A cystoscopy, or cystourethroscopy by its full name, is a procedure that allows your physician to get a detailed view of the inside of your bladder and urethra. This is so that any causes of bleeding, blocking or abnormalities of the bladder and its lining can be investigated.
The procedure typically takes less than 30 minutes and is performed using a device called a cystoscope. The cystoscope is inserted into the urethra and helps your doctor see inside to diagnose, treat and monitor conditions that affect the bladder and urethra. This includes bladder cancer, of which 2,567 cases were diagnosed in Nevada between 2000 and 2004.
Cystoscopy is similar for both males and females.
Why are cystoscopies done?
Your doctor may notice indications such as blood in the urine, incontinence, painful urination or an overactive bladder before performing a cystoscopy to investigate further. A cystoscopy may also be done to determine the causes of frequent urinary tract infections (UTI) or diagnose an enlarged prostate. Special tools can also be passed through the cystoscope to treat certain conditions such as removing small bladder tumors, removing bladder stones, or to take a biopsy.
Cystoscopy is most often performed on men and women who are on anticoagulation therapy, have visible signs of blood in the urine, have a family history of bladder cancer or have other factors related to an increased risk of cancer such as tobacco use.
Bladder cancer is the fourth most common type of cancer among men, and men are four times as likely as women to develop it. Around twice as many white men as black men are diagnosed with it, and the average age for diagnosis is 73.
Types of cystoscopy procedure
There are two types of cystoscopy, both of which are most commonly performed in-office under local anesthesia. However, in some cases, it may be performed in the hospital under either general or local anesthesia depending on the reason for the procedure.
A rigid cystoscope has the advantage of producing a clearer picture than the fiber optics bundle used in the flexible version. Rigid versions also have a greater flowrate of the sterilized water or saline solution which is used to fill the bladder to help the doctor see more clearly and increases visibility.
Rigid cystoscopes come in a larger variety of sizes than do flexible versions, with smaller sizes being used for diagnosis and larger ones typically being used for therapeutic procedures due to their increased flowrate and size. Rigid versions also enable a wider variety of tools to be used with them so that they are better for use in therapies such as the removal of small tumors, etc.
Flexible cystoscopes are smaller in size than their rigid counterparts, which enables greater patient comfort. They are also more easily used with the patient in the prone position, as opposed to rigid versions that require a less comfortable “frog-leg” position for insertion.
Flexible versions allow for easier viewing of the inside of the bladder due to the increased mobility of their movement. Because of this, they are most often used for in-office diagnostic procedures as opposed to more invasive therapies.
How to prepare for your cystoscopy procedure
Before having a cystoscopy done, your doctor may prescribe antibiotics to be taken before and after the treatment.
You will likely need to drink plenty of fluids to allow for urination immediately before the procedure, which must be performed on an empty bladder. Your specialist may also use a urine sample to test for UTI’s before the procedure to determine any need for antibiotics.
You also need to plan ahead if you will be receiving a sedative or general anesthetic so that you can arrange a ride home once the procedure is finished.
Cystoscopy recovery and side effects
Is cystoscopy painful? It can be, although once it is over you can usually resume your daily life without a problem. However, you may need to remain in the recovery room or anticipate the time necessary to allow medications to leave your system if general anesthesia or sedative is used.
There may be also side effects, such as:
- Burning or soreness in and around the urethra
- Discomfort during urination
- Traces of blood in the urine
- Frequent urge to urinate
These symptoms shouldn’t last longer than a day after the procedure. If they last longer than 48 hours or if you develop a fever, you need to let your doctor know as soon as possible.
Also, after the procedure, your doctor may recommend that you:
- Drink at least 32oz of water in the two hours following
- Ease the burning sensation using a warm bath
- Use a warm, damp washcloth over the urethral opening to ease discomfort
- Use an over-the-counter pain medication
You may also need to continue the use of an antibiotic for a couple of days to prevent infection.
Speak to our specialists about a cystoscopy
If you are experiencing painful urination, incontinence, overactive bladder, symptoms of a swollen prostate or UTI, you need to schedule an appointment with an Intermountain Health specialist to see if a cystoscopy may be necessary.
Doing this will help your doctor quickly and correctly diagnose and treat conditions that may be causing your symptoms. This is critical in the event of your conditions indicating the presence of polyps, tumors or cancer of the urethra or bladder.
The good news is that with early detection, bladder cancer has a high survival rate with a 5-year recovery rate of 77%, a 10-year recovery rate of 70% and a 15-year recovery rate of 65%.