What is a cystoscopy?
The term cystoscopy comes from the Greek ‘cysto’ for bladder and ‘scopy’ meaning to look. A flexible cystoscopy is an examination of the inside of the bladder and the urethra (waterpipe) using a fine flexible telescope with a light and a tiny camera in the end. This examination is carried out by a urology doctor.
Why do I need a cystoscopy?
A cystoscopy is useful for finding out what is causing symptoms
such as blood in the urine, difficulties passing urine and as a check-up for certain bladder conditions. It allows the doctor to inspect the bladder lining very closely for abnormal growths, ulcers or stones. During the procedure, the doctor may also take a biopsy (a small sample of the lining of the bladder) for examination in the laboratory.
The urinary system (‘waterworks’) explained
The bladder is a muscular bag which, when full, is about the size of a grapefruit. It stores urine which travels down the ureters (tubes that connect the kidneys and bladder) from the kidneys. When the time comes to pass water, the muscle wall squeezes the urine out into the waterpipe or urethra.
In women, the urethra is only about an inch long. In men it is much longer and follows an S-shaped course from the bladder outlet, where it passes through the prostate gland, and down to the end of the penis. Both men and women have muscular glands called sphincters which control the flow of urine. A woman’s sphincter muscle lies around most of her short urethra, while in the man the main sphincter is just below the prostate gland.
Benefits of flexible cystoscopy?
The main benefits of a flexible cystoscopy are that it is quick, relatively painless and does not require a general anaesthetic. The doctor should be able to discuss the results with you straight after the procedure.
Are there any alternatives?
Not really. Your doctor will already have explained why the examination is necessary. X-rays and urine tests may not always give enough information for the doctor to make a proper diagnosis of your condition.
How do I prepare for my flexible cystoscopy?
No special preparation is needed. On the day of the investigation you can eat and drink as normal and take any medication you would usually take. After the cystoscopy you can leave under your own steam, there is no need to rest afterwards. Flexible cystoscopy is usually performed as an outpatient appointment or day case whilst you are awake.
On arrival you may be asked to first provide a urine sample. You will need to lie on your back on a bed. The opening to your urethra (at the end of the penis or entrance to the vagina) will be cleansed with a sterile solution. A lubricating gel will be squirted into the urethra to lubricate it, making it more comfortable to pass the cystoscope into the bladder.
Men may be asked to try and pass urine or cough when the flexible cystoscope reaches the sphincter below the prostate gland. This relaxes the sphincter and allows the cystoscope to pass through. This may cause a brief stinging sensation. When the telescope is in place, sterile fluid is run into the bladder to fully inflate it so that the doctor can do a thorough inspection of the bladder lining.
The procedure takes only about 5 minutes, although it will be slightly longer if a biopsy is taken from the bladder lining. The cystoscope is gently removed and you are able to get dressed. You may feel the need to pass urine as your bladder will be full of water and you will be able to do this straight away.
You will be told the result and any follow up plans. A copy of the results will also be sent to your GP.
Most cystoscopies are done without any problems. For the next 24 hours you may have a mild burning feeling when passing urine and you may need to go more often than usual. The urine may also look pink due to mild bleeding, especially if a biopsy has been taken. This should resolve itself within 48 hours.
You are advised to drink at least two litres (approximately three pints) of fluid per day for the next two days.
Occasionally, a urine infection can develop. The symptoms of this would be persistent pain on passing urine, cloudy or smelly urine and often a fever (high temperature). If you have any of these symptoms please contact your GP.
01935 384 564