The changing role of cystoscopy in the pediatric patient.

Cystoscopy is used too often in the pediatric patient and frequently is without diagnostic or therapeutic benefit to the child. Cystoscopy is of little proved benefit in the evaluation and treatment of recurrent cystitis, primary enuresis and most cases of hematuria. In children initially diagnosed with vesicoureteral reflux therapeutic determinations generally can be made on the basis of response to appropriate antimicrobial therapy and from uroradiographic findings. Cystoscopy remains a valuable tool to evaluate urinary obstruction and severe congenital defects, such as intersex and cloacal anomalies, and to help place percutaneous suprapubic tubes for bladder cycling before urinary undiversion and for urodynamic evaluation.