Types of Cystodiathermy Surgery

Types of cystodiathermy surgery is a minimally invasive medical procedure used to treat cysts and abnormal growths in the urinary bladder by using electric current to destroy unwanted tissue. It is particularly effective in managing bladder lesions, superficial tumors, and chronic infections that don’t respond to medication. Over the years, various types of cystodiathermy surgeries have emerged to suit different clinical needs. Understanding the types, benefits, risks, and recovery associated with these surgeries can help patients make informed decisions.

The human urinary bladder is a vital organ that stores urine and supports the body’s waste elimination process. However, it can sometimes develop abnormal growths such as cysts, lesions, or superficial tumors due to infection, inflammation, or more serious conditions like bladder cancer. When medications or lifestyle changes are not enough to address these issues, surgical intervention becomes necessary. One of the most commonly used minimally invasive techniques for treating such conditions is cystodiathermy surgery.

What Is Cystodiathermy?

Cystodiathermy is a surgical procedure that involves the destruction of abnormal bladder tissue using heat generated by high-frequency electric current. It is typically performed using a cystoscope—a thin, flexible tube with a camera and surgical tools that is inserted through the urethra into the bladder.

Cystodiathermy is commonly used to treat :-

1. Small bladder tumors

2. Chronic cystitis (bladder inflammation)

3. Bladder polyps

4. Bleeding from bladder lesions

5. Lesions found during cystoscopy

Types of Cystodiathermy Surgery

Depending on the specific diagnosis and extent of tissue involvement, cystodiathermy can be categorized into several types. Below are the most commonly performed types :-

Fulguration Cystodiathermy

Fulguration involves applying electrical current in a spark-gap manner to burn and destroy abnormal tissue without direct contact. It is ideal for superficial bladder lesions, papilloma, and bleeding vessels.

Indications :-

1. Superficial bladder tumors

2. Capillary hemorrhages

3. Benign bladder growths

Advantages :-

1. Minimal bleeding

2. Reduced risk of tissue perforation

3. Quick procedure time

Recovery :- Most patients can go home the same day, with mild discomfort during urination for a few days.

Focal Cystodiathermy

Focal cystodiathermy targets a localized area of bladder tissue. The electrical current is applied directly to a small, well-defined lesion. It is useful for patients with isolated cystic growths or small ulcers.

Indications :-

1. Localized cystic lesions

2. Recurrent ulcers

3. Small tumors

Advantages :-

1. Precise destruction of tissue

2. Minimal damage to surrounding areas

3. Effective for treating small recurrent lesions

Recovery :- Urinary symptoms typically improve within a week, and follow-up cystoscopy is often recommended within 3–6 months.

Transurethral Cystodiathermy (TUC)

Transurethral cystodiathermy is performed entirely through the urethra using a resectoscope. It is often combined with resection or biopsy and is suited for moderate-sized lesions.

Indications :-

1. Bladder tumors (non-invasive)

2. Chronic bladder wall inflammation

3. Larger polyps or growths

Advantages :-

1. No external incisions

2. Faster healing

3. Can be done under spinal or general anesthesia

Recovery :- Patients may experience urinary frequency and burning for 2–5 days. Rest and hydration are advised during the recovery phase.

Bipolar Cystodiathermy

This technique uses bipolar current instead of the traditional monopolar system. The current is confined between two electrodes, reducing the risk of collateral tissue damage. It is safer for patients with pacemakers or other implanted devices.

Indications :-

1. Tumor removal in sensitive patients

2. Polyps near the bladder neck

3. Patients with cardiovascular implants

Advantages :-

1. Less risk of electric interference

2. Reduced chance of deep tissue damage

3. More precise control during surgery

Recovery :- Most patients return to daily activities within a few days. Minimal catheter use is required post-operatively.

Pediatric Cystodiathermy

Children with recurrent urinary tract infections or congenital bladder anomalies may require cystodiathermy. The procedure is adapted to the pediatric anatomy and often done under general anesthesia.

Indications :-

1. Pediatric bladder polyps

2. Congenital bladder lesions

3. Vesicoureteral reflux management

Advantages :-

1. Effective in preventing recurrent infections

2. Helps avoid long-term antibiotic use

3. Safe for children when performed by specialists

Recovery :- Hospital observation for 24 hours is typically recommended. Full recovery is expected in 1–2 weeks.

Laser-Assisted Cystodiathermy (Hybrid Technique)

Some advanced urology centers offer laser-assisted cystodiathermy, where laser energy is combined with electrical diathermy for improved precision. This is particularly useful for treating high-risk bladder lesions or in patients with bleeding disorders.

Indications :-

1. Recurrent bladder tumors

2. Vascular lesions

3. Bleeding complications

Advantages :-

1. Controlled tissue ablation

2. Less post-op bleeding

3. Enhanced visual accuracy during the procedure

Recovery :- Shorter catheterization time, less pain, and quicker return to normal bladder function.

How Is Cystodiathermy Performed?

Here’s what to expect during the procedure :-

Preoperative Preparation

1. Urine tests and imaging (ultrasound, CT scan) are performed.

2. Blood tests and anesthesia evaluation are required.

3. Antibiotics may be prescribed to prevent infection.

Procedure

1. Patient is placed under local, spinal, or general anesthesia.

2. A cystoscope is inserted via the urethra.

3. Abnormal tissue is identified and destroyed using electrical current.

4. In some cases, tissue samples are taken for biopsy.

Postoperative Care

1. A urinary catheter may be inserted for 24–48 hours.

2. Patients are monitored for bleeding, infection, or urinary retention.

3. Pain relievers and hydration are advised during recovery.

Benefits of Cystodiathermy Surgery

1. Minimally invasive :- No external cuts or stitches

2. Quick recovery time :- Most patients return to normal activities within days

3. Cost-effective :- Avoids long hospital stays

4. High success rate :- Especially for small or recurrent lesions

5. Repeatable :- Safe for multiple sessions if required

Risks and Complications

Like any surgical procedure, cystodiathermy carries certain risks :-

1. Mild burning or discomfort during urination

2. Temporary blood in urine (hematuria)

3. Urinary tract infections (UTIs)

4. Bladder spasms or irritation

5. Rare risk of bladder wall perforation

Most complications are minor and manageable with medication or short-term observation.

Recovery and Follow-Up

After cystodiathermy surgery, patients are advised to :-

1. Drink plenty of fluids to flush the bladder

2. Avoid strenuous activity for a few days

3. Follow prescribed antibiotics or painkillers

4. Watch for signs of infection like fever or severe pain

Follow-up cystoscopy may be scheduled within 3–6 months to monitor healing and ensure the lesion has not returned.

Conclusion

Cystodiathermy is a safe, effective, and minimally invasive procedure used to treat a variety of bladder conditions. The availability of different types such as fulguration, focal, transurethral, bipolar, and pediatric cystodiathermy allows for a tailored approach to patient care. With advancements like laser-assisted techniques, the precision and safety of these surgeries continue to improve.