Cystoscopy
Cystoscopy is a test to look at the inner lining of the bladder and the tube from the bladder to the outside of the body (urethra). The cystoscope is a thin, lighted viewing tool that is put into the urethra and moved into the bladder.
A cystoscopy can check for stones, tumors, bleeding, and infection. Cystoscopy can see areas of the bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be put through the cystoscope to remove samples of tissue (biopsy) or samples of urine.
Cystoscopy also can be used to treat some bladder problems, such as removing small bladder stones and some small growths.
Why is a cystoscopy done?
Cystoscopy may be done to:
- Find the cause of many urinary system problems. Examples include blood in the urine, pain when you urinate, incontinence, frequent urinary tract infections, and blockages in the urinary tract.
- Remove tissue samples for testing (biopsy).
- Remove a foreign object.
- Insert a stent. This helps urine flow from the kidneys to the bladder.
- Treat certain problems. The test can be used to remove stones or growths, help stop bleeding in the bladder, or remove a blockage.
- Inject a dye that is used for a special type of X-ray of the ureter and kidney.
How is cystoscopy done?
Before the test
The test is done in a hospital or the doctor's office.
You'll need to take off all or most of your clothes. You'll have a cloth or paper covering to use during the test.
If you are having this done in a hospital, you may get a sedative to help you relax about an hour before the test. An intravenous (I.V.) needle may be placed in your arm to give you other medicines and fluids.
You will lie on your back on a table. You may have your knees bent, legs apart. Your feet or thighs may be placed in stirrups. Your genital area is cleaned with an antiseptic solution. Your belly and thighs are covered with sterile cloths.
For this test, you will have one of three kinds of anesthesia.
- Local anesthetic. This anesthetic is inserted in your urethra.
- General anesthetic. You are put to sleep either with medicine through an IV or with gases inhaled through a mask. Sometimes both methods are used.
- Spinal anesthetic. The doctor or nurse first numbs the area on your back where the needle will be inserted. Then the needle is guided into the spinal canal and the anesthetic is injected. You may not be able to move your legs until the medicine wears off.
During the test
After the anesthetic takes effect, the cystoscope, or scope, is inserted into your urethra and moved into your bladder. If your urethra has a spot that is too narrow, other smaller tools are inserted first. They will gradually make it large enough for the scope.
Next, the doctor puts either sterile water or salt water (saline) into your bladder to make it larger and to create a clear view. The doctor may also put in medicine to reduce chances of infection.
The doctor can also insert tiny tools through the scope to collect tissue samples for biopsy. The tissue samples are sent to the lab to be checked.
After the test
If a local anesthetic is used, you may be able to get up right after the test. If a general anesthetic is used, you will stay in the recovery room until you are awake and able to walk. (This usually takes an hour or less.) You can eat and drink as soon as you are fully awake and can swallow without choking. If a spinal anesthetic was used, you will stay in the recovery room until feeling in your legs has returned. (This usually takes about an hour.)
How do you prepare for a cystoscopy?
Tell your doctor if you:
- Are allergic to any medicines, including anesthetics.
- Take a blood thinner, or if you have had bleeding problems.
- Are or might be pregnant.
The anesthesia used for this test may be local, spinal, or general. So talk to your doctor about which method is best for you. Ask if you should plan on staying overnight in the hospital. If you won't be staying in the hospital, plan to have someone drive you home after the test.
Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, use only a sip of water.
Empty your bladder just before the test. You may get medicine to prevent a urinary tract infection that could be caused by the test.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean.
What do the results of a cystoscopy mean?
Your doctor may be able to talk to you about some of the results right after the test. The results of a biopsy usually take several days.
Normal:
- The urethra, bladder, and openings to the ureters are normal.
- There are no polyps or other abnormal growths, swelling, bleeding, narrow areas (strictures), or structural problems.
Abnormal:
- There is narrowing of the urethra because of previous infections or an enlarged prostate gland.
- There are bladder tumors (which may or may not be cancerous), polyps, ulcers, urinary stones, or inflammation of the bladder walls.
- Problems in the structure of the urinary tract present since birth (congenital) are seen.
- In a woman, pelvic organ prolapse is present.
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