Cystoscopy Procedure
Overview
Cystoscopy is a medical test where doctors look inside the bladder and urethra. To do this, doctors use a special hollow tube called a cystoscope. This device has a lens that helps the doctor view the lining of the bladder and the tube that carries urine out of the body.
Key Points About Cystoscopy:
- Doctors can perform it in different settings: a test room, an outpatient clinic, or a hospital.
- Options for comfort include local anesthetic jelly, sedation, or general anesthesia.
- The type of cystoscopy depends on the reason for the test.
| Procedure Part | Description |
|---|---|
| Scope (cystoscope) | Hollow tube with a lens, inserted through the urethra. |
| Bladder exam | Doctors check the inner lining for problems. |
| Comfort methods | Local numbing, sedation, or full anesthesia. |
Cystoscopy allows doctors to directly see any issues inside the bladder or urethra.
Reasons for the Procedure
Doctors often use cystoscopy to figure out why someone has problems with their bladder or urethra. Common reasons include checking for blood in the urine, pain when urinating, frequent urge to urinate, or trouble holding urine.
It can also help explain repeated urinary tract infections, though doctors usually avoid it if someone has an active infection. Doctors use this procedure to find conditions like:
- Bladder cancer
- Bladder stones
- Bladder inflammation (cystitis)
- Narrowing caused by an enlarged prostate
Doctors can use special tools during cystoscopy to treat some issues right away. For example, doctors may remove very small tumors in the bladder during the procedure. Sometimes, doctors use a smaller scope called a ureteroscope at the same time to check the tubes that connect the kidneys to the bladder.
Table: Conditions Cystoscopy Can Help Diagnose or Treat
| Condition | Use of Cystoscopy |
|---|---|
| Urinary tract tumors | Diagnosis, removal |
| Bladder stones | Diagnosis, sometimes treatment |
| Bladder inflammation | Diagnosis |
| Enlarged prostate | Detection |
Possible Risks
A cystoscopy, like any medical procedure, can have some risks. Most people have only mild symptoms, but some may have complications. The table below shows some common risks:
| Risk | Details |
|---|---|
| Infection | Germs can get into the urinary tract, possibly causing a urinary tract infection (UTI). Certain people, such as older adults or those with unusual urinary tract anatomy, may be more at risk. |
| Bleeding | A small amount of blood in urine can happen, but heavy bleeding is rare. |
| Pain and Discomfort | Some people feel pain in the belly or have burning during urination. This usually goes away after a few days. |
Warning Signs That Need Immediate Attention
Sometimes, a serious problem can develop after the procedure. Contact a doctor if you have:
- High fever (over 101.4°F or 38.5°C)
- Strong pain or belly pain with nausea
- Unable to pee
- Heavy bleeding (bright red blood or big clots in urine)
- Chills
- Burning with urination that does not get better after two days
Quick action helps prevent further issues.
Getting Ready for the Procedure
Some people get medicine that helps them relax or be fully asleep (general anesthesia) during their cystoscopy. If you need this, arrange for someone else to drive you home after the appointment. Do not drive yourself after receiving any type of sedative or anesthesia. Making plans ahead of time helps keep everyone safe.
What You Can Expect
What Happens During the Procedure
Doctors perform most cystoscopy procedures on an outpatient basis, so the patient goes home the same day. The procedure time depends on whether anesthesia or sedation is used. In a clinic, it can take about five to 15 minutes. If sedation or general anesthesia are required, the process may last up to 30 minutes.
Before starting, staff usually ask patients to empty their bladder. Next, patients lie on a table, often with their knees bent and feet in stirrups to allow for easier access. The medical team may use a sedative to help the person feel calm, or a general anesthetic if needed. Both medications may be given through a vein.
To minimize discomfort, staff apply a numbing gel to the urethra. After a few minutes, the urologist gently inserts a thin tube called a cystoscope through the urethra. The urologist chooses the smallest scope for comfort, but might use a larger one if tissue samples or special medical tools are required.
While looking through the cystoscope, the urologist examines the inner walls of the urethra and bladder. Sometimes, a small camera attached to the cystoscope shows live video on a monitor for better viewing. Staff slowly put a sterile liquid into the bladder to inflate it.
This helps the doctor see all areas clearly, but can cause a feeling of needing to urinate. This urge is normal and will go away once the test is finished. During the procedure, the doctor might collect small samples of tissue from inside the bladder or urethra if more testing is needed.
Key Steps During the Exam:
| Step | What happens |
|---|---|
| Get ready | Patient empties bladder, lies on exam table |
| Numbing and sedative | Local numbing is placed; sedation or anesthesia may be given |
| Scope is inserted | Cystoscope is gently put in through the urethra |
| Bladder is filled | Sterile fluid fills the bladder for better viewing |
| Visual exam | Urologist checks the urethra and bladder surfaces |
| Sampling (if needed) | Tissue samples taken for further tests |
What to Expect After the Exam
After the cystoscopy, most patients can continue their regular day. If any sedative or general anesthesia was used, staff will watch the patient in a recovery area until it is safe to go home.
It is common to notice blood in the urine, or see pink toilet tissue, after the exam. Some people may feel a burning sensation when they urinate, or need to use the bathroom more often for a day or two. These side effects usually go away soon.
Tips for Managing Discomfort After Cystoscopy
- Drink plenty of water—try about 16 ounces each hour for the first two hours.
- Use over-the-counter pain medicine if needed.
- Gently hold a warm, damp washcloth on the urethra opening to ease pain.
- Soak in a warm bath, unless told not to by the doctor.
If bleeding gets worse, there are large blood clots, a fever develops, or urinating becomes very difficult, tell a healthcare provider right away.
Findings
Doctors often review cystoscopy results right after the procedure. If a biopsy is done, the tissue goes to a lab for more testing, which can take several days. The urologist may see stones, blockages, or abnormal growths during the exam. Doctors will share results about these either in person or at the next appointment.
Possible Results
| Finding | What It Means |
|---|---|
| Normal | Bladder looks healthy |
| Stones | Small, hard masses are present |
| Biopsy Results | May show signs of cancer or not |
