cystica, multilocular 312. Cystitis cystica 314. Cystitis cystica 315. Cystitis glandularis 313. Cystitis cystica The Clothes Line man 316. Cystitis glandularis Cystitis cystica + glandularis 317. Cystitis glandularis 318. Cystitis glandularis 319. Cystitis glandularis close- up 320. Cystitis glandularis close-up 321. Cystitis glandularis
20 322. Cystitis glandularis - imminent TUR 323. PAD - Cystitis cystica 324. PAD - Multiple cystitis cystica 325. PAD - cystitis cystica 326. PAD - cystitis glandularis 327. PAD - cystitis glandularis 328. Bladder neck sclerosis after open operation 333. Primary bladder neck sclerosis 329. Bladder neck sclerosis after TUR-P 334. Primary bladder neck sclerosis 330. Bladder neck sclerosis after TUR-P 331. Posterior barrier obstructing the urethra 332. Posterior barrier of the prostate 338. Benign epithelial cyst - prostate part of the urethra 335. Ectopic ureter opening in the prostate 336. Ectopic ureter in the prostate 337. Ectopic ureter opening in the prostate Ectopic ureter in man + epithelial cysts + cavernous hemangioma Bladder neck sclerosis and barrier Microscopic examination of cystitis cystica and glandularis Diseases of the ­prostate
21 339. Benign epithelial cyst - prostate 340. Benign epithelial polyp in prostatic part of the urethra 341. Benign epthelial polyps - prostate 342. Fibroma at the verumontanum 344. Cavernous haemangioma at the verumontanum 343. Fibroma distal to the verumontanum 345. False prostatic passage being resected 346. Fresh false passage A in the prostate 347. Fresh false passage of the prostate 348. Healed false passage A in the prostate 349. Big prostate - verumontanum 350. Enlarged prostate. Fairly large verumontanum 351. Large prostate and large third lobe 352. Large prostate and large third lobe 353. Large prostate and third lobe 354. Large prostate - middle lower part 355. Large prostate - middle part 356. Large prostate - middle part - upper Large prostate + third lobe False passage 359. Marked prostatic hyperplasia 360. Medium sized prostate 357. Large prostate - middle upper part 358. Large prostate - verumontanum Moderate enlargment of the prostate
22 365. Moderately hyperplastic prostate 361. Medium sized til large prostate 362. Moderately enlarged prostate 363. Moderately enlarged prostate and varicous vessels 364. Moderately enlarged prostate + large third lobe 366. Prostatic cancer - asymmetry 371. Prostatic cancer growing into the urethra 367. Prostatic cancer - asymmetry 372. Prostatic cancer in the urinary bladder 368. Prostatic cancer growing into the bladder 373. Prostatic cancer - asymmetry 369. Prostatic cancer growing into the bladder 370. Prostatic cancer growing into the urethra 375. Slight hyperplasia of the prostate 379. Crystals of uric acid on the prostate surface 376. Slight hyperplasia of the prostate 380. Large hyperplastic prostate and subepithelial concrements 377. Slight to moderate hyperplasia of the prostate 381. Large vessels. Moderately enlarged prostate 374. Prostatic cancer - epithelial dysplasi in pars prostatica urethrae 378. Slightly to moderatly enlarged prostate 382. Small stone in prostatic ductulus Urothelial cancer in prostatic urethra + varicose vessels + conrements Slight enlargement of the prostate Prostatic cancer
23 383. Stone in prostatic ductulus. Verumontanum at 5 o’clock 384. Subepithelial, small prostatic concrements 389. Varicose vessels i the prostatic part of the urethra 385. Supepithelial concrements of the prostate 386. Urothelial cancer grade 2 in the prostatic part of the urethra 387. Urothelial cancer grade 2 in the prostatic part of the urethra 388. Varicose veins at the internal opening of the urethra 390. Recurrent adenoma after open operation 391. Recurrent adenoma after open operation 392. Sign of Schramm - widely open internal urethral orifice. Neurologic disease 393. Two urethra openings after cystoscopy (trauma) 394. Two urethra openings after incomplete TUR-P 395. Abnormal refluxing ureteral orifice and cystitis cystica 396. Ectopic ureteral orifice Various Ectopic ureteral orifice 397. Refluxing ureteral orifice 398. Ureteral duplication on the left side Case report ectopic ureteral orifice
Digital atlas of cystoscopy.pdf
Digital atlas of cystoscopy.pdf
26 399. Bladder roof oedema caused by catheter tip 404. Decubitus caused by catheter tip 410. New and old catheter balloon casts 400. Bladder roof oedema caused by catheter tip 406. Slight catheter tip oedema 411. Bladder stones. Patient with indwelling catheter 401. Catheter tip decubitus 407. Subepithelial bleeding caused by catheter tip 412. Catheter balloon cast 414. Catheter balloon cast 402. Catheter tip oedema 408. Thickwalled, contracted bladder caused by indwelling catheter 413. Catheter balloon cast 403. Decubitus caused by catheter tip 409. Trabeculated bladder with sub­ epithelial cathetertip induced bleedings 415. Catheter balloon cast 416. Catheter balloon cast + catheter tip 417. Catheter balloon cast seen from the inside 418. Catheter balloon encrustment 419. Catheter tip, catheter balloon cast, piece of rubber Catheter balloon encrustments Bladder wall ­ oedema - decubitus - bleeding Indwelling catheter - complications 405. Catheter tip injury of bladder roof
27 420. Catheters with slight encrustment after 30 days 425. Encrusted catheter balloon 430. Old and new catheter balloon casts 421. X-ray. Encrusted catheter balloon 435. False urethral passage. Splint in true urethra 422. X-ray. Encrusted catheter balloon - close- up view 426. Encrusted catheter ballon - side view - suprapubic cystoscopy 431. Old balloon casts looking like soup-plates 436. Old urethral stricture A, false passage to patients left 427. Encrusted catheter balloon 432. Old catheter balloon stone 437. Remnants of small false passages in the urethra 423. Contracted bladder + small stone caused by longtime indwelling catheter 428. Encrusted catheter balloon - suprapubic cystoscopy 433. Pile of cracked catheter balloon encrustment 424. Eggshell concrement pile 429. Indwelling catheter - eggshell encrustment 434. Soup plate stone - old balloon encrustment 438. Ureteral stricture A (left) and false passage (right, larger) in urethra False passage 440. Urethral stricture and fistulation in leu­ kaemic man with CAD. Some months later 441. Urethral stricture and fistulation in leukaemic man with indwelling catheter 443. Wedged-shaped false passage in the urethra 442. Urethral stricture after TUR-P. False passage below 439. Urethral fistula­ tion and stricture in leukaemic man with indwelling catheter
28 444. Deep and large false passage in the prostate 449. Healed false passage in the prostate 451. Deep false passage into corpus spongiosum urethrae 445. False passage in left lobe of the prostate 450. Old false passage in the prostate 452. Deep false passage in male urethra-corpus spongiosum!! 446. False passage in the prostate 453. Deep false passage into corpus spongiosum urethrae 447. Fresh false passage A in the left lobe of prostate 448. Healed false passage A in left lobe of prostate 455. Catheter balloon dilated urethra 456. Splint in normal urethra from the urethral dilatation 454. Strange scrotal swelling 457. Catheter occasioned urethritis 458. Catheter-caused urethritis 459. Indwelling catheter urethritis 460. Indwelling catheter urethritis 461. Membrane and urethritis caused by indwelling catheter 462. Membraneous urethritis caused by indwelling catheter 463. Urethra after some days with indwelling catheter Urethtritis caused by indwelling catheter Strange urethral swelling False passage False passage into corpus spongio- sum urethrae False passage False passage in the prostate Case report. Strange swelling
29 464. Urethritis caused by indwelling catheter 466. Internal urethrotomy 467. Internal urethrotomy 465. Internal urethrotomy 468. Internal urethrotomy 469. Internal urethrotomy 470. Internal urethrotomy - stricture cut open 471. Internal urethrotomy - the knife 472. Hunnercystitis - scar 473. Hunnercystitis - early stage - oedema Interstitial (Hunner) - cystitis Internal urethrotomy 474. Hunnercystitis - haemorrhage and oedema 477. Interstitial cystitis - scar 476. Hunnercystitis - scar 475. Hunnercystitis - scar
30 479. Colonic cancer growing in the bladder 480. Colonic cancer growing in the bladder 478. Colonic cancer growing in the bladder 481. Impression in left bladder wall caused by sigmoidcancer not invading bladder 483. Oedema caused by simoidal cancer 485. Bezoar cystoscopy 484. Oedema close to colonic cancer invading bladder 486. Bezoar cystoscopy 487. Bladder bezoar 482. Oedema caused by colonic cancer invading the bladder 488. Bladder bezoar cystoscopy 490. Bladder bezoar penetrated by the cystoscope 491. Bladder bezoar removed from the bladder 492. Bladder bezoar - size 489. Bladder bezoar- Looking like miss Piggy 493. Bladder bezoar X-ray 495. Candia albicans - very few - on micro­ scopic examination of bladder bezoar 494. Bladder bezoar - microscopic examination Large Bladder Bezoar Intrusion from outside the bladder
31 498. Litholapaxy 500. Stone to hard to handle with litholapaxy 502. Litholapaxy - curette 501. Stone to hard to handle with litholapaxy 497. Litholapaxy 499. Stone fragments after litholapaxy 496. Stone punch 503. Abating haemorrhagic bacterial cystitis 504. Abating haemorrhagic cystits 505. Acute bacterial cystitis and prostatitis 506. Acute bacterial haemorrhagic cystitis 508. Acute, haemorrhagic cystitis 509. Bacterial haemorrhagic (velvet) cystitis 507. Acute cystitis and prostatitis Litholapaxy Non specific cystitis - inflammation 510. Bladder diverticulum with non- specific inflammation 513. Haemorrhagic, bacterial cystitis 514. Haemorrhagic, non-specific cystitis 515. Haemorrhagisk cystitis and cystitis cystica 511. Cystitis, non- specific 512. Diffuse, non- specific cystitis
32 519. Non-specific cystitis in man with bacterial prostatitis 520. Non-specific cystitis in trabeculated bladder 516. Mild, non-specific cystitis 518. Non-specific cystitis 517. Non specific haemorrh. cystitis + cystitis cystica 521. Non-specific cystitis with haemorrhage 523. Trabeculated bladder with non- specific cystitis 522. Non-specific cystitis and oedema 524. Coat of arms - Royal Urologic Department of Umeå 525. Cover picture - Atlas of cystoscopy 526. Difficult to see - ureteral orifice 531. Broad ureteral orifice and blood vessels leading into it 527. Sleeping ureteral orifice 532. Compressed vessels in filled bladder 528. Air bubbles at bladder roof 533. Corkscrew vessels - normal bladder 529. Bladder - normal 530. Bladder - normal Normal bladder Introducing slides Coat of Arms - Royal Department of Urology Normal anatomy + epithelial metaplasi + pseudopolyps
33 534. Left uretral orifice - normal 535. Normal bladder - funny vessels 537. Normal bladder - corkscrew vessels 538. Normal bladder epithelium 539. Normal bladder - infrequent vessels 540. Normal bladder rich in vessels 536. Normal bladder 541. Normal bladder epithelium 542. Normal bladder looking like optical nerve 543. Normal bladder - vessel looking like a hydra 544. Normal bladder. Airbubble impressed by uterus 546. Normal bladder - abnormal vessels 545. Normal bladder + epithelial metaplasia 547. Normal bladder - autostrada vessels 548. Normal bladder - corkscrew vessels 549. Normal bladder - funny vessels 551. Normal bladder - roof air bubble looking like a frog 550. Normal bladder - rich in vessels 552. Normal bladder - varicose vessel 553. Normal bladder - varicose vessels 556. Slightly abnormal ureteral orifice 557. Ureteral orifice a bit difficult to see 558. Ureteral orifice - difficult to discover 555. Normal, well visible ureteral orifice 554. Normal right ureteral orifice
34 559. Vessel compres- sion in maximally filled bladder 560. Biopsy epithelial metaplasia - female trigonum 561. Epithelial metaplasia female trigonum 562. Epithelial metaplasia, female trigonum 563. Crista urethralis 564. Crista urethralis- like extension above the verumontanum prostatae 565. Normal but difficult to see verumontanum 566. Normal crista urethralis with a small cyst 567. Normal prostate 569. Normal prostate with ductuli orifices 574. Normal prostate. Openings of vas deferens well visible 570. Normal prostate with ductuli 571. Normal prostate, difficult to see verumontanum 575. Normal verumontanum 572. Normal prostate, duplicated crista ure- thralis-like extension above the verumontanum 576. Small cyst at the bladder neck 573. Normal prostate, well visible verumontanum 577. Subepithelial concrements in the verumentanumal epithelium 568. Normal prostate 578. Normal prostate - young man - no fluid instilled 579. Slow fluid instillation 580. Moderate flow of instilled water Normal prostate Normal prostate - different flow speed of instilled water Normal prostate Normal bladder Epithelial meta- plasia of female trigonum
35 595. Normal pars membranacea 590. Pars membranacea - normal 591. Eternal sphincter - normal 592. External sfincter - normal 581. Rapid flow of instilled water 593. Normal fossa navicularis + the pendulant part of the urethra 594. Normal male external sfincter 596. Normal pars membrancea 597. Normal pars pendulans (fluid filled light cable). Urethral gland openings! 598. Normal proximal urethra. Air bubbles in the lubricating jelly 582. Normal female urethra Normal urethra - male Normal urethra - female 584. Normal female urethra 583. Normal female urethra 587. Pseudopolyps close to the internal meatus - female urethra 585. Proximal opening of female urethra 586. Proximal urethral opening of normal female urethra 588. Pseudopolyps in the female urethra close to the internal meatus 589. Pseudopolyps of the female urethra - close to the internal meatus 600. Normal proximal urethra. Opening of the gland of Cowperi 599. Normal proximal urethra. Impressions of the bulbocavernosus muscle! 601. Opening of glandula Cowperi 602. Pars membranacea - normal 603. Pars membranacea - normal
36 606. Balanitis xerotica obliterans 608. Carcinoma of the penis 607. Carcinoma of the penis 609. Hypospadia glandis 610. Lichen sclerosis 611. Malignt lymphoma in external urethral orifice 612. Non specifik inflammation (PAD) 613. Urethral caruncula 615. Fairly deep resection of ureteral orifice 616. Healed resected ureteral orifice 614. Urethral caruncula 617. Looking into resected refluxing ureter Penis + external ­ urethral orifice Resection of ureteral orifice 604. Pars membranacea - normal 605. Proximal urethra - normal. Air bubbles in lubricating jelly
37 618. Re-implanted ureter and suture granuloma 620. Superficial recsection of urteral orifice 621. Superficial resection of ureteral orifice 619. Resected, refluxing ureteral orifice 622. Bladder wall sucked into drainage hole of a catheter 623. Catheter inserted into left ureteral orifice 624. Double-J-catheter in ureteral orifice 625. Suprapubic catheter during TUR 627. Suprapubic cystoscopy - hyperplasia 632. Urethral stricture - urethrotomia interna - catheter through stricture 628. Suprapubic cystoscopy - hyperplastic prostate 629. Suprapubic cystoscopy - primary bladder neck sclerosis 630. Suprapubic cystoscopy - third lobe 626. Suprapubic catheter - indwelling 631. Tip of catheter Suprapubic cystoscopy + ureteral stent 634. Amazon river fish 635. Amazon river fish. Penis protection 633. Amazon river fish The Amazon River Fish
38 636. Amazon river fish - lateral view 637. Bladder trabeculation 638. Maximally distended trabeculated bladder 639. Trabeculation 640. Trabeculation 641. Trabeculation, bladder half-filled 642. Trabeculation - thinwalled bladder - woman 643. Trabeculation - thinwalled bladder - woman 644. Bilharzial subepithelial eggs 649. Bilharzia - sandy patches + tuberculoma 645. Bilharzial tubercles at the left ureteral orifice 646. Bilharzial tuberculoma 648. Bilharzia - sandy patches 647. Bilharzia - sandy patches Bladder amyloidosis Bilharzia Amazon River Fish Tuberculous cystitis - Bilharzia - Amyloidosis Trabeculation
39 651. Bladder amyloidosis 652. Bladder amyloidosis 653. Bladder amyloidosis - left bladder wall 650. Bladder amyloidosis 655. Active bladder tuberculosis 656. Active bladder tuberculosis 654. Active bladder tuberculosis 659. Bladder tuberculosis treated for five months 660. Bladder tuberculosis treated for five months 657. Active tuberculous cystitis 658. Bladder tubeculosis treated for five months 661. Bladder tuberculosis treated for five months 662. Healing bladder tuberculosis after five months of treatment 663. Marked granulo- matous changes after five months of treatment. Bladdertuberculosis 664. Beginning TUR-P, large prostate Bladder tuberculosis TUR-P + complications 665. Bleeding venous sinusoids close to the prostatic capsule 666. English channel in a patient in bad condition 671. Large capsule perforation during TUR-P 667. Excellent TUR-P, verumontanum at six o’clock 668. Excellent TUR-P. Verumontanum. 669. Excellent TUR-P - verumonatum at six o’clock 670. Large capsular perforation
40 672. Large perforation during TUR-P 673. Prostatic capsule perforation - fat tissue protruding 674. Secretions empty from the prostate during TUR-P 676. Subepithelial bleeding caused by resection tube 681. TUR-P capsular perforations 686. TUR-P hyperplastic tissue 677. Subepithelial bleedings caysed by resection tube 682. TUR-P carcinomatous tissue 688. TUR-P incomplete resection 678. TUR-P internal sphicter 683. TUR-P fairly large perforation of the prostatic capsule 687. TUR-P incomplete resection 679. TUR-P bleeding from vessel at internal sphincter 684. TUR-P gas bubbles 675. Small concrement in the prostate during TUR-P 680. TUR-P bleeding from vessel in hyperplastic tissue 685. TUR-P hyperplastic tissue 689. TUR-P internal urethral sphincter 690. TUR-P left lobe resected 691. TUR-P love bite by resection tube 692. TUR-P prostate capsule and very small concrements 693. TUR-P unexpected cancer 694. TUR-P upper half of right lobe reseceted 695. TUR-P, prostatic cancer 696. TUR-P, prostatic concrements
41 704. Evaporating the prostate 703. End result of TUR-P 697. TUR-P, slightly more tissue remains 698. TUR-P, small perforations 699. TUR-P, unex- pected prostatic cancer (yellowish tissue) 701. TUR-P. Love bite by resection tube 705. Bladder neck incison half-way 710. Prostatic caposule almost cut through 702. TUR-P-prostatic capsule 706. Bladder neck sclerosis Bladder neck incision 707. Bladder neck sclerosis Incision to be started 708. Neck incision at 4 o’clock 700. TUR-P,small perforation - fat tissue intruding 709. Neck incision at 8 o’clock. Approaching capsule 711. Prostatic capsule at 4 o’clock incision 712. Prostatic capsule at bladder neck incision Obturating, recurrent adenoma after open operation Bladder neck incision in bladder neck sclerosis 713. Recurrent adenoma during fluid instillation 714. Recurrent adenom during fluid emptying 715. Recurrent adenom after open operation - falling down into the urethra 716. Bladder neck sclerosis after TUR-P 717. Bladder neck sclerosis after open operation Postoperative bladder neck sclerosis+various Case report
42 718. Bladder neck sclerosis after TUR-P 722. Injected, reddened urethra immediately after TUR-P 723. Prostatic cavity one year after TUR-P 720. Bladder neck sclerosis after TUR-P 724. Prostatic cavity eleven months after TUR-P 721. Bladder neck sclerosis after TUR-P. Verumontanum at six o’clock 726. Stricture of the urethra caused by TUR-P 727. TUR-P cavity after six months 728. TUR-P vas opening, close up 729. Two urethra openings after incomplete TUR-P 725. Prostatic cavity one year after TUR-P 730. Two urethra openings after insufficient TUR-P 731. Urethral stricture caused by TUR-P 732. Vas openings after TUR-P 734. Resectoscope components 735. Resectoscope tip 733. Resectoscope 736. TUR-P 737. EP - Bladder scar 10 days after open op. and reimplant. of ureter 738. EP - 10 days after open op. and reimplant. of ureter 739. EP - After open operation reimplant. of ueter 10 days The resectoscope Ureteral cancer. Deep resection of ureteral orifice 719. Bladder neck scle- rosis after transvesical adenoma enucleation
43 740. EP - Bladder scar 10 days after operation 743. EP - 10 days after open operation, reimplant. of ureter 744. EP - Iv urographi after deep resection 741. EP - Bladder scar 10 days after operation 742. EP - Bladder scar 10 days after operation 748. EP - Resected ureteral cancer - recurrence 753. EP - Re- implanted ureter after 6 months 749. EP - Deeply resected orifice 752. EP - Re- implanted ureter after seven days 750. EP - Deeply resected orifice - scarred 754. EP - Resected ureteral cancer. Tumour recurrence 751. EP - Deeply resected orifice - tumourfree 755. EP - Resected ureteral orifice - more tumour 745. EP - Iv urographi after deep resection - stasis 746. EP - Iv urographi six months after reimplantation 747. EP - Resected ureteral cancer - recurrence 756. EP - The recurrent tumour puts out its tongue against the intruder Case report EP 758. I.v. urographi after TUR-A 757. I.v. urographi before TUR-A Ureterocele A and B 759. Left ureterocele A
44 762. Left ureterocele, cut open by TUR 763. Looking into ureter running into ureterocele A 764. Right ureterocele half-filled A 760. Left ureterocele A before TUR 765. Right ureterocele A before TUR 761. Left ureterocele A viewed from urethra 766. Ureter running into ureterocele A, close up 769. Small ureterocele B distended 770. Small ureterocele B half-filled 771. Ureterocele B, slightly filled 772. Ureterocele B, empty 767. Ureter running into ureterocele A. Refluxing 768. Ureterocele A. TUR halfway 776. Failed attempt to put ureteral catheter through urethral stricture 777. Irritated urethral stricuture after attempt to catheterizing 778. Moderate urethral stricture 774. Incision of urethral diverticulum in male 773. Urethral diverticulum in male 775. Urine flow before and after operation Case report - ureterocele A Urethral stricture- fistulation-diverticulum Urethral diverticulum in male - operation of
45 781. Stricture of the urethra 782. Urethral stricture 784. Urethral stricture 779. Multiple urethral strictures caused by indwelling catheter 780. Narrow urethral stricture 783. Urethral stricture 785. Urethral stricture after dilatation 786. Urethral stricture with ureteral catheter 787. Urethral stricture with ureteral catheter. False passage 788. Urethral stricture with ureteral catheter + urethral fistulation 789. Urethral stricture + false passage below 791. Small opening in prox. part of urethral diverticulum 790. Urtehral stricture traumatized by catheterizing attempt Diverticulum of urethra in man 792. Urethral diverticulum A 794. Urethral diverticulum A 793. Urethral diverticulum A 795. Urethral diverticulum B 797. Urethral diverticulum 1 in woman 799. Urethral diverticulum (to the left) 2 in woman 798. Urethral diverticulum 1 in woman Diverticulum of urethra in woman 796. Urethral diverticulum B
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Digital atlas of cystoscopy.pdf

  • 2. This booklet and CD are published and sponsored by Astra Tech AB. This publication reflects Dr. Schönebeck’s findings during cystoscopy and not necessary the view of Astra Tech. Copyright of the concept “Digital Atlas of Cystoscopy” belongs to Astra Tech. Pictures on the CD are free to use, but please reference Dr. Jan Schönebeck.
  • 3. C O N T E N T S Preface 4 Abnormal vessels. Bleeding 5 Bladder cancer Urothelial dysplasia Ureteral cancer 6 Bladder diverticulum + various 12 Bladder fistulas (colon – vagina – uterus) 13 Bladder septum or membrane. Züdler incontinence prosthesis 14 Bladder stones. Ureteral and urethral stones 15 Bricker conduit – coecocystoplasty 18 Clothes Line Man 18 Cystitis cystica + glandularis 19 Diseases of the prostate 20 Ectopic ureteral orifice 23 Indwelling catheter – complications 26 Internal urethrotomy 29 Interstitial (Hunner) – cystitis 29 Intrusion from outside the bladder 30 Large Bladder Bezoar 30 Litholapaxy 31 Non specific cystitis – inflammation 31 Normal anatomy + epithelial metaplasi + pseudopolyps 32 Penis + external urethral orifice 36 Resection of ureteral orifice 36 Suprapubic cystoscopy + ureteral stent 37 The Amazon River Fish 37 Trabeculation 38 Tuberculous cystitis – Bilharzia – Amyloidosis 38 TUR-P + complications 39 Ureteral cancer. Deep resection of ureteral orifice 42 Ureterocele A and B 43 Urethral diverticulum in male – operation of 44 Urethral stricture – fistulation – diverticulum 44
  • 4. P R E F A C E In the beginning of the 80ies it was regarded as impossible to take good quality photos inside the urinary bladder due to insuf- ficient light conditions. Be- ing a urologist with an interest in photo docu- mentation I solved this problem. In 1984 I published a selec- tion of my photos in the book ”Atlas of cystoscopy” which was soon sold out. However, my interest continued. When I retired about 1500 slides rested in my boxes. After purging some about 800 remained. I realised that my heirs would have no interest in my slides. They were most likely to be destructed. Furthermore, the slides were fairly bulky. I decided to digi- talize them and by that I solved both problem, they now occupied only three DVDs and could be saved for long-term. However my wish is that my pic- tures should be made easily avail- able for education, making it pos- sible for young physicians to have the possibility to learn the spectrum of the cystoscopic appearance of bladder diseases. The photos could also, for educational purposes, be used in PowerPoint pre- sentations, in text-books, in scientific articles and case reports. To achieve this it was necessary to adapt the material to fit into one CD and to have the possibility to distribute it to as many hospitals as possible. I therefore contacted Astra Tech. The company immediately declared that they were willing to support the project. The result is now in your hands, a CD named ”Digital Atlas of Cystosopy” and which at no cost is distributed to a large number of urologists, surgeons and gynecolo- gists. I want to thank Astra Tech for their generous support which made creation of this CD possible. It con- tains about 800 cystoscopy photos illustrating a majority of all findings you might find with cystoscopy. Ljungby, Sweden, August 2007 Jan Schönebeck Associate professor of urology, retired
  • 5. 015. Varicose vessels of bladder wall 014. Slightly abnormal vessels - radiotherapy 013. Old clot (almost black) leaving right ureter 016. Haemangioma A - urinary bladder 017. Haemangioma A of urinary bladder - close-up 012. Fresh clot leaving right ureter 011. Clot leaving left ureter 010. Bleeding in bladder wall caused by bladder stone 009. Bleeding from bladder wall caused by rapid evacuation of urine retention 008. Bleeding from bladder wall caused by rapid emptying of urine retention 007. Abnormal vessels - radiotherapy 006. Abnormal vessels - radiotherapy 005. Abnormal vessels of bladder wall - radiotherapy 004. Abnormal vessels after radiotherapy 003. Abnormal vessels after radiotherapy 002. Abnormal vessels after radiotherapy 001. Abnormal vessels - radiotherapy 020. Biopsy - haemangioma B Haemangioma B + microscopic examination 018. Haemangioma B - urinary bladder 019. Haemangioma B - urinary bladder close-up Abnormal vessels. Bleeding
  • 6. 021. Abnormal blood vessels close to bladder tumour 026. Bladder biopsy 031. Large bladder cancer at i.v. urography 022. Abnormal large vessel feeding bladder tumour 027. Bladder cancer grade 1 after biopsy 032. Large vessel feeding the bladder cancer grade 2 023. Abnormal vessels close to bladder tumour 028. Bladder scar after TUR 033. Large vessels feeding bladder cancer 024. Abnormal vessels close to bladder tumour. TUR imminent 029. Bladder wall after TUR 034. Lower lip of urtereal orifice resected and healed 025. Bladder biopsy 030. Healed ureteral orifice after TUR for bladder cancer 035. Occluded ureter after resection. Dilated. 036. Radiotherapy cystitis and necrosis 041. Scars after earlier TURs 037. Recurrent bladder cancer. Biopsy ongoing 042. Small stones growing in TUR - scar 038. Resected ureteral orifice 039. Resected ureteral orifice 040. Scar after TUR Bladder cancer - various Bladder cancer Urothelial dysplasia Ureteral cancer
  • 7. 046. Ureteral splint after TUR close to orifice 048. Primary adenocarcinoma of the bladder 047. Urothelial cancer in TUR-P cavity 049. Primary adenocarcinoima of the bladder 043. Status post resection of bladder cancer 050. Primary adenocarcinoma of the bladder 044. TUR - scar 051. Primary adenocarcinoma of the bladder 045. Ureter occluded by bladder cancer. After TUR dilated ureter 052. Primary adenocarcinoma of the bladder 053. Bladder cancer - signetringcell 054. Signetringcell­ cancer 055. Signetringcell­ cancer 056. Signetringcell­ cancer Primary adenocarcinoma Signetringcell- cancer Squamous carcinoma 057. Bladder carcinoma - squamous 058. Bladder squamous carcinoma 059. Bladder cancer - squamous 060. Bladder squamous carcinoma 061. Squamous carcinoma of the bladder Ureteral cancer 062. EP. Resected ureteral cancer. Recurrence 063. EP. Ureteral cancer - recurrence puts out its tongue
  • 8. 068. Resection of uretral cancer - small tumour remnant 064. Ureteral cancer bulging into the bladder 065. Larger part of ureteral cancer resected 069. Ureteral cancer completely resected 066. Resection of ureteral cancer grade 2 070. Ureteral cancer grade 2 bulging into the bladder 067. Resection of ureteral cancer grade 2 071. Ureteral cancer grade 2 from left orifice 072. Bladder cancer grade 1 077. Urothelial cancer grade 1 079. Bladder cancer grade 2 084. Grade 2 cancer 073. Bladder cancer grade 1 - cloverleaf 078. Urothelial cancer grade 1 - coral like 080. Bladder cancer grade 2 074. Bladder cancer grade 1 - doomsday 082. Bladder cancer grade 2 - diverticulum 075. Urothelial cancer grade 1 081. Bladder cancer grade 2 - cluster of grapes 076. Urothelial cancer grade 1 083. Early grade 2 recurrence in scar close to orificium 085. Grade 2 cancer - Dooms day approaching 086. Grade 2 cancer - encrustations Urothelial cancer grade 1 Urothelial cancer grade 2
  • 9. 087. Grade 2 cancer in prostatic part of the urethra 088. Grade 2 cancer in prostatic part of urethra 089. Grade 2 cancer in prostatic urethra 090. Grade 2 cancer with blood clot 091. Grade 2 cancer with blood clot garland 096. Grade 2 cancer with plentiful vascular supply 092. Grade 2 cancer with calcification 097. Grade 2 cancer with small encrustation 093. Grade 2 cancer with encrustation 094. Grade 2 cancer with encrustations 095. Grade 2 cancer with feeding vessel 098. Grade 2 cancer with strange vessel 099. Grade 2 recurrences in old scar 100. Grade 2 urothelial cancer in prostatic part of urethra 101. Grade 2 recurrence in TUR scar 102. Large grade 2 cancer 103. Multiple recurrences grade 2 in scar 104. Some small grade 2 cancers 105. Two grade 2 tumours with feeding vessels 106. Urothelial cancer grade 2 107. Urothelial cancer grade 2 close to ureteral orifice 108. Urothelial cancer grade 2 in prostatic part of urethra 109. Urothelial cancer grade 2 in prostatic part of urethra. 110. X-ray. Bladder cancer with calcifications
  • 10. 10 111. Bladder cancer grade 3 in bladder roof 116. Bladder cancer grade 3 in diverticulum 121. Grade 3 cancer in bladder roof + gas bubbles 126. Grade 3 urothelial cancer 112. Bladder cancer grade 3 117. Flat, grade 3 cancer in bladder roof 122. Grade 3 cancer in diverticulum. Ca. in situ at diverticulum edge 127. Grade 3, encrusted cancer 113. Bladder cancer grade 3 118. Grade 3 cancer in bladder roof 123. Grade 3 cancer solid as well as ridged 128. Urothelial cancer grade 3 114. Bladder cancer grade 3 119. Grade 3 bladder cancer 124. Grade 3 recurrence in bladder scar 129. Urothelial cancer grade 3 115. Bladder cancer grade 3 facing Dooms Day 120. Grade 3 cancer in bladder roof 125. Grade 3 urothelial cancer 130. Carcinoma in situ at upper edge of diverticulum 132. Diverticulum A. Urothelial cancer grade 2 133. Diverticulum A after TUR 131. Diverticulum A. Urothelial cancer grade 2 Urothelial cancer in bladder diver- ticulum Urothelial cancer grade 3
  • 11. 11 135. Diverticulum B. Clot and urothelial cancer grade 2 140. Diverticulum D clotfilled and urothelial cancer 136. Diverticulum B. TUR has just started 141. Diverticulum D. Three months after TUR 137. Diverticulum B. Urothelial cancer grade 2 134. Diverticulum A after TUR for urothelial cancer grade 2 138. Diverticulum C. Urothelial cancer grade 2 139. Diverticulum C. Urothelial cancer grade 2 145. Urothelial cancer grade 2 on its way into diverticulum 142. Diverticulum. Urothelial cancer grade 3 143. Diverticulum. Urothelial cancer grade 3. Edge biopsy, ca. in situ 144. I.v. urography shows bladder diverticulum 146. Carcinoma in situ 147. Carcinoma in situ at upper edge of diverticulum 148. Diverticula bottom - epithelial dysplasia 149. Diverticulum. Epithelial dysplasia in bottom 150. Epithelial dysplasia in bottom of diverticulum Urothelial dysplasia - carcinoma in situ 151. Normal area in bladder A with epithelial dysplasia 152. Urothelial dysplasia bladder A 156. Urothelial dysplasia 155. Urothelial dysplasia 153. Urothelial dysplasia bladder A 154. Urothelial dysplasia bladder A
  • 12. 12 157. Rottening sutur keeping splint in place 158. Biopsy from nonspecific ulceration in diverticulum bottom 159. Bladder diverticulum 160. Bladder diverticulum 161. Bladder diverticulum 162. Bladder diverticulum 167. Large bladder diverticulum 172. Ureteral orifice cut open 163. Bladder roof dipping into prostatic urethra. Atonic bladder 168. Nonspecific ulceration in bladder diverticulum 173. Ureteral splint 164. Bladder trabeculation 169. Small bladder diverticulum 165. Catgut sutur cutting through bladder wall 170. Stent in ureter after operation according to Boari 166. Diverticulum. Epithelial dysplasia at bottom 171. Suture holding splint in place but cutting through bladder wall 174. Bladder cancer grade 2 growing into a diverticulum A 179. Diverticulum A. Urothelial cancer grade 2 175. Bladder diverti­ culum - urothelial cancer grade 3 176. Bladder diverticulum at i.v. urography 177. Diverticulum A after TUR 178. Diverticulum A and bladder cancer grade 2 after TUR Bladder diverticulum + various
  • 13. 13 180. Diverticulum B, grade 2 tumour, TUR instituted 181. Diverticulum B. Close up cancer grade 2 182. Diverticulum C, cancer grade 2 183. Diverticulum C, cancer grade 2 184. Diverticulum cancer grade 3. Ca. in situ in edge biopsy 189. Urothelial cancer grade 2 growing into diverticulum A 185. Diverticulum D clot-filled, urothelia cancer grade 2 186. Diverticulum D three months after TUR 187. Diverticulum with septum. Ca. in situ in upper edge 188. Diverticulum, blood clot, cancer grade 2 190. Vesicointestinal fistula - colonic cancer 191. Vesicointestinal fistula - sigmoiditis 192. Vesicointestinal fistula - sigmoiditis 193. Vesicointestinal fistula - sigmoiditis 195. Vesicointestinal fistula - sigmoiditis 196. Vesicointestinal fistula - vegetable remnants in the bladder 194. Vesicointestinal fistula - sigmoiditis Vesico-­intestinal fistula Bladder fistulas (colon - vagina - uterus) 197. Vesicointestinal fistula with fecal intrusion - sigmoiditis 198. Vesicosigmoidal fistula B - sigmoiditis 199. Vesicosigmoidal fistula B - sigmoiditis 200. Vesico-uterine fistula in middle of period Vesico-uterine fistula caused by sectio cesarea
  • 14. 14 201. Vesico-uterine fistula - menstruation 203. Vesicovaginal fistula A 204. Vesicovaginal fistula A 206. Vesicovaginal fistula B after hysterectomi 208. Bladder membrane B 214. Bladder membrane 205. Vesicovaginal fistula A 215. Bladder membrane 202. Vesico-vaginal fistula A after hysterectomi 210. Bladder membrane B 207. Vesicovaginal fistula B 211. Bladder membrane B 212. Bladder membrane seen from above 216. Züdler sling has cut through the bladder 213. Bladder membrane seen from above 217. Züdler sling has perforated the bladder wall 209. Bladder membrane B sideways view Züdlerprosthesis penetrating ­ bladder wall Vesico-vaginal fistula Bladder septum or membrane. Züdler incontinence prosthesis Bladder membrane Bladder septum or membrane
  • 15. 15 218. Züdlersling halfway cut through 229. Bladder stone - coral like 230. Bladder stone - coral like 231. Bladder stone - coral- or minelike 219. Birth of a ureteric stone 224. Bladder stone with blood clot 220. Birth of a ureteric stone - close up 225. Bladder stone with foot 221. Bladder stone 226. Bladder stone, mine- or corallike 222. Bladder stone 227. Bladder stone - asteroidlike 223. Bladder stone with blod clot 228. Bladder stone - carafe corkformed Bladder stones. Ureteral and urethral stones The Züdler urine incontinence sling 236. Bladder stones - geometrical, darkened background 232. Bladder stone - jellyfishlike 234. Bladder stone - mulberrylike 235. Bladder stone - olivelike 233. Bladder stone - minelike
  • 16. 16 241. Bladder stones - Barbarafamily like 246. Corallike bladderstone 250. Many small bladder stones 242. Bladder stones - X-ray 247. Dull bladder stone at right ureterial orifice 251. Marblelike bladder stones 243. Bladderstone 238. Geometrical bladder stones 252. Minelike bladder stone + catheter balloon. Suprapubic cystoscopy 244. Bladderstone - like black and white patterned cow 248. Irregular bladder stone 253. Multiple marblelike bladder stones 245. Corallike bladderstone 249. Large bladder stones 254. Painful delivery of bladder stone 256. Painful delivery of ureteric stone into the bladder 260. Stones in prostatic part of the urethra 239. Pyramidal bladderstone 261. Stratified bladder stone after partial lithotripsy 257. Razorsharp bladder stone 258. Razorsharp bladder stone 259. Sharp bloodstained bladder stone 240. Bladder stones - different 237. Bladder stones, geometrical 255. Concrements proximal to urethral stricture in female with MS
  • 17. 17 272. Catheter balloon with incrustation 277. Small bladder stone + fibrin. Patient with indwelling catheter 273. Catheter balloon - incrustation 270. Soup plate stone 274. Lithotripsy- curette 275. Old balloon shell-stone 276. Shell stone from bladder catheter balloon 264. Articulated bladder stones 266. Old and fairly fresh casts of catheter balloon + catheter tip 265. Articulated bladder stones 267. Cast of catheter balloon in urinary bladder 268. Catheter balloon shell-stones 269. Catheter balloon stones - soup- platestones 271. Catheter balloon with incrustation 262. Three dull bladder stones 263. Ureteral stone in left orifice. Incision of the orificium to begin Extraction of urethral stone Bladder stones and indwelling catheter Articulated bladder stones 278. Urethral stone stuck in urethra 280. Stone powder after ESVL leaving ureter 281. Stone powder after ESVL leaving ureter 282. Stone powder after ESVL leaving ureter Stone powder leaving ureter after ESVL 279. Stone extraction with biopsy forceps
  • 18. 18 283. Cutting open too narrow ureteral orifice at stone extraction 288. Extracted stone 284. Cutting open too narrow ureteral orifice 289. Extracted stone in bladder 285. Cutting open too narrow ureteral orifice 290. Ureteral orifice after stone extraction 286. Dormia basket catheter on its way into ureter 287. Dormia basket with stone 291. Bricker conduit 292. Bricker conduit with ureteral opening 293. Bricker conduit with ureteral orifice 294. Coecocystoplasty 296. Coecocystoplasty - colonic part 297. Coecocystoplasty - border coecum - bladder 298. Coecocystoplasty - coecal part 295. Coecocystoplasty - border coecum - bladder 299. Clothes line man 300. Clothes line, suprapubic cystoscopy 301. Clothes line - the intravesical knot - suprapubic cystoscopy Transurethral ureteric stone extraktion Clothes Line Man Bricker conduit - coecocystoplasty
  • 19. 19 303. Clothes line 302. Clothes line in the bladder. Sectio alta 304. Cystitis cystica 305. Cystitis cystica 306. Cystitis cystica 307. Cystitis cystica 309. Cystitis cystica and non-specific cystitis 310. Cystitis cystica at bladder neck 308. Cystitis cystica - widely spread 311. Cystitis cystica, multilocular 312. Cystitis cystica 314. Cystitis cystica 315. Cystitis glandularis 313. Cystitis cystica The Clothes Line man 316. Cystitis glandularis Cystitis cystica + glandularis 317. Cystitis glandularis 318. Cystitis glandularis 319. Cystitis glandularis close- up 320. Cystitis glandularis close-up 321. Cystitis glandularis
  • 20. 20 322. Cystitis glandularis - imminent TUR 323. PAD - Cystitis cystica 324. PAD - Multiple cystitis cystica 325. PAD - cystitis cystica 326. PAD - cystitis glandularis 327. PAD - cystitis glandularis 328. Bladder neck sclerosis after open operation 333. Primary bladder neck sclerosis 329. Bladder neck sclerosis after TUR-P 334. Primary bladder neck sclerosis 330. Bladder neck sclerosis after TUR-P 331. Posterior barrier obstructing the urethra 332. Posterior barrier of the prostate 338. Benign epithelial cyst - prostate part of the urethra 335. Ectopic ureter opening in the prostate 336. Ectopic ureter in the prostate 337. Ectopic ureter opening in the prostate Ectopic ureter in man + epithelial cysts + cavernous hemangioma Bladder neck sclerosis and barrier Microscopic examination of cystitis cystica and glandularis Diseases of the ­prostate
  • 21. 21 339. Benign epithelial cyst - prostate 340. Benign epithelial polyp in prostatic part of the urethra 341. Benign epthelial polyps - prostate 342. Fibroma at the verumontanum 344. Cavernous haemangioma at the verumontanum 343. Fibroma distal to the verumontanum 345. False prostatic passage being resected 346. Fresh false passage A in the prostate 347. Fresh false passage of the prostate 348. Healed false passage A in the prostate 349. Big prostate - verumontanum 350. Enlarged prostate. Fairly large verumontanum 351. Large prostate and large third lobe 352. Large prostate and large third lobe 353. Large prostate and third lobe 354. Large prostate - middle lower part 355. Large prostate - middle part 356. Large prostate - middle part - upper Large prostate + third lobe False passage 359. Marked prostatic hyperplasia 360. Medium sized prostate 357. Large prostate - middle upper part 358. Large prostate - verumontanum Moderate enlargment of the prostate
  • 22. 22 365. Moderately hyperplastic prostate 361. Medium sized til large prostate 362. Moderately enlarged prostate 363. Moderately enlarged prostate and varicous vessels 364. Moderately enlarged prostate + large third lobe 366. Prostatic cancer - asymmetry 371. Prostatic cancer growing into the urethra 367. Prostatic cancer - asymmetry 372. Prostatic cancer in the urinary bladder 368. Prostatic cancer growing into the bladder 373. Prostatic cancer - asymmetry 369. Prostatic cancer growing into the bladder 370. Prostatic cancer growing into the urethra 375. Slight hyperplasia of the prostate 379. Crystals of uric acid on the prostate surface 376. Slight hyperplasia of the prostate 380. Large hyperplastic prostate and subepithelial concrements 377. Slight to moderate hyperplasia of the prostate 381. Large vessels. Moderately enlarged prostate 374. Prostatic cancer - epithelial dysplasi in pars prostatica urethrae 378. Slightly to moderatly enlarged prostate 382. Small stone in prostatic ductulus Urothelial cancer in prostatic urethra + varicose vessels + conrements Slight enlargement of the prostate Prostatic cancer
  • 23. 23 383. Stone in prostatic ductulus. Verumontanum at 5 o’clock 384. Subepithelial, small prostatic concrements 389. Varicose vessels i the prostatic part of the urethra 385. Supepithelial concrements of the prostate 386. Urothelial cancer grade 2 in the prostatic part of the urethra 387. Urothelial cancer grade 2 in the prostatic part of the urethra 388. Varicose veins at the internal opening of the urethra 390. Recurrent adenoma after open operation 391. Recurrent adenoma after open operation 392. Sign of Schramm - widely open internal urethral orifice. Neurologic disease 393. Two urethra openings after cystoscopy (trauma) 394. Two urethra openings after incomplete TUR-P 395. Abnormal refluxing ureteral orifice and cystitis cystica 396. Ectopic ureteral orifice Various Ectopic ureteral orifice 397. Refluxing ureteral orifice 398. Ureteral duplication on the left side Case report ectopic ureteral orifice
  • 26. 26 399. Bladder roof oedema caused by catheter tip 404. Decubitus caused by catheter tip 410. New and old catheter balloon casts 400. Bladder roof oedema caused by catheter tip 406. Slight catheter tip oedema 411. Bladder stones. Patient with indwelling catheter 401. Catheter tip decubitus 407. Subepithelial bleeding caused by catheter tip 412. Catheter balloon cast 414. Catheter balloon cast 402. Catheter tip oedema 408. Thickwalled, contracted bladder caused by indwelling catheter 413. Catheter balloon cast 403. Decubitus caused by catheter tip 409. Trabeculated bladder with sub­ epithelial cathetertip induced bleedings 415. Catheter balloon cast 416. Catheter balloon cast + catheter tip 417. Catheter balloon cast seen from the inside 418. Catheter balloon encrustment 419. Catheter tip, catheter balloon cast, piece of rubber Catheter balloon encrustments Bladder wall ­ oedema - decubitus - bleeding Indwelling catheter - complications 405. Catheter tip injury of bladder roof
  • 27. 27 420. Catheters with slight encrustment after 30 days 425. Encrusted catheter balloon 430. Old and new catheter balloon casts 421. X-ray. Encrusted catheter balloon 435. False urethral passage. Splint in true urethra 422. X-ray. Encrusted catheter balloon - close- up view 426. Encrusted catheter ballon - side view - suprapubic cystoscopy 431. Old balloon casts looking like soup-plates 436. Old urethral stricture A, false passage to patients left 427. Encrusted catheter balloon 432. Old catheter balloon stone 437. Remnants of small false passages in the urethra 423. Contracted bladder + small stone caused by longtime indwelling catheter 428. Encrusted catheter balloon - suprapubic cystoscopy 433. Pile of cracked catheter balloon encrustment 424. Eggshell concrement pile 429. Indwelling catheter - eggshell encrustment 434. Soup plate stone - old balloon encrustment 438. Ureteral stricture A (left) and false passage (right, larger) in urethra False passage 440. Urethral stricture and fistulation in leu­ kaemic man with CAD. Some months later 441. Urethral stricture and fistulation in leukaemic man with indwelling catheter 443. Wedged-shaped false passage in the urethra 442. Urethral stricture after TUR-P. False passage below 439. Urethral fistula­ tion and stricture in leukaemic man with indwelling catheter
  • 28. 28 444. Deep and large false passage in the prostate 449. Healed false passage in the prostate 451. Deep false passage into corpus spongiosum urethrae 445. False passage in left lobe of the prostate 450. Old false passage in the prostate 452. Deep false passage in male urethra-corpus spongiosum!! 446. False passage in the prostate 453. Deep false passage into corpus spongiosum urethrae 447. Fresh false passage A in the left lobe of prostate 448. Healed false passage A in left lobe of prostate 455. Catheter balloon dilated urethra 456. Splint in normal urethra from the urethral dilatation 454. Strange scrotal swelling 457. Catheter occasioned urethritis 458. Catheter-caused urethritis 459. Indwelling catheter urethritis 460. Indwelling catheter urethritis 461. Membrane and urethritis caused by indwelling catheter 462. Membraneous urethritis caused by indwelling catheter 463. Urethra after some days with indwelling catheter Urethtritis caused by indwelling catheter Strange urethral swelling False passage False passage into corpus spongio- sum urethrae False passage False passage in the prostate Case report. Strange swelling
  • 29. 29 464. Urethritis caused by indwelling catheter 466. Internal urethrotomy 467. Internal urethrotomy 465. Internal urethrotomy 468. Internal urethrotomy 469. Internal urethrotomy 470. Internal urethrotomy - stricture cut open 471. Internal urethrotomy - the knife 472. Hunnercystitis - scar 473. Hunnercystitis - early stage - oedema Interstitial (Hunner) - cystitis Internal urethrotomy 474. Hunnercystitis - haemorrhage and oedema 477. Interstitial cystitis - scar 476. Hunnercystitis - scar 475. Hunnercystitis - scar
  • 30. 30 479. Colonic cancer growing in the bladder 480. Colonic cancer growing in the bladder 478. Colonic cancer growing in the bladder 481. Impression in left bladder wall caused by sigmoidcancer not invading bladder 483. Oedema caused by simoidal cancer 485. Bezoar cystoscopy 484. Oedema close to colonic cancer invading bladder 486. Bezoar cystoscopy 487. Bladder bezoar 482. Oedema caused by colonic cancer invading the bladder 488. Bladder bezoar cystoscopy 490. Bladder bezoar penetrated by the cystoscope 491. Bladder bezoar removed from the bladder 492. Bladder bezoar - size 489. Bladder bezoar- Looking like miss Piggy 493. Bladder bezoar X-ray 495. Candia albicans - very few - on micro­ scopic examination of bladder bezoar 494. Bladder bezoar - microscopic examination Large Bladder Bezoar Intrusion from outside the bladder
  • 31. 31 498. Litholapaxy 500. Stone to hard to handle with litholapaxy 502. Litholapaxy - curette 501. Stone to hard to handle with litholapaxy 497. Litholapaxy 499. Stone fragments after litholapaxy 496. Stone punch 503. Abating haemorrhagic bacterial cystitis 504. Abating haemorrhagic cystits 505. Acute bacterial cystitis and prostatitis 506. Acute bacterial haemorrhagic cystitis 508. Acute, haemorrhagic cystitis 509. Bacterial haemorrhagic (velvet) cystitis 507. Acute cystitis and prostatitis Litholapaxy Non specific cystitis - inflammation 510. Bladder diverticulum with non- specific inflammation 513. Haemorrhagic, bacterial cystitis 514. Haemorrhagic, non-specific cystitis 515. Haemorrhagisk cystitis and cystitis cystica 511. Cystitis, non- specific 512. Diffuse, non- specific cystitis
  • 32. 32 519. Non-specific cystitis in man with bacterial prostatitis 520. Non-specific cystitis in trabeculated bladder 516. Mild, non-specific cystitis 518. Non-specific cystitis 517. Non specific haemorrh. cystitis + cystitis cystica 521. Non-specific cystitis with haemorrhage 523. Trabeculated bladder with non- specific cystitis 522. Non-specific cystitis and oedema 524. Coat of arms - Royal Urologic Department of Umeå 525. Cover picture - Atlas of cystoscopy 526. Difficult to see - ureteral orifice 531. Broad ureteral orifice and blood vessels leading into it 527. Sleeping ureteral orifice 532. Compressed vessels in filled bladder 528. Air bubbles at bladder roof 533. Corkscrew vessels - normal bladder 529. Bladder - normal 530. Bladder - normal Normal bladder Introducing slides Coat of Arms - Royal Department of Urology Normal anatomy + epithelial metaplasi + pseudopolyps
  • 33. 33 534. Left uretral orifice - normal 535. Normal bladder - funny vessels 537. Normal bladder - corkscrew vessels 538. Normal bladder epithelium 539. Normal bladder - infrequent vessels 540. Normal bladder rich in vessels 536. Normal bladder 541. Normal bladder epithelium 542. Normal bladder looking like optical nerve 543. Normal bladder - vessel looking like a hydra 544. Normal bladder. Airbubble impressed by uterus 546. Normal bladder - abnormal vessels 545. Normal bladder + epithelial metaplasia 547. Normal bladder - autostrada vessels 548. Normal bladder - corkscrew vessels 549. Normal bladder - funny vessels 551. Normal bladder - roof air bubble looking like a frog 550. Normal bladder - rich in vessels 552. Normal bladder - varicose vessel 553. Normal bladder - varicose vessels 556. Slightly abnormal ureteral orifice 557. Ureteral orifice a bit difficult to see 558. Ureteral orifice - difficult to discover 555. Normal, well visible ureteral orifice 554. Normal right ureteral orifice
  • 34. 34 559. Vessel compres- sion in maximally filled bladder 560. Biopsy epithelial metaplasia - female trigonum 561. Epithelial metaplasia female trigonum 562. Epithelial metaplasia, female trigonum 563. Crista urethralis 564. Crista urethralis- like extension above the verumontanum prostatae 565. Normal but difficult to see verumontanum 566. Normal crista urethralis with a small cyst 567. Normal prostate 569. Normal prostate with ductuli orifices 574. Normal prostate. Openings of vas deferens well visible 570. Normal prostate with ductuli 571. Normal prostate, difficult to see verumontanum 575. Normal verumontanum 572. Normal prostate, duplicated crista ure- thralis-like extension above the verumontanum 576. Small cyst at the bladder neck 573. Normal prostate, well visible verumontanum 577. Subepithelial concrements in the verumentanumal epithelium 568. Normal prostate 578. Normal prostate - young man - no fluid instilled 579. Slow fluid instillation 580. Moderate flow of instilled water Normal prostate Normal prostate - different flow speed of instilled water Normal prostate Normal bladder Epithelial meta- plasia of female trigonum
  • 35. 35 595. Normal pars membranacea 590. Pars membranacea - normal 591. Eternal sphincter - normal 592. External sfincter - normal 581. Rapid flow of instilled water 593. Normal fossa navicularis + the pendulant part of the urethra 594. Normal male external sfincter 596. Normal pars membrancea 597. Normal pars pendulans (fluid filled light cable). Urethral gland openings! 598. Normal proximal urethra. Air bubbles in the lubricating jelly 582. Normal female urethra Normal urethra - male Normal urethra - female 584. Normal female urethra 583. Normal female urethra 587. Pseudopolyps close to the internal meatus - female urethra 585. Proximal opening of female urethra 586. Proximal urethral opening of normal female urethra 588. Pseudopolyps in the female urethra close to the internal meatus 589. Pseudopolyps of the female urethra - close to the internal meatus 600. Normal proximal urethra. Opening of the gland of Cowperi 599. Normal proximal urethra. Impressions of the bulbocavernosus muscle! 601. Opening of glandula Cowperi 602. Pars membranacea - normal 603. Pars membranacea - normal
  • 36. 36 606. Balanitis xerotica obliterans 608. Carcinoma of the penis 607. Carcinoma of the penis 609. Hypospadia glandis 610. Lichen sclerosis 611. Malignt lymphoma in external urethral orifice 612. Non specifik inflammation (PAD) 613. Urethral caruncula 615. Fairly deep resection of ureteral orifice 616. Healed resected ureteral orifice 614. Urethral caruncula 617. Looking into resected refluxing ureter Penis + external ­ urethral orifice Resection of ureteral orifice 604. Pars membranacea - normal 605. Proximal urethra - normal. Air bubbles in lubricating jelly
  • 37. 37 618. Re-implanted ureter and suture granuloma 620. Superficial recsection of urteral orifice 621. Superficial resection of ureteral orifice 619. Resected, refluxing ureteral orifice 622. Bladder wall sucked into drainage hole of a catheter 623. Catheter inserted into left ureteral orifice 624. Double-J-catheter in ureteral orifice 625. Suprapubic catheter during TUR 627. Suprapubic cystoscopy - hyperplasia 632. Urethral stricture - urethrotomia interna - catheter through stricture 628. Suprapubic cystoscopy - hyperplastic prostate 629. Suprapubic cystoscopy - primary bladder neck sclerosis 630. Suprapubic cystoscopy - third lobe 626. Suprapubic catheter - indwelling 631. Tip of catheter Suprapubic cystoscopy + ureteral stent 634. Amazon river fish 635. Amazon river fish. Penis protection 633. Amazon river fish The Amazon River Fish
  • 38. 38 636. Amazon river fish - lateral view 637. Bladder trabeculation 638. Maximally distended trabeculated bladder 639. Trabeculation 640. Trabeculation 641. Trabeculation, bladder half-filled 642. Trabeculation - thinwalled bladder - woman 643. Trabeculation - thinwalled bladder - woman 644. Bilharzial subepithelial eggs 649. Bilharzia - sandy patches + tuberculoma 645. Bilharzial tubercles at the left ureteral orifice 646. Bilharzial tuberculoma 648. Bilharzia - sandy patches 647. Bilharzia - sandy patches Bladder amyloidosis Bilharzia Amazon River Fish Tuberculous cystitis - Bilharzia - Amyloidosis Trabeculation
  • 39. 39 651. Bladder amyloidosis 652. Bladder amyloidosis 653. Bladder amyloidosis - left bladder wall 650. Bladder amyloidosis 655. Active bladder tuberculosis 656. Active bladder tuberculosis 654. Active bladder tuberculosis 659. Bladder tuberculosis treated for five months 660. Bladder tuberculosis treated for five months 657. Active tuberculous cystitis 658. Bladder tubeculosis treated for five months 661. Bladder tuberculosis treated for five months 662. Healing bladder tuberculosis after five months of treatment 663. Marked granulo- matous changes after five months of treatment. Bladdertuberculosis 664. Beginning TUR-P, large prostate Bladder tuberculosis TUR-P + complications 665. Bleeding venous sinusoids close to the prostatic capsule 666. English channel in a patient in bad condition 671. Large capsule perforation during TUR-P 667. Excellent TUR-P, verumontanum at six o’clock 668. Excellent TUR-P. Verumontanum. 669. Excellent TUR-P - verumonatum at six o’clock 670. Large capsular perforation
  • 40. 40 672. Large perforation during TUR-P 673. Prostatic capsule perforation - fat tissue protruding 674. Secretions empty from the prostate during TUR-P 676. Subepithelial bleeding caused by resection tube 681. TUR-P capsular perforations 686. TUR-P hyperplastic tissue 677. Subepithelial bleedings caysed by resection tube 682. TUR-P carcinomatous tissue 688. TUR-P incomplete resection 678. TUR-P internal sphicter 683. TUR-P fairly large perforation of the prostatic capsule 687. TUR-P incomplete resection 679. TUR-P bleeding from vessel at internal sphincter 684. TUR-P gas bubbles 675. Small concrement in the prostate during TUR-P 680. TUR-P bleeding from vessel in hyperplastic tissue 685. TUR-P hyperplastic tissue 689. TUR-P internal urethral sphincter 690. TUR-P left lobe resected 691. TUR-P love bite by resection tube 692. TUR-P prostate capsule and very small concrements 693. TUR-P unexpected cancer 694. TUR-P upper half of right lobe reseceted 695. TUR-P, prostatic cancer 696. TUR-P, prostatic concrements
  • 41. 41 704. Evaporating the prostate 703. End result of TUR-P 697. TUR-P, slightly more tissue remains 698. TUR-P, small perforations 699. TUR-P, unex- pected prostatic cancer (yellowish tissue) 701. TUR-P. Love bite by resection tube 705. Bladder neck incison half-way 710. Prostatic caposule almost cut through 702. TUR-P-prostatic capsule 706. Bladder neck sclerosis Bladder neck incision 707. Bladder neck sclerosis Incision to be started 708. Neck incision at 4 o’clock 700. TUR-P,small perforation - fat tissue intruding 709. Neck incision at 8 o’clock. Approaching capsule 711. Prostatic capsule at 4 o’clock incision 712. Prostatic capsule at bladder neck incision Obturating, recurrent adenoma after open operation Bladder neck incision in bladder neck sclerosis 713. Recurrent adenoma during fluid instillation 714. Recurrent adenom during fluid emptying 715. Recurrent adenom after open operation - falling down into the urethra 716. Bladder neck sclerosis after TUR-P 717. Bladder neck sclerosis after open operation Postoperative bladder neck sclerosis+various Case report
  • 42. 42 718. Bladder neck sclerosis after TUR-P 722. Injected, reddened urethra immediately after TUR-P 723. Prostatic cavity one year after TUR-P 720. Bladder neck sclerosis after TUR-P 724. Prostatic cavity eleven months after TUR-P 721. Bladder neck sclerosis after TUR-P. Verumontanum at six o’clock 726. Stricture of the urethra caused by TUR-P 727. TUR-P cavity after six months 728. TUR-P vas opening, close up 729. Two urethra openings after incomplete TUR-P 725. Prostatic cavity one year after TUR-P 730. Two urethra openings after insufficient TUR-P 731. Urethral stricture caused by TUR-P 732. Vas openings after TUR-P 734. Resectoscope components 735. Resectoscope tip 733. Resectoscope 736. TUR-P 737. EP - Bladder scar 10 days after open op. and reimplant. of ureter 738. EP - 10 days after open op. and reimplant. of ureter 739. EP - After open operation reimplant. of ueter 10 days The resectoscope Ureteral cancer. Deep resection of ureteral orifice 719. Bladder neck scle- rosis after transvesical adenoma enucleation
  • 43. 43 740. EP - Bladder scar 10 days after operation 743. EP - 10 days after open operation, reimplant. of ureter 744. EP - Iv urographi after deep resection 741. EP - Bladder scar 10 days after operation 742. EP - Bladder scar 10 days after operation 748. EP - Resected ureteral cancer - recurrence 753. EP - Re- implanted ureter after 6 months 749. EP - Deeply resected orifice 752. EP - Re- implanted ureter after seven days 750. EP - Deeply resected orifice - scarred 754. EP - Resected ureteral cancer. Tumour recurrence 751. EP - Deeply resected orifice - tumourfree 755. EP - Resected ureteral orifice - more tumour 745. EP - Iv urographi after deep resection - stasis 746. EP - Iv urographi six months after reimplantation 747. EP - Resected ureteral cancer - recurrence 756. EP - The recurrent tumour puts out its tongue against the intruder Case report EP 758. I.v. urographi after TUR-A 757. I.v. urographi before TUR-A Ureterocele A and B 759. Left ureterocele A
  • 44. 44 762. Left ureterocele, cut open by TUR 763. Looking into ureter running into ureterocele A 764. Right ureterocele half-filled A 760. Left ureterocele A before TUR 765. Right ureterocele A before TUR 761. Left ureterocele A viewed from urethra 766. Ureter running into ureterocele A, close up 769. Small ureterocele B distended 770. Small ureterocele B half-filled 771. Ureterocele B, slightly filled 772. Ureterocele B, empty 767. Ureter running into ureterocele A. Refluxing 768. Ureterocele A. TUR halfway 776. Failed attempt to put ureteral catheter through urethral stricture 777. Irritated urethral stricuture after attempt to catheterizing 778. Moderate urethral stricture 774. Incision of urethral diverticulum in male 773. Urethral diverticulum in male 775. Urine flow before and after operation Case report - ureterocele A Urethral stricture- fistulation-diverticulum Urethral diverticulum in male - operation of
  • 45. 45 781. Stricture of the urethra 782. Urethral stricture 784. Urethral stricture 779. Multiple urethral strictures caused by indwelling catheter 780. Narrow urethral stricture 783. Urethral stricture 785. Urethral stricture after dilatation 786. Urethral stricture with ureteral catheter 787. Urethral stricture with ureteral catheter. False passage 788. Urethral stricture with ureteral catheter + urethral fistulation 789. Urethral stricture + false passage below 791. Small opening in prox. part of urethral diverticulum 790. Urtehral stricture traumatized by catheterizing attempt Diverticulum of urethra in man 792. Urethral diverticulum A 794. Urethral diverticulum A 793. Urethral diverticulum A 795. Urethral diverticulum B 797. Urethral diverticulum 1 in woman 799. Urethral diverticulum (to the left) 2 in woman 798. Urethral diverticulum 1 in woman Diverticulum of urethra in woman 796. Urethral diverticulum B
  • 46. LoFric® Primo™ is safe · Urotonic™ Surface Technology · Optimal length and Insertion aid · Most well documented · Over 23 years of clinical experience LoFric® Primo™ is smart · Foldable and discreet · Integrated sterile water · Easy to open · Insertion aid
  • 47. Astra Tech – inventor of LoFric® , the first hydrophilic catheter The indication for bladder cath- eterisation is any condition of incomplete bladder empty- ing. There are several alter- natives for catheterisation of the bladder. Today, intermittent catheteri- sation is the method of choice. LoFric is the only catheter in the world with Urotonic Surface Technology – a patented surface layer technology that makes catheterisation more comfortable for the user.
  • 48. Astra Tech AB, P.O. Box 14, SE-431 21 Mölndal, Sweden. Tel: +46 31 776 30 00. Fax: +46 31 776 30 10. www.astratech.com A company in the AstraZeneca Group 77893-GBX-0708