Definition of Cystoscopy

Cystoscopy: A procedure in which the doctor inserts a lighted instrument called a cystoscope into the urethra (the tube that carries urine from the bladder to the outside of the body) in order to look inside the urethra and bladder.

The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers (flexible glass fibers) that carry an image from the tip of the instrument to a viewing piece at the other end. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems.

Cystoscopy may be done for any one of a number of reasons including frequent urinary tract infections; blood in the urine (hematuria); loss of bladder control (incontinence) or an overactive bladder; unusual cells that have been found in urine sample; the need for a bladder catheter; painful urination, chronic pelvic pain, or interstitial cystitis; urinary blockage such as prostate enlargement, stricture, or narrowing of the urinary tract; an unusual growth, polyp, tumor, or cancer: and a stone in the urinary tract.

If a stone is lodged higher in the urinary tract, the doctor may extend the cystoscope through the bladder and up into the ureter. (The ureter is the tube that carries urine from the kidney to the bladder.) When used to view the ureters, the cystoscope is called a ureteroscope. The doctor can then see the stone and remove it with a small basket at the end of a wire inserted through an extra tube in the ureteroscope. The doctor may also use the extra tube in the cystoscope to extend a flexible fiber that carries a laser beam to break the stone into smaller pieces that can then pass out of the body in the urine. Ureteroscopy may be done under a spinal or general anesthetic.

For cystoscopy, the doctor gently inserts the tip of the cystoscope into the urethra and slowly glide it up into the bladder. Relaxing the pelvic muscles helps make this part of the test easier. A sterile liquid (water or saline) will flow through the cystoscope to slowly fill the bladder and stretch it so that the doctor has a better view of the bladder wall. As the bladder reaches capacity, the patient feels some discomfort and the urge to urinate. (You will be able to empty your bladder as soon as the examination is over.) The time from insertion of the cystoscope to removal may be only a few minutes, or it may be longer if the doctor finds a stone and decides to remove it. Taking a biopsy will also make the procedure last longer. In most cases, the entire examination, including preparation, will take about 15 to 20 minutes.

After the test, there may be a mild burning feeling on urination and there may also be small amounts of blood in the urine. These problems should not last more than 24 hours. Tell your doctor if bleeding or pain is severe or if problems last more than a couple of days. To relieve discomfort, drink two 8-ounce glasses of water each hour for 2 hours. Ask your doctor if you can take a warm bath to relieve the burning feeling. If not, you may be able to hold a warm, damp washcloth over the urethral opening. Your doctor may give you an antibiotic to take for 1 or 2 days to prevent an infection. If you have signs of infection--including pain, chills, or fever -- call your doctor.