Cystoscopy is a medical procedure that allows a urologist to visualize the entire inner lining of the urethra and bladder in an elaborate amount.
Why is cystoscopy performed?
Cystoscopy is generally performed to further investigate urologic signs or symptoms. It is an anatomic visualization of the inner part of the bladder, the urethra, and the ureteral openings into the bladder.
X-ray, ultrasound, and CT or MRI imaging may miss findings in the bladder that can only be seen by looking directly, using a scope. Cystoscopy can diagnose different types of anatomic issues in the bladder or urethra.
How is cystoscopy performed?
Cystoscopy is usually performed in the clinic or hospital, in a procedure room. A thin telescope is carefully passed through the urethra tube and into the bladder where live images are viewed on a monitor.
The cystoscopy procedure itself takes less than five minutes and is performed by a doctor. The doctor is able to see the entire bladder and urethra in great detail.
What should the patient expect before, during and after cystoscopy?
No preparation is needed before the procedure. The patient may eat and drink normally. He may be asked to give a urine sample to ensure there is no infection. The patient will be brought to a procedure room where a team member will prepare the genital area with a cleansing liquid. The patient will lie on a procedure room exam table. The entire process includes time for preparation and time for the application of lidocaine gel, to help ease the procedure. The patient may be given antibiotics before the procedure if he had a recent heart infection, a heart-valve replacement, or recent joint replacement surgery.
Cystoscopy should not be painful, but it can be uncomfortable at times. It is important to breathe, relax the muscles and not be tense during the procedure.
The patient may have mild discomfort or burning when he urinates, but this should go away within 24 hours. The patient may have some bleeding, but this should resolve by itself over time. If the patient has symptoms that can last longer than 24 hours, he should contact doctor's office. Cystoscopy is generally a safe procedure with a low risk of infection or bleeding.
State of the art cystoscopy equipment with high-definition capability is available in procedure rooms at the hospital. Doctors also perform narrow band imaging (NBI) cystoscopy to enhance detection of bladder cancer.
Flexible and rigid cystoscopy is performed based on the patient's needs. All of the cystoscopes go through a rigorous sterilization process with a high level of sterilization with multiple checks and balances.
Diagnostic cystoscopy (looking inside the bladder for the purposes of a diagnosis) is generally performed in the office. Patients with a history of bladder cancer need "surveillance cystoscopy" in which the cystoscopy is performed regularly to see if cancer has come back.
The following cystoscopy procedures are also regularly performed in the urology office:
Cystoscopy with the removal of ureteral stent
Cystoscopy with the injection of Botox
Cystoscopy with urethral bulking injection
Simple cystoscopy is performed in the office with the patient awake. More complex cystoscopy procedures are also performed in the operating room.
For example, if a bladder tumor is detected then the cystoscopy with bladder biopsy will be performed in the operating room using an anesthetic.