Trendelenburg, Abdominal Insufflation and Time to Completion of Cystoscopy

Not Applicable

Completed

Conditions: Ureteral Integrity
Bladder Integrity
Bladder Function
Ureteral Function

Interventions: Other: Flat position
Other: Trendelenburg position
Device: Insufflation

Brief Summary: Objective:

The investigators seek to compare the efficiency of the cystoscopy with two interventions:

1. patient position during the cystoscopy (Trendelenburg (head down) or flat)

2. Abdominal insufflation (insufflation versus no insufflation)

Detailed Description: This is a randomized controlled trial assessing time to completion of cystoscopy in seconds after minimally invasive gynecologic surgery.

The investigators seek to compare the efficiency of the cystoscopy with two interventions:

1. patient position during the cystoscopy (Trendelenburg (head down) or flat)

2. Abdominal insufflation (insufflation versus no insufflation).

Both interventions are used as usual care and depend on surgeon preference without evidence why one would be faster at completing the cystoscopy. Also note that these two interventions are performed multiple times during the surgery itself and outside the cystoscopy procedure routinely. The investigator's main objective is to assess which intervention or combination of interventions is more efficient.

Recruitment & Eligibility

Inclusion Criteria

Patient undergoing Planned cystoscopy in the benign gynecology service, (specifically undergoing a laparoscopic or robotic procedure requiring insufflation).

Exclusion Criteria

Pregnancy
Known urologic anomaly
Unplanned cystoscopy
Cancer surgery
Urogynecology surgery
comorbidities including cardiac disease, chronic hypertension, any stage kidney disease (including abnormal creatinine level), and use of diuretics.
Undergoing extensive ureterolysis
Blood loss more than 500 milliliters (mLs)
Contra-indications to position change and insufflation

Arm && Interventions

Group	Intervention	Description
Flat position with no Insufflation	Flat position	-
Trendelenburg position and Insufflation	Trendelenburg position	insufflation to 15 mm Hg
Trendelenburg position with no Insufflation	Trendelenburg position	-
Flat position and Insufflation	Insufflation	-
Flat position and Insufflation	Flat position	-
Trendelenburg position and Insufflation	Insufflation	insufflation to 15 mm Hg

Primary Outcome Measures

Name	Time	Method
Time in Seconds to Complete the Cystourethroscopy	From the start of the cystoscopy to the completion of the cystoscopy (about 4 minutes)	Time in seconds to satisfactorily complete the cystourethroscopy (including visualization of the dome, the ureteral jets, the bladder mucosa, and the urethra).

Secondary Outcome Measures