What is Cystoscopy

A cystoscopy is a diagnostic and minor surgical procedure used to study the bladder and the lower urinary tract. During the procedure, a tube-like instrument called a cystoscope is inserted into the urethra and bladder to examine the area. It is typically done in a doctor's office or hospital under local anesthesia.

Preparation For Cystoscopy

Before a cystoscopy procedure, your doctor will review your medical history and discuss possible risks and special preparations. Generally, you should plan to be at the medical facility for at least 2 hours. You may be asked to stop taking certain medications before the procedure, such as:

  • Blood thinners (anticoagulants such as warfarin)
  • Pain medications (especially nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen)
  • Certain antiseizure medications

You may also be asked to drink plenty of fluids before the procedure and to empty your bladder just before the procedure is performed.

Procedure Of Cystoscopy

During cystoscopy, you will likely be given local anesthesia or a numbing agent in the urethra. You may also be given a sedative. General anesthesia is rarely used. After the area is numbed, the cystoscope is inserted into the urinary tract.

The physician could then use the cystoscope to perform minor procedures such as injecting medications or inserting a stent. If your doctor is collecting tissue samples for a biopsy, they will use surgical instruments inserted through the cystoscope. Fluids may be drained from the bladder as well.

Types Of Cystoscopy

There are four main types of cystoscopy:

  • Flexible cystoscopy. This is the most common type. It involves inserting a slender, flexible tube with a light and camera through the urethra.
  • Rigid cystoscopy. This procedure is used primarily as a form of treatment, not as a diagnostic tool. It is done with a rigid cystoscope that does not bend, and it requires a general anesthetic.
  • Transurethral microwave thermotherapy. This procedure is used to treat enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). It uses a special instrument that heats the bladder neck area in order to shrink the prostate.
  • Transurethral needle ablation. This procedure is done to treat bladder cancer. It involves inserting thin needles through the urethra into the bladder while using ultrasound imagery to pinpoint the tumors.

Risks Of Cystoscopy

Possible complications of cystoscopy include pain, bleeding, and infection. Rarely, more serious complications may occur, such as severe bleeding, a tear in the urethra, and bladder perforation.

Why Cystoscopy Is Recommended?

A cystoscopy may be recommended if your doctor suspects you may have abnormalities in your urinary tract such as inflammation, blockages, or tumors. It is also used to diagnose other conditions such as obstruction of the urethra or prostate enlargement. The procedure is also used to evaluate urinary incontinence or infertility.

When to Do Cystoscopy?

Your doctor may recommend a cystoscopy if you have any of the following signs and symptoms:

  • Frequent or painful urination
  • Incontinence
  • Blood in the urine
  • Pain in the lower abdomen or pelvic area
  • Pain during sexual intercourse
  • Infertility

It may also be recommended if you have previously had bladder cancer or radiation therapy to the bladder or pelvic areas.