Diagnostics
Cystoscopy
Who performs cystoscopy?
Why is cystoscopy performed?
Cystoscopy is done for various reasons, including:
- Investigating urinary problems such as blood in the urine, frequent urination, painful urination, or recurrent urinary tract infections (UTIs).
- Diagnosing and monitoring bladder conditions like bladder stones, tumors, or bladder inflammation (cystitis).
- Diagnose an enlarged prostate.
- Removing small bladder growths or polyps.
What are the types of cystoscopies?
There are two types of cystoscopes: rigid and flexible. The choice depends on the patient’s specific needs.
Rigid: These cystoscopes do not bend and allow the urologists to pass instruments through the tube for biopsies or tumor removal.
Flexible: Bendable scopes are used to examine the bladder and urethra, aiding in diagnosis.
The doctor will choose the most appropriate type for the patient’s procedure.
How is cystoscopy performed?
Preparation for cystoscopy
The type of cystoscopy a patient undergoes depends on the reason for the procedure. It may be an outpatient procedure, enabling the patient to return home on the same day, or in some cases, hospitalization may be required, necessitating an overnight stay.
For most diagnostic cystoscopies, a numbing gel is applied to the urethra to minimize discomfort. However, sedation or general anesthesia may be necessary for more invasive cystoscopies used for treatment purposes.
Follow the doctor’s instructions carefully regarding preparation.
- Fasting for several hours before the procedure, depending on the anesthesia type and the purpose of the cystoscopy.
- Provide a urine sample on the day of the procedure to check for a urinary tract infection (UTI). If an infection is present, it will need treatment before the cystoscopy can be performed.
- Empty bladder right before the procedure.
- Bring an updated list of medications and supplements.
- Temporarily stop taking blood-thinning medications like aspirin or warfarin, but always check with the doctor before doing so.
- Inform the doctor if pregnancy is a possibility, as regional and general anesthesia can pose risks to a developing fetus.
During cystoscopy
- The patient may receive local anesthesia or be sedated to minimize discomfort during the procedure.
- The cystoscope is gently inserted into the urethra and advanced into the bladder.
- Sterile water or saline is used to expand the bladder for better visibility.
- Using the cystoscope’s camera, the doctor carefully examines the bladder’s inner lining and the urethra.
- Small tools may be passed through the cystoscope to collect tissue samples or treat any identified issues if necessary.
Typically, a diagnostic cystoscopy lasts around 5 to 20 minutes, though it may vary slightly. However, the procedure may take longer to complete if a biopsy or treatment is required.
After cystoscopy
After the cystoscopy procedure, the patient may experience some discomfort, such as belly pain, blood-tinged urine, or pain while urinating for the first day or two. The patient may also feel a frequent and urgent need to urinate. These issues are generally temporary and should improve within 48 hours.
To prevent infection, the doctor may prescribe antibiotics. To alleviate side effects, the patient can try the following:
- Apply a warm, damp washcloth to the opening of the urethra or take a relaxing warm bath to soothe discomfort.
- Stay well-hydrated by drinking several glasses of water daily to help flush out the bladder.
- Consider using over-the-counter pain relievers to help manage pain.
Cystoscopy is generally considered a safe procedure, with serious complications being rare. The primary risks associated with cystoscopy include:
- In some cases, a urinary tract infection may develop after the procedure, necessitating antibiotic treatment.
- There is a slight possibility of experiencing difficulty in emptying the bladder. A catheter may be inserted temporarily to facilitate bladder emptying in such cases.
While extremely uncommon, there is also a minimal risk of potential damage to the bladder from the cystoscope.
References
- Cleveland Clinic. Cystoscopy. Available from: https://my.clevelandclinic.org/health/diagnostics/16553-cystoscopy
- Overview Cystoscopy. Available from: https://www.nhs.uk/conditions/cystoscopy/#:~:text=A%20cystoscopy%20is%20a%20procedure,or%20nurse%20to%20see%20inside
- Mayo Clinic. Cystoscopy. Available from: https://www.mayoclinic.org/tests-procedures/cystoscopy/about/pac-20393694
- 4. Cystoscopy. Available from: https://medlineplus.gov/ency/article/003903.htm
