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Cystoscopy

What is a cystoscopy?

A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, a doctor inserts this tube through your urethra (the tube that carries urine out of your bladder) and into your bladder so they can visualize the inside of your bladder. Magnified images from the camera are displayed on a screen where your doctor can see them.

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Purpose

Reasons for having a cystoscopy

Your doctor might order this test if you have urinary problems, such as a constant need to urinate or painful urination. Your doctor might also order the procedure to investigate reasons for:

A cystoscopy can reveal several conditions, including bladder tumors, stones, or cancer. Your doctor can also use this procedure to diagnose:

A cystoscopy can also be used to treat underlying bladder conditions. Your doctor can pass tiny surgical tools through the scope to remove small bladder tumors and stones or to take a sample of bladder tissue.

Other uses include:

  • taking a urine sample to check for tumors or infection
  • inserting a small tube to assist with urine flow
  • injecting dye so kidney problems can be identified on an X-ray

Preparation

Preparing for a cystoscopy

Your doctor might prescribe antibiotics before and after the procedure if you have a UTI or a weak immune system. You may also need to give a urine sample before the test. If your doctor plans to give you general anesthesia, you’ll feel groggy afterward. That means before the procedure, you’ll need to arrange a ride home. Plan to take time to rest at home after the procedure, as well.

Ask your doctor if you can continue taking any regular medications. Certain medications can cause excessive bleeding during the procedure.

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Anesthesia

Anesthesia during a cystoscopy

The procedure might be performed in a hospital or doctor’s office. You will need some form of anesthesia, so talk to your doctor about your options before the procedure. These include:

Local anesthesia: Outpatient procedures generally involve local anesthesia. This means you’ll be awake. You can drink and eat normally on your appointment day and go home immediately after the procedure.

General anesthesia: General anesthesia means you’ll be unconscious during the cystoscopy. With general anesthesia, you may need to fast for several hours ahead of time.

Regional anesthesia: Regional anesthesia involves an injection in your back. This will numb you below the waist. You might feel a sting from the shot.

With either regional or general anesthesia, you will probably need to stay in the hospital for a few hours after the procedure.

Procedure

The cystoscopy procedure

Just before the cystoscopy, you need go to the bathroom to empty your bladder. Then, you change into a surgical gown and lie down on your back on a treatment table. Your feet may be positioned in stirrups. The nurse may provide you with antibiotics to help prevent a bladder infection.

At this point, you’ll be given anesthesia. If you get general anesthesia, this will be all that you are conscious of until you wake up. If you get a local or regional anesthetic, you may also be given a sedative to relax you. Your urethra will be numbed with an anesthetic spray or gel. You’ll still feel some sensations, but the gel makes the procedure less painful. The doctor will lubricate the scope with gel and carefully insert it into the urethra. This may burn slightly, and it may feel like urinating.

If the procedure is investigatory, your doctor will use a flexible scope. Biopsies or other surgical procedures require a slightly thicker, rigid scope. The bigger scope allows surgical instruments to pass through it.

Your doctor looks through a lens as the scope enters your bladder. A sterile solution also flows through to flood your bladder. This makes it easier for your doctor to see what’s going on. The fluid might give you an uncomfortable feeling of needing to urinate.

With local anesthesia, your cystoscopy may take less than five minutes. If you’re sedated or given general anesthesia, the entire procedure may take 15 to 30 minutes.

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Risks

Potential risks of a cystoscopy

It’s normal to have a burning sensation while urinating for two to three days after the procedure. You may need to urinate more frequently than usual. Don’t try to hold it, as the blood in your bladder could clot and create a blockage.

Blood in the urine is also common after the procedure, especially if you had a biopsy. Drinking lots of water helps ease the burning and bleeding.

Some people develop more serious complications, including:

Swollen urethra (urethritis): This is the most common complication. It makes urination difficult. If you can’t urinate for more than eight hours after the procedure, contact your doctor.

Infection: In rare cases, germs enter your urinary tract and cause infection. Fever, strange smelling urine, nausea, and lower back pain are all symptoms of infection. You might need antibiotics.

Bleeding: A few people suffer from more serious bleeding. Call your doctor if this happens.

You should also call your doctor if you:

  • develop a fever higher than 100.4ºF
  • have bright red blood or clots of tissue in your urine
  • are unable to void, even though you feel the need
  • have persistent stomach pain
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Recovery

Recovering after a cystoscopy

Give yourself time to rest. Drink lots of fluids and stay close to the bathroom. Holding a damp, warm washcloth over your urethra can help relieve any pain. If your doctor gives you permission, take pain medications such as Tylenol or Advil.

If you were given general anesthesia, have someone stay with you. after the procedure. You may feel sleepy or dizzy. Don’t drink alcohol, drive, or operate complex machinery for the rest of the day.

If you had a biopsy done, you’ll need time to heal. Avoid heavy lifting for the next two weeks. Ask your doctor when it’s safe to have sexual intercourse.

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Results

Interpreting the results of the test

Your doctor might have your results immediately, or it could take a few days. If you had a biopsy, you’ll have to wait for lab results. Ask your doctor when to expect any news.

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