Cystoscopy is an examination of the inside of the bladder and urethra, using a fine telescope passed through the urethra.
Flexible Cystoscopy is carried out using a fine, flexible, fiber-optic telescope under local anesthetic. This is often performed in the office setting or as an outpatient.
Rigid cystoscopy is carried out under general anesthesia. This is often performed in the hospital or as an inpatient.
Cystoscopy with a biopsy is a minor procedure. It causes only minor discomfort.
How cystoscopy with biopsy is performed?
The doctor uses a thin, flexible tube called a cystoscope
. The cystoscope has optic fibers inside it, and a light and eyepiece at one end. The doctor can see down the cystoscope to look at the pictures. These may also be shown on a TV monitor.
Your doctor also passes small instruments down the cystoscope to take samples of tissue (biopsies) from the lining of your bladder.
You usually have this test under a general anesthetic.
What happens after cystoscopy with biopsy?
You go to the hospital for this test, usually on the day. You are asked not eat or drink anything for at least 6 hours before the cystoscopy with biopsy.
You might need a blood test and a chest x-ray
before the cystoscopy. This is normal for anyone having a general anesthetic.
In some hospitals, you may have a spinal anesthetic instead of a general anesthetic. This is an injection into your spine (epidural) so you can’t feel anything below your waist. You may also have some antibiotics before the test.
Your doctor may put a dye into your bladder an hour before your cystoscopy with biopsy. The dye is sensitive to light. During the cystoscopy, they shine a blue light on the bladder lining. This is called photodynamic diagnosis. It can help to show up any areas of cancer more clearly.
How test is performed?
Your specialist thoroughly examines the inside of your bladder and urethra using the cystoscope while you’re under anesthetic. They take samples of tissue (biopsies) from any areas that look abnormal. They also take biopsies from areas that look normal, to compare them with. This helps to make sure of the diagnosis.
The sampled areas are then sealed with a hot probe (cauterized) to help stop any bleeding.
What happens after the test?
You can usually go home the same day. This depends on:
•    how many biopsies were taken
•    how you react to the anesthetic
•    the time of day you have the anesthetic – if it’s very late in the day, it may be better to stay overnight
What are the further tests that are performed after cystoscopy with biopsy?
Sometimes, when the doctors examine the biopsies, they do not include tissue from the muscle wall. If this happens, the doctor will ask you to have another cystoscopy with biopsy, to take samples from the muscle wall. You should have this done within 6 weeks of your first operation.
Will any discomfort will be felt during cystoscopy with biopsy?
You may feel minor pain in your urethra on passing urine. You may also see traces of blood in the urine. These symptoms should not last longer than 24 hours. Drinking more water helps a lot. Occasionally, infection (called cystitis) may occur and give you more pain, frequency, and urgency than expected. Fever may also occur, rarely. Should you suspect that infection is present, contact your doctor. He will need to prescribe antibiotics to cure this.
What is involved in the procedure of cystoscopy with biopsy?
As you are awake throughout the procedure, your doctor may give you a running commentary while he gets you prepared. The genital area is cleaned with a mild antiseptic and the area covered with a sterile (infertile) sheet. Then a local anesthetic gel is put into the urethra.
The gel comes in a tube and is squeezed into the urethra. There may be slight stinging as it starts to work. When the instrument reaches the sphincter inside the urethra, you will be asked to do the action of voiding or a cough, to relax the sphincter
. There may be a brief moment of discomfort as the telescope passes through.
When your doctor examines the bladder, he fills your bladder with saline and you may feel that you want to pass urine. By the end of the procedure which only takes a few minutes, you may feel the fullness and need to pass water again.
What are the risks of cystoscopy with biopsy?
Most people do not have problems after having a cystoscopy but as with any medical procedure, there are possible risks. You might have mild burning or stinging when you pass urine. It may also look slightly bloodstained for a day or two. Drinking plenty should help with this.
You should contact the hospital if you are still bleeding 48 hours after your test, the bleeding is getting worse or there are blood clots in your urine.
There is a small risk of infection. Symptoms can include:
-  going to the toilet more often
-  burning and stinging when passing urine
-  feeling hot and cold or shivery
-  cloudy or offensive smelling urine
Cystoscopy with biopsy will minimum cost to Rs. 35,000 to maximum Rs. 70,000.
-  generally feeling unwell