Cystoscopy is a procedure performed by a urologist used to examine the inside of the bladder and urethra. It is used to monitor the health of your bladder and the entire urinary tract, as well as establishing a diagnosis based on symptoms you may be having.

This pretty standard procedure is often confusing because people don’t understand how it’s done or why. It’s time to dispel the misinformation using this concise but extensive FAQ article.

How is a cystoscopy performed?

To perform a cystoscopy, a urologist needs a cystoscope.  A cystoscope is a hollow tube with a lens on the end of it. By connecting the cystoscope to a screen, your provider can see the inside of your urethra and bladder and examine them accordingly. It’s one of the most standard procedures in urology, designed to diagnose and treat a variety of urologic conditions.

Because a rigid tube is being placed in the urethra up to the bladder, it can be uncomfortable. Several methods can be used to make this procedure less painful. The first involves using anesthetic jelly to numb the walls of your urethra. A second choice involves conscious sedation, a similar type of sedation used when you get a colonoscopy. Finally, a cystoscopy can be done in the operating room while you are under general anesthesia. Sometimes a combination approach is best.



Why is it used?

For most, cystoscopy is something done only when there is a problem at hand. For some people at risk of certain bladder or urologic conditions, however, it’s a great way of monitoring your bladder’s health.

Sometimes, symptoms of painful urination or blood in the urine may mean something is going on in your bladder and urethra. Other times, risk factors such as family history or certain jobs might increase your risk of bladder conditions, such as bladder cancer. For these reasons and more, your provider might recommend a cystoscopy. This can detect bladder cancers at an early age.

Sometimes, cystoscopy reveals cystitis (bladder inflammation) or bladder stones. In these cases, special tools can be connected to the cystoscope to remove them. For example, smaller bladder tumors can be removed with lasers attached to the cystoscope. It’s much less painful and less complicated than open surgery.

In a similar procedure, a smaller scope can be inserted into the ureters. The ureters drain urine from the kidney into the bladder. Occasionally, stones can get caught in the ureters causing significant pain and problems with excretion of urine. This procedure is termed ureteroscopy.



Are there any risks?

Like with every procedure, there are risks involved. Since a foreign body is entering your body, there are chances of an infection. Sometimes, your provider will prescribe antibiotics to take beforehand to decrease the risk of infection.

Bleeding is another risk that may occur if the cystoscopy tube scratches the walls of the urethra or bladder. The bleeding is usually minor and heals on its own.



How do I prepare?

No preparation is typically needed for cystoscopy unless you are undergoing general anesthesia. If you have been prescribed antibiotics, you should take them as directed before the procedure. You will also likely be instructed to fill your bladder before the procedure. This is usually because the urologist may ask you for a urine sample before the cystoscopy to do a detailed analysis of your urine. If this is needed, you’ll need to drink plenty of water before the procedure.

If you are undergoing general anesthesia, you will need to not eat or drink anything for at least 8 hours before the procedure unless specifically instructed otherwise.



What should I do if I’m going to receive anesthesia or sedation?

Sedation and anesthesia can severely impact your reflexes and reaction time for a specified period. You will need someone to drive you home to avoid a potential car accident. If your cystoscopy takes place under total anesthesia, you may need to stay in the hospital for a few hours or even overnight.



What are your expectations for the procedure?

Sometimes, tissue samples are taken because static images of the urethra and bladder might not be enough to determine a diagnosis or establish a conclusion. Before the procedure starts, your provider will apply numbing jelly into your urethra. You’ll need to wait a few minutes before your urethra is numb, decreasing pain.

If the urologist needs to take a tissue sample or perform an actual surgical procedure, a larger scope might be needed. This may increase the level of discomfort. Your provider might also use a sterile solution to fill your bladder. This is used to allow the urologist to more completely examine the tissues as the bladder wall is stretched out. This might give you the urge to urinate shortly after the procedure.



What to do after the procedure?

You will most likely be allowed to return to your daily routine fairly quickly after the procedure. If you’ve been sedated or required anesthesia, you might have to wait in the recovery area for a few hours until you are discharged home.

Sometimes, your urethra might feel irritated, but this tends to go away quickly. To accelerate the process, you can take a warm, moist washcloth and place it on the opening to ease any discomfort. A warm bath and sufficient hydration will also help the irritation go away.



What about the results?

The results will be discussed after the procedure with your provider. Additional tests may take place; the urologist might want to discuss them in a separate appointment.  Many factors impact treatment and recovery time. If the cystoscopy was for screening purposes, recovery will be quick. If the cystoscopy was for biopsy or stone removal, recovery might take a few days or even weeks. This should be discussed with your provider.



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