Cystoscopy

Cystoscopy is a procedure that allows the urologist to examine the inside of the bladder (where urine is stored) and the inside of the urethra (the tube that helps urine to flow out of the bladder). During this procedure, the urologist uses a hollow tube, named as cystoscope to see inside the patient’s urinary system especially the lining of the bladder and the tube (urethra). The cystoscope is equipped with an advanced lens and is inserted into the patient’s urethra and then slowly into the bladder. This procedure is mainly used to check any issues or problems inside the lower urinary tract and is specifically used to check the bladder lining problems. 
Sometimes, cystoscopy can be done to remove unwanted particle such as bladder stone from the bladder. This procedure may be used to take a biopsy or a sample tissue from the bladder lining to detect bladder cancer. Moreover, cystoscopy can also be used to place a catheter (thin drainage tube of urine). 


Why it's done Risks How you prepare What you can expect Results

Doctors use cystoscopy to diagnose, monitor and treat conditions affecting the bladder and urethra. Common reasons your doctor may recommend a cystoscopy include:

  • Investigating causes of bladder signs and symptoms. Cystoscopy may help your doctor learn the causes of signs and symptoms such as blood in the urine, frequent urinary tract infections, incontinence, overactive bladder and painful urination.
  • Diagnosing bladder and urinary tract diseases and conditions. A cystoscopy may be used in diagnosing bladder cancer, bladder stones and bladder inflammation (cystitis).
  • Treating bladder diseases and conditions. Special tools can be passed through the cystoscope to treat a bladder disease or condition. For instance, very small bladder tumors may be removed during cystoscopy.
  • Diagnosing an enlarged prostate. A cystoscopy may reveal a narrowing of the urethra where it passes through the prostate gland, indicating an enlarged prostate (benign prostatic hyperplasia).

In certain cases, your doctor may conduct a procedure called ureteroscopy (u-ree-tur-OS-kuh-pee) to examine your urinary tract beyond your bladder at the same time as your cystoscopy. Ureteroscopy uses a smaller scope to examine your ureters — the tubes that carry urine from your kidneys to your bladder.

Cystoscopy carries a risk of complications, including:

  • Infection. Rarely, cystoscopy can introduce germs into your urinary tract, which can cause infection. Cystoscopy may also irritate an existing urinary tract infection, worsening it. In select cases, your doctor may prescribe antibiotics to take before and after your cystoscopy to prevent infection.
  • Bleeding. Cystoscopy may cause some blood in your urine. Rarely, bleeding may be serious.
  • Pain. Cystoscopy may cause abdominal pain and a burning sensation when urinating. In most cases, these symptoms are mild and gradually decrease after the procedure.

Signs and symptoms of a complication

Call your doctor or go to the nearest emergency room if you experience:

  • Bright red blood in your urine
  • A fever higher than 100 F (38 C)
  • Pain or burning during urination that lasts more than two days

To prepare for your cystoscopy exam, your health care team may ask that you:

  • Take antibiotics if prescribed by your doctor. In select cases, your doctor may prescribe antibiotics before and after your cystoscopy. Examples of people who may need to take antibiotics include those who have an active urinary tract infection and those whose bodies have difficulty fighting infections.
  • Wait to empty your bladder. In certain situations, your doctor may order a urine test before your cystoscopy. Wait to empty your bladder until you get to your appointment in case you need to give a urine sample.

Prepare for sedation or anesthesia
If you'll receive an intravenous (IV) sedative or general anesthetic during your cystoscopy, plan ahead for your recovery. To prepare, you can:

  • Find a ride home. You'll be asked not to drive yourself home, so arrange a ride.
  • Clear your schedule for the day. Plan to take it easy after your procedure. Avoid being active for the rest of the day. You may need to take the day off work. Though you may feel fine, your judgment and reflexes may be slowed.
  • Ask someone to stay nearby. Have a friend or relative stay with you or check on you throughout the day.

During the Procedure: 


The cystoscopy procedure is simple and it takes approximately 30mins to complete the procedure. This procedure can be done in a testing room or as an outpatient procedure. The steps, which are followed, during the procedure are as mentioned.

  • The patient is asked to lie on an exam table. The doctors apply some gel or give local anesthesia in the patient’s urethra to reduce any discomfort or pain during the procedure

 

  • The cystoscope will be gently inserted through the urethra into the patient’s bladder. During this procedure, the patients may feel some discomfort or some sensation in the lower abdomen. A cystoscope is a thin and long tube with a lens at one end, through which the doctors can see, and a tiny lens at the other end, through which the light passes inside the urethra and bladder. The scope is camera-equipped and the pictures can be visualized on a monitor. Two types of cystoscopes are available- one with a flexible tube and other with a stiff tube. 

 

  • The patient’s bladder will be filled with a sterile solution after inserting the cystoscope. Generally, the solution inflates the bladder and this allows the doctors to see the bladder’s wall properly. The patients may feel to pass urine and if necessary the doctor can remove some solution from the bladder during the procedure. Once the procedure is over the patients can go to the bathroom to urinate.

 

  • In this brief procedure, the doctor will examine the patient’s bladder and urethra and can identify the problems, related to these. During a cystoscopy, the doctor can diagnose bladder stones, abnormal tissues, polyps, tumors or cancers etc. The doctor either can remove a bladder stone if any or can also take a biopsy for further investigation.

    After the procedure:


Cystoscopy can be done as an outpatient procedure and most of the patients go home after the procedure. The patients may be asked to remain in the hospital to recover from anesthesia effect completely. Sometimes right after the procedure, the patient may experience the following conditions.


  • Burning sensation while urination
    • Soreness around the urethra
    • Small amount of blood in the urine
    • Discomfort in the lower abdomen part while urination
    • Need to urinate urgently


These side-effects, typically, lasts for 24 hours and gradually decrease over time. However, if the symptoms persists after 48hours, the patients should go to the doctors immediately for further consultation. 
Occasionally, some patients may also experience increased urinary frequency and change in urine color (sometimes dark yellow, pink or red). This is common if the patient has undergone a biopsy test. 


After the procedure the doctors may recommend the following pointers to the patients:

  • Drink 473ml (or 16 ounces) water, after every hour for 2 hours after the procedure
    • Take a warm bath to reduce the burning sensation
    • Take a pain-killer medicine
    • Hold a warm cloth over the opening of the urethra

The doctor may prescribe antibiotics, as well, to prevent infections. In case of any other concerns, the patient should consult the doctor. 

 

Generally, the doctors can discuss the results with patients immediately after the procedure. In some cases, however, specifically in the cases wherein biopsy is required to be done, the report would be sent to the lab to detect any types of cancers and hence the reports would be available in some time. The results will be communicated to the patients when the tests are completed. 

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