A cystoscopy is an imaging test that helps doctors view the inside of the bladder. While the test is useful for a number of different bladder conditions, it’s a key part of the bladder cancer diagnostic process.

When cancer is suspected, a doctor or healthcare professional can use a cystoscopy to find, assess, and stage tumors. A biopsy is often done at the same time. In some cases, small tumors can even be removed during a cystoscopy.

In this article, we take a closer look at cystoscopies, including how they’re used to detect bladder cancer and what the procedure is like.

A cystoscopy is a medical test that allows doctors to see the inside of the bladder. It’s used to check for a range of bladder problems, including bladder cancer. Sometimes, bladder health problems are treated during the test.

A cystoscope is a long and thin tube that’s passed through the urethra and the bladder. There are two types of cystoscopies:

  • Flexible cystoscopy: A flexible cystoscopy uses a thin and flexible cystoscopy. This test is typically done while you’re awake.
  • Rigid cystoscopy: A rigid cystoscopy uses a wider cystoscopy that isn’t flexible. This test is normally done under general or local anesthesia.

Typically, a rigid cystoscope is used when treatment is being done alongside the imaging. A flexible cystoscopy is done for an up-close look at the bladder. However, a doctor might order either type as part of the bladder cancer diagnostic process.

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How a cystoscope is used to examine the urethra and bladder. Illustration by Jason Hoffman

A cystoscopy helps doctors see the inside of your bladder. When cancer is suspected, doctors can use this test to check for tumors and assess tumor size and location.

If any abnormal areas are seen during the cystoscopy, a small piece of tissue can be removed and biopsied. Sometimes, if the tumor is very small, it can even be removed during the cystoscopy procedure.

A cystoscopy can also be used as part of follow-up surveillance after cancer treatment is complete. You might have a cystoscopy at 6-month and 12-month follow-up appointments to make sure there’s no sign the tumor is recurring.

A cystoscopy is a quick procedure. The exact amount of time and number of steps will depend on the type of cystoscopy being done and if any other procedures, such as biopsies or surgical removals, are also being done.

Here are the typical steps involved for a cystoscopy:

  1. You’ll change into a hospital gown.
  2. You’ll be asked to empty your bladder.
  3. If you have female anatomy, you’ll lie down on a table with your feet in stirrups and your knees bent. If you have male anatomy and a flexible cystoscope is used, you’ll typically lie flat on your back in the supine position. If a rigid cystoscope is used, you’ll lie on your back with your knees bent in the lithotomy position.
  4. You might receive a general anesthetic, particularly if a rigid cystoscope is used or if a biopsy or surgical removal is needed. A doctor will talk with you about this ahead of time.
  5. The cystoscope will be covered in a numbing gel to prevent pain. Numbing gel will also be placed into the urethra prior to inserting the cystoscope.
  6. The cystoscope will be carefully inserted through your urethra and into your bladder.
  7. A doctor will examine the inside of your urethra and bladder.
  8. A solution will be inserted into your bladder to inflate it so that the doctor can get a better look.
  9. Additional procedures, such as a biopsy or the removal of a small tumor, might be performed.
  10. The cystoscope will be removed.

A cystoscopy is a very safe procedure. However, all medical procedures involve some risk. Potential risks of a cystoscopy include:

If you’re having trouble urinating, or if you have any symptoms of a UTI, such as stomach pain, pelvic pain, urinary urgency, or cloudy urine, it’s important to call a doctor. You might need antibiotics to treat your UTI. If you’re having trouble passing urine, you might need a temporary urinary catheter.

In many cases, a cystoscopy can provide immediate results. Doctors can typically see the bladder and urethra as they perform the test. This means they might be able to discuss results with you right away.

However, this isn’t always the case. For instance, if you had a biopsy alongside your cystoscopy, it could take 2 to 3 weeks to get results.

Cystoscopies are very accurate and very important tests for bladder cancer. According to research, cystoscopies have a bladder cancer detection accuracy rate of about 97%. Tests such as biopsies are also important, but cystoscopies are vital in bladder cancer diagnosis.

Cystoscopies are typically used in combination with other tests to help confirm a bladder cancer diagnosis. It’s likely a doctor will order additional tests, including:

  • Urinalysis: A urinalysis is sometimes done to rule out an infection as the cause of your symptoms.
  • Urine tumor marker tests: These tests looks for substances in a urine sample that can be an indicator of cancer.
  • MRIs, CTs, or other imaging tests: Imaging tests can help doctors get an even closer and more detailed look at the inside of your bladder. Dye is sometimes injected into your bloodstream before imaging so that the doctor can study the way it passes through your urinary tract. This is called an intravenous pyelogram.
  • Transurethral resection of a bladder tumor (TURBT): A TURBT is a diagnostic test and treatment combined. It removes abnormal bladder tissue and allows that tissue to be biopsied. A TURBT is typically only an option with very small and early stage tumors.

How common is bladder cancer?

According to the American Cancer Society, about 81,800 people in the United States will receive a bladder cancer diagnosis in 2022. The overall lifetime risk of bladder cancer is 1 in 27 in men and 1 in 89 in women.

How treatable is bladder cancer?

Bladder cancer is treatable if it’s diagnosed early. For instance, bladder cancer that hasn’t spread beyond the bladder has a 5-year survival rate of 96%.

Between 2011 and 2017, the overall 5-year survival rate for bladder cancer was 77%. Treatments for bladder cancer have improved in recent years, and it’s likely that survival rates have increased.

What causes bladder cancer?

Bladder cancer is linked to chromosomal changes. However, researchers don’t know what causes these changes to occur.

They do know that some risk factors, such as smoking, exposure to certain chemicals, previous radiation treatments, and frequent UTIs, can increase your risk of bladder cancer.

Can a UTI turn into bladder cancer if left untreated?

A UTI can’t turn into bladder cancer. However, frequent and chronic UTIs are a known risk factor of bladder cancer.

A cystoscopy is an imaging test that’s an important part of diagnosing bladder cancer. During a cystoscopy, a thin tube is inserted through the urethra and into the bladder. This allows doctors to see the inside of the bladder and check for tumors and abnormal growth.

Sometimes, biopsies or surgeries to remove small tumors are done during a cystoscopy.

A cystoscopy is very accurate, but you’ll likely have additional tests, such as a urine tumor marker test or further imaging tests, to confirm the results.