Cystoscopy

Performed with a specialized hollow tube with a lens attached, a cystoscopy is a procedure that’s done when there’s a need to view and/or access the bladder or the tube that carries urine from the body (urethra).

It’s a procedure that can be done for diagnostic purposes to determine what’s going on with the urinary tract and its various parts. In some instances, a urologist will perform a cystoscopy for treatment purposes.

It’s not unusual for a cystoscopy to be performed for investigative purposes. This is what may happen if a patient has an overactive bladder (OAB), painful urination without a clear reason, or blood in their urine. For diagnostic purposes, a cystoscopy might also be done to get a better idea of what may be causing recurring urinary tract infections (UTIs). A cystoscopy may also be performed to:

• Locate and remove bladder stones
• View areas affected by bladder inflammation (cystitis)
• Treat certain bladder-related conditions
• Remove small growths
• Look for signs of an enlarged prostate (benign prostatic hyperplasia)

A urologist sometimes prescribes antibiotics prior to performing a cystoscopy to reduce infection risk or help reduce issues with an existing infection in the urinary tract. A urine test is sometimes done before a cystoscopy takes place. If this is the case, a patient will likely be advised to come to their appointment with a full or semi-full bladder.

The type of sedation used when a cystoscopy is performed will depend on why the procedure is being done. A simple outpatient procedure, for instance, may only require a local anesthetic or numbing agent. More extensive procedures involving a cystoscope may be done with an intravenous (IV) sedative or a general anesthetic.

Patients normally lie down on a table, usually with their legs bent at the knees. If a sedative is used, patients stay aware and awake during the procedure. After numbing jelly is applied to ease discomfort, the cystoscope is inserted through the urethra. Smaller scopes are typically used when a cystoscopy is done for diagnostic purposes. A larger scope is usually necessary if specially designed instruments will have to be passed through the scope.

The lens attached to the scope allows a urologist to view the urethra and bladder in great detail on a monitor. A sterile solution is inserted into the bladder to allow for a better view of this structure. Tissue samples are sometimes taken. If performed for treatment purposes, growths, stones, or scar tissue may be removed. Other procedures may also be performed through the scope.

Following a cystoscopy, most patients are able to resume their normal routine. Some patients briefly experience a burning sensation during urination, slight bleeding from the urethra, or frequent urination for a few days. Taking warm baths and drinking more water may help with post-procedure issues.

In some cases, results from a cystoscopy can be discussed with a patient during or immediately after a procedure. However, if the purpose of the procedure was to collect tissue samples to perform a biopsy if some type of urologic cancer is suspected, results will be discussed after a laboratory analysis is completed. Risks associated with a cystoscopy include pain, bleeding, and infection, although serious complications are rare.