Cystoscopy

If the bladder needs to be examined in detail, a urologist may perform a cystoscopy.

A cystoscopy is a procedure that involves accessing the bladder from the tube that transports urine (urethra) with a long tube with an attached lens called a cystoscope. Used for both diagnostic and treatment purposes, a cystoscopy may be performed by a urologist as an outpatient procedure with or without sedation or with a local anesthetic.

In some situations, the procedure is done in a hospital under general anesthesia.
The specific way a cystoscopy is performed will depend on the reason why it’s being done.

Reasons to Have a Cystoscopy

Investigate recurring urinary tract or bladder infections

Diagnose bladder diseases or bladder inflammation

Evaluate enlarged prostate conditions

For investigative purposes, a cystoscopy may be done to determine the reason why a patient is having recurring urinary tract infections or bladder infections. The procedure may also be done to diagnose bladder diseases, bladder inflammation (cystitis), or enlarged prostate (benign prostatic hyperplasia). A cystoscopy might also be done to treat certain bladder problems, such as ones involving small tumors, with special instruments.

Preparation

Since the procedure isn’t usually done when a patient has an active infection, certain steps may be taken before the procedure.

Patients may be asked to take antibiotics prior to having a cystoscopy.

In some cases, a urine test might be done prior to using the scope.

Patients should wait to empty their bladder until their appointment unless told otherwise.

How It’s Done

An outpatient cystoscopy is usually done in a urologist’s office. Just prior to preparing to insert the scope, the bladder should be emptied. Patients lie down on a table, usually with feet in stirrups. Some type of sedation may be done, although this isn’t always necessary. Numbing jelly makes it easier to insert the flexible scope into the urethra.

The urethra and bladder are viewed in detail with real-time images captured by the tiny camera attached to the tube.

The images can be magnified for increased clarity and detail.

A sterile solution may be used to inflate the bladder to improve the view.

A larger scope may be used when instruments or tissue samples are needed.

If a cystoscopy is being done for treatment purposes, a larger scope is often used so instruments can be safely inserted. A larger scope is also used to take tissue samples.

After a Cystoscopy

Results may be discussed with a patient immediately after the procedure is completed. If a biopsy was taken, results won’t be known until lab tests are done. There may be some slight irritation following a cystoscopy. Staying hydrated and taking a warm bath may ease discomfort experienced following the procedure.

Results may sometimes be discussed immediately after the procedure

Biopsy results require laboratory testing before confirmation

Mild irritation may occur following the cystoscopy procedure

Hydration or warm baths may help ease discomfort afterward

A cystoscopy is just one of several diagnostic procedures a urologist may perform to determine what’s causing a patient’s symptoms. Oftentimes, what’s learned from a visual inspection of the bladder and nearby structures is combined with results from urine and blood tests and ultrasounds and other image tests.

Diagnostics and Evaluation

Combined Diagnostic Techniques

A urologist sometimes performs a ureteroscopy at the same time a cystoscopy is done. It’s a similar process involving a smaller scope that’s used to view the tube that transports urine from the kidneys to the bladder.

Removing Stones in the Ureter

The two techniques are often combined when it’s discovered that a patient has stones in the lower part of the ureter. During an outpatient procedure, a tiny wire basket can be used to remove the stones.

Diagnostic Evaluation of the Urinary System

The goal is to develop a complete picture of what’s going on with the urinary system so an accurate diagnosis can be made to determine which treatments to recommend, some of which can also be performed with a cystoscope.