In cystoscopy, a flexible or rigid viewing tube (cystoscope) is passed through the urethra and into the bladder. Fiberoptic cables permit a physician to visually inspect these structures. In addition, various instruments may be passed through the scope to obtain fluid or tissue samples for laboratory examination, and to perform diagnostic or therapeutic procedures. Cystoscopy is often performed on people with urinary symptoms such as bloody urine (hematuria), frequency, urgency, incontinence, or urinary retention.
Purpose of the Cystoscopy
- To detect abnormalities of the urethra and bladder, including inflammation, tumors, stones, or narrowed passages
- To help determine the cause of urinary dysfunction or recurrent urinary tract infections
- To obtain fluid or tissue samples from the lower urinary tract
- To perform therapeutic measures, such as removal of stones; placement of a catheter or stents to drain the ureters; or transurethral resection of the prostate (TURP), a treatment that removes excess tissue from the inner portion of the prostate in men with prostate enlargement (benign prostatic hyperplasia or BPH)
Who Performs Cystoscopy
- A physician, usually a urinary tract specialist (urologist)
Special Concerns about Cystoscopy
- If cystoscopy is being performed for diagnostic purposes, it can usually be done under local anesthesia. However, general or spinal anesthesia will be administered if a bladder or tissue biopsy is required or if therapeutic measures (such as TURP or the removal of stones) are planned.
- The procedure should be postponed if you currently have a urinary tract infection.
Before the Cystoscopy
- If general or spinal anesthesia is required, do not eat or drink anything after midnight on the day before the procedure. No fasting is required before local anesthesia.
- Drink plenty of fluids on the night before the procedure.
- At the testing facility, you will be asked to disrobe and put on a hospital gown.
- An intravenous (IV) needle or catheter may be inserted into a vein in your arm immediately before the procedure begins and any medications, such as a sedative or general anesthesia, are administered.
- If spinal anesthesia is used, the medication is injected into your lower spinal column to numb the lower half of your body. You will remain conscious throughout the procedure.
- If general anesthesia is being used, a thin tube attached to a breathing machine will be inserted through your mouth and into your windpipe to help you breathe.
What You Experience during Cystoscopy
- You will lie on your back with your knees bent, legs spread apart, and feet resting in stirrups. Lie very still throughout the procedure to prevent trauma to the urinary tract.
- If applicable, a local anesthetic jelly is instilled into your urethra to numb it.
- The cystoscope is gently inserted into the urethra and passed into the bladder. Fluid is infused through the scope to fill the bladder. This will create an urge to urinate, but this step is necessary to stretch the bladder walls and provide the doctor with a better view of the area.
- If appropriate, a biopsy sample or urine specimen is taken and sent to a laboratory for analysis, or therapeutic procedures are performed.
- The cystoscope is slowly withdrawn.
- The procedure usually takes about 5 to 10 minutes.
Risks and Complications of Cystoscopy
- If general anesthesia is necessary, the procedure carries the associated risks.
- Rare complications include infection, urinary retention (inability to void due to swelling), bleeding, injury to the bladder or urethra and inadvertent perforation of the bladder.
After the Cystoscopy
- Do not attempt to walk or stand alone directly after the procedure. Dizziness or fainting may occur.
- If a local anesthesia was used, you are free to leave after the test. After general or spinal anesthesia, you will remain in the hospital until you recover from the effects of the anesthetic. During this time, your vital signs will be monitored, and you will be observed for any signs of complications.
- Drink plenty of fluids (but no alcohol) to prevent accumulation of bacteria in your bladder and to reduce the slight burning sensation that may occur during urination (which may persist for 1 or 2 days).
- You may be given an antibiotic to reduce the risk of infection.
- It is common to have a temporary pink tinge to your urine at first. However, if bright red blood or blood clots are present, notify your doctor.
- Call your doctor immediately if you experience pain in your back, stomach, or side; urinary difficulties; chills; fever; nausea or vomiting; cough; shortness of breath; chest pain; burning urination lasting more than two days; or heavy bleeding lasting more than six hours after cystoscopy.
Results of Cystoscopy
- During the visual inspection of your urinary tract, the doctor will note any abnormalities.
- If tissue or fluid samples were taken, specimen containers may be sent to several different laboratories for analysis. For example, biopsied tissue may be inspected under a microscope for the presence of unusual cells, or urine may be cultured for infectious organisms.
- This test usually results in a definitive diagnosis. Your doctor will recommend appropriate medical or surgical treatment, depending on the specific problem.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media