A Guide to a Cystoscopy

What Happens During the Procedure

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A cystoscopy is a medical procedure that allows a doctor to view the interior of the urethra and bladder. A thin tube, called a cystoscope, is threaded into the bladder through the urinary opening. A small camera attached to the tube relays live video feed to a monitor, providing an immediate view of the urethra and bladder.

Why Would I Need a Cystoscopy?

A cystoscopy is used to investigate and diagnose many urinary symptoms and conditions.

Your doctor may want you to have a cystoscopy if you are experiencing:

  • Blood in the urine (when the cause cannot be identified)
  • Painful urination
  • Interstitial cystitis
  • Recurrent bladder infections
  • Bladder stones
  • Abnormality discovered on MRI or CT scan

A useful aspect of cystoscopy is its ability to biopsy suspicious tissue during the procedure and even remove small growths. The cystoscope is equipped with a tool that can quickly biopsy an area if needed. This makes the cystoscopy a standard procedure for diagnosing malignant diseases like bladder cancer.

Is Anesthesia Used During a Cystoscopy?

A cystoscopy can be done under general anesthesia, local anesthesia or without any anesthesia. The type of anesthesia used (if any) during the procedure is dependent on your health status and history.

If your doctor chooses to perform the cystoscopy under general anesthesia, the procedure will take place in a hospital or surgical center.

A cystoscopy performed with a local anesthetic or without any anesthesia can be completed in the doctor's office. Most cystoscopy procedures are performed in office but if the doctor anticipates the procedure may be longer than average, he may choose general anesthesia. If you had a previous cystoscopy with a local anesthesia and did not tolerate it well, your doctor may offer to do the procedure under general anesthesia.

What Happens During a Cystoscopy?

In Office with Local Anesthetic

A cystoscopy generally takes about 5-20 minutes to perform. Time varies based on the reason why the cystoscopy is needed and what is discovered during the procedure.

During a cystoscopy, you will first be asked to undress from the waist down or to change into a gown. You will be asked to lay on an exam table and place your feet in stirrups. If a local anesthetic is used, it will be inserted into the urethra. Local anesthetics during a cystoscopy procedure are in the form of a gel or other jelly-like substance. The doctor will wait a few minutes for the anesthetic to effectively numb the area before inserting the cystoscope.

After you are numb, the doctor will insert the scope into your urethra and thread it through to the bladder. A solution of saline or sterile water will then flood the bladder via the cystoscope. You will likely feel some pressure and have the urge to empty your bladder. The solution expands the bladder, allowing the doctor to get a more detailed view.

If the doctor finds an abnormal growth, a biopsy may be done during the cystoscopy. It takes only seconds for your doctor to obtain a tissue sample. The sample will then be sent to a lab for testing.

At the end of the cystoscopy, the doctor will remove the cystoscope and you will be allowed to empty your bladder. After the procedure, you may experience a slight burning sensation when you urinate and may see a small amount of blood in your urine. This is normal and can be expected for up to 24 hours after the procedure. Your doctor will likely want you to drink a certain amount of water every few hours after the procedure, as well.

Under General Anesthesia

If your doctor decides that your procedure is best done under general anesthesia, it will be done in a hospital or surgical center. The procedure is done in the same manner as if it was performed in the doctor's office (see above).

You will need someone to drive you home after the procedure, so be sure to have arrangements made beforehand.

Risks Associated With Cystoscopy

In most cases, a cystoscopy is a safe, common procedure without complications. Rarely, complications can occur, such as infection and bleeding. Complications related to the anesthesia can arise, which your doctor will discuss with you prior to the procedure.