A cystoscopy is a relatively common urological test used for a variety of urological conditions. The information below will answer all your questions about cystoscopy.
1. What is the purpose of cystoscopy?
A cystoscopy is most commonly used to determine the cause of blood in the urine, to perform a biopsy for bladder cancer, and to evaluate interstitial cystitis (painful bladder syndrome), bladder stones, vesicoureteral reflux (when urine flows from the bladder back toward the kidneys), and recurrent bladder infections.
2. How is a cystoscopy performed?
Cystoscopy is an outpatient surgery with either local or general anesthesia.
Your urologist will place a cystoscope, a thin, wire-like instrument that contains a lighted scope or camera, through your urethra into your bladder. In some cases, a video camera is attached to the cystoscope.
Once the cystoscope is in your bladder, saline solution, along with medication to prevent infection, is injected. Filling the bladder helps your doctor see the entire bladder wall and anything that should not be there, such as bladder stones.
In some cases, the urologist may attach very small instruments to the cystoscope to remove tissue from your bladder for biopsy. Small bladder stones may also be removed.
At the end of the procedure, the fluid is drained.
3. How will you feel when you are undergoing the procedure?
Depending on who you ask, you will get different answers. It will also depend on whether or not you are under general anesthesia. Urologists sometimes describe a "slight pinch" while you are undergoing cystoscopy, but many people with interstitial cystitis say that just hearing the word "cystoscopy" makes them feel like a flare is coming on.
When the procedure is over, you may feel some soreness.
4. What kind of self-care is important after the procedure is performed?
Your urologist will give you specific directions on how to care for yourself after the procedure is done. You should not drive after the procedure, and should make arrangements for someone to take you home.
The most important thing is to take it easy on the day of the procedure. You should rest and drink plenty of fluids after you get home for the next few days.
5. What are the risks of undergoing cystoscopy?
Cystoscopy is usually a safe procedure, but there are risks. In rare instances, patients develop infections, increased bleeding, have complications from anesthesia, or the bladder wall may be punctured. Antibiotics are routinely given before the procedure to reduce the risk of infection.
In men, it is possible for scar tissue to develop, which can cause the urethra to narrow, a condition known as strictures. When this happens, another procedure may need to be performed to remove the scar tissue.
6. What are the advantages of cystoscopy?
The small instrumentation attached to the cystoscope allows your doctor to remove very small areas for biopsy, something that would not be possible with imaging studies. Small bladder stones may also be removed. Cystoscopy also permits urologists to deliver very targeted medication to areas that are inflamed or cancerous.
Cystoscopy is often referred to by other names, most often "cysto," as well as cystourethrography and cystoscope.
Carter HB, Chan DY. Basic instrumentation and cystoscopy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 6.