Cystoscopy

What is a cystoscopy?

This procedure allows your healthcare provider to examine the inside of your urethra and bladder by inserting a small tube called a cystoscope through the urethra. The scope is a thin, flexible, lighted tube through which fluid can flow.

Another name for this procedure is cystourethroscopy.

When is it used?

The test is used for both diagnosis and treatment. Some of the diagnostic uses of cystoscopy are:

• looking for stones or tumors in the bladder
• examining the bladder lining, prostate gland, and urethra
• doing a biopsy by removing a sample of bladder tissue to check for cancer or other problems.

How do I prepare for a cystoscopy?

If you are going to have regional or general anesthesia for the procedure, find someone to drive you home after the procedure.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before the procedure.

Follow instructions given to you by your healthcare provider. Cystoscopy is usually done under local anesthetic, but if you are going to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a local, regional, or general anesthetic before the procedure to help keep you from feeling pain. Local and regional anesthesia numb part of your body while you stay awake. General anesthesia relaxes your muscles and puts you to sleep.

Your healthcare provider will insert the cystoscope inside your urethra and into your bladder. The urethra carries urine from your bladder to outside the body. Your provider will pass water through the tube and into your bladder to stretch the bladder and give a better view. Then your provider will examine your bladder, urethra, and prostate gland (in men).

Your provider will measure how much water your bladder can hold and look for:

• abnormalities in the bladder lining or bladder muscles
• tumors
• stones
• Inflammation
• the size of the prostate gland
• constrictions in the urethra.

If you have the procedure with a local anesthetic, you may have some sensation when the scope is passed through the urethra and again when it is removed. However, the flexible scope is not as uncomfortable as the rigid scopes used in the past. You also may feel coolness when the water fills the bladder. If a biopsy is taken, you may notice a tug or pinching feeling when the tissue is removed. If you do have a biopsy, your healthcare provider might need to use diathermy to control any bleeding. This a type of deep heat treatment. It usually feels like a light burn.

Cystoscopy usually takes 15 to 45 minutes to complete. The scope is usually in the bladder for no more than 5 to 10 minutes.

What happens after the procedure?

Usually you can go home after the procedure.

It is normal to have the following symptoms for several days:

• frequent urination with some burning after urination
• urine that is red or pink in color with a few stringlike blood clots.

Your provider may prescribe medicine for you to take after the procedure. Ask your provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

It may help your healthcare provider make a better diagnosis and in some cases, cure the problem.

What are the risks associated with this procedure?

Cystoscopy is usually a simple procedure with few risks. However, there are some risks. For example:

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• A local anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.
• You may not be able to urinate. If you have a lot of discomfort, you may need to have your bladder drained with a catheter temporarily.
• You may have infection and bleeding.
• Your bladder could be punctured, but this is very rare.

Precautions, of course, are taken against these risks. You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever.
• There is a lot of blood in your urine.
• You are unable to urinate.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.