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What is a cystoscopy?

Patients come into our office presenting a variety of symptoms and sometimes, in addition to a physical exam, we need to perform further procedures to help us identify which urological condition(s) we are seeing. One of these procedures is called a cystoscopy, and it can help our doctors provide an accurate diagnosis of the issue.

A cystoscopy helps doctors to view the insides of a patient’s urinary tract — specifically within the urethra and the bladder. This procedure, which is sometimes referred to as a cystourethroscopy, can help diagnose any conditions that may be causing the following symptoms:

  • Painful urination
  • Difficulty urinating
  • Blood in the urine
  • Incontinence
  • Frequent urinary tract infections (UTIs)
  • Pelvic pain or pressure

A cystoscopy can help doctors determine whether the patient is suffering from an infection, a bladder disease, an enlarged prostate, bladder stones, or another type of blockage in the urinary tract. Doctors can also look for any “red flags” that could mean a cancerous growth, which would be confirmed with additional testing.

During the procedure, the doctor inserts a cystoscope into the tip of the patient’s penis and through the urethra. This thin tube has a lighted camera on the end, allowing the doctor to see the lining of the urethra. The cystoscope is then guided into the bladder, so the doctor can view the bladder lining. Water or a saline solution may also be circulated into the bladder in order to expand the bladder wall.

Sometimes, images from the cystoscope camera are projected onto a screen during the procedure, so the doctor is able to see the urinary tract in real time. In a healthy bladder, the lining will be smooth and there will be no visible bulges or blockages.

What should I expect during a cystoscopy?

The entire cystoscopy procedure, which takes anywhere from 1 to 5 minutes, is performed in our office. Sometimes we can determine a diagnosis immediately, and others will need to have additional lab work done and have results presented at a follow-up appointment.

Prior to the cystoscopy appointment, we will ask you to refrain from emptying your bladder, so that we can collect a urine sample immediately before the procedure. This sample allows us to check for any existing infections.

We will use local anesthesia on your urethra, so you will be awake during the procedure and can eat and drink normally before your appointment.  You may be offered an oral sedative which you should take at least 30 minutes prior to your appointment.  If we need to use general anesthesia — which means you will be unconscious during the cystoscopy — we will let you know in advance as you may need to fast beforehand and schedule time in an operating room.

You may experience slight discomfort during the procedure and you may feel an urgent need to urinate.  This is normal and expected.

The doctor may prescribe an antibiotic to prevent infection before or after the cystoscopy. Someone will need to accompany you to the cystoscopy appointment, as we do not allow patients to drive themselves home after the procedure if they have taken a sedative.  If you did not, you may drive home on your own.

What is the recovery time?

After the procedure, most patients find that they need to take it easy for the rest of the day, and may need to refrain from exercise or sexual intercourse for a couple of days due to mild soreness in the urethra. As this is not a surgery, your desired level of physical activity is more about your comfort than anything else, and we typically tell patients to resume work, exercise, and sex when they feel up to it.

You will need to increase your water intake for the first several hours after the procedure to help flush out the bladder and keep the flow of urine moving.

The most common side effects from the procedure are below and typically clear up within a day or two

  • Burning sensation while urinating
  • Blood in the urine, or pink-colored urine
  • Frequent urination

It is important to urinate when you feel the urge, as attempting to hold it in could cause a blood clot. Applying a heated compress — like a warm washcloth — over the urethra several times a day can help with soreness.

It is rare that patients develop more serious complications from a cystoscopy, but occasionally, further complications may occur, including:

  • Urethritis, or swelling of the urethra, can stop the flow of urine. If you have not urinated for over 8 hours, notify the doctor.
  • Continued bleeding. Normal amounts of blood will cause urine to have a pinkish tinge, but if bleeding is heavy, the consistency of the blood is thick, or bleeding continues past three days post-procedure, notify the doctor.
  • Infection, including a UTI. This is not usually an issue since antibiotics are prescribed, but if you notice sudden back pain, fever, nausea, or a foul smell when you urinate, contact the doctor.

Cystoscopy is an extremely common procedure in our office. We use first-rate cystoscopy devices and medical imaging equipment to view the urinary tract clearly and in great detail. If you are suffering from issues like frequent bladder infections, incontinence, or an enlarged prostate gland, we may suggest a cystoscopy procedure to get a better look and provide an accurate diagnosis so we can treat the problem effectively.