A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, a doctor inserts this tube through your urethera (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.
Reasons of Cystoscopy
Your doctor might also order the procedure to investigate reasons for:
Blood in your urine
frequent urinary tract infections
an overactive bladder
Enlarged prostate gland
Problems with the ureters (tubes connecting your bladder to your kidneys)
A cystoscopy can reveal several conditions, including bladder tumors, stones, or cancer. 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 of the Procedure
You might be asked to:
Take antibiotics. Your doctor might prescribe antibiotics to take before and after cystoscopy, especially if you have trouble fighting off infections.
Wait to empty your bladder. Your doctor might order a urine test before your cystoscopy. Wait to empty your bladder until you get to your appointment in case you need to give a urine sample.
During the Procedure
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.
The cystoscopy procedure
Before 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.
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: 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.
You should call your doctor if you:
Develop a fever higher than 100.4ºF (38ºC)
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
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 acetaminophen (Tylenol) or ibrufen. 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.
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People often worry that a cystoscopy will be painful, but it does not usually hurt. Tell your doctor or nurse if you feel any pain during it. It can be a bit uncomfortable and you may feel like you need to pee during the procedure, but this will only last a few minutes.
Cystoscopy may be an embarrassing procedure for the patient. Exposure and handling of the genitalia must be performed with respect. The patient should remain exposed only as long as is necessary to complete the evaluation.
You may feel the need to urinate more often, and your urine may be pink. These symptoms should get better in 1 or 2 days. You will probably be able to go back to work or most of your usual activities in 1 or 2 days. This care sheet gives you a general idea about how long it will take for you to recover.
For a variety of reasons, urinary retention (inability to urinate) can occur after cystoscopy. This will generally require the placement of a catheter to drain the bladder. Swelling caused by the procedure can obstruct the flow of urine.
Your bladder is filled with fluid. This stretches the bladder so that your doctor can look closely at the inside of your bladder. After the cystoscopy, your urethra may be sore at first, and it may burn when you urinate for the first few days after the procedure.
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