Cystoscopy

What is cystoscopy?

Cystoscopy is aprocedure to examine the inside of the bladder and urethra, the tube that carries urine from the bladder to the outside of the body.

What are the indications for performing cystoscopy?

Cystoscopy is used to diagnose, monitor and treat conditions that affect the bladder and urethra.

Reasons for performing a cystosocopy include:

• Hematuria – blood in the urine
• Recurrent urine infections
• Assessing an enlarged prostate
• Monitoring and treatment of bladder tumours
• Treatment of stones in the bladder, ureter or kidneys

How is cystoscopy performed?

Your doctor performing the examination uses a cystoscope, this is a thin instrument with an camera on one end and a tiny lens and a light on the other end that is inserted into the bladder. The cystoscope is gently inserted into the urethra (waterpipe), and slowly glided into the bladder.The small lens magnifies the inner lining of the urethra and bladder, allowing the doctor to clearly view any abnormalities. The bladder is filled with fluid to allow adequate examination of the lining of the bladder wall.

A rigid or a flexible cystoscope can be used. Rigid cystoscopy is usually performed with general anaesthetics, rigid cystoscope has instrument channels which allows the use of laser fibers, biopsy forceps or diathermy to treat bladder conditions.

Flexible cystoscopes are the same size as a urinary catheter, flexible cystoscopy can be performed under sedation or local anaesthetics.  Inspection of the bladder and urethra with the flexible cystoscopy normally takes around 5 minutes. When the flexible cystoscopy is performed under local anaesthetics, as the bladder fills, you may feel some discomfort or pressure and the urge to urinate. You will be allowed empty your bladder as soon as the examination is over.

What are the risks and complications associated with cystoscopy?

Cystoscopy is usually well tolerated as a day procedure. Potential risks include:

• Bleeding: it can cause some blood in the urine for up to one week after the procedure, serious bleeding is very rare.
• Pain: you may notice a burning sensation during urinating after the procedure, but these symptoms are mild and will usually resolved after 24-48 hours
• Infection: there is a less than 5% risk of a urine infection after cystoscopy. Please let your doctors know if burning during voiding is not improving or persists after 48 hours. Drinking plenty of water following the cystoscopy will reduce the risk of having a urine infection.