Cystoscopy

Cystoscopy is a surgical procedure. This is performed to see the inside of the bladder and urethra using a telescope.

Alternative Names

Cystourethroscopy; Endoscopy of the bladder

How the Test is Performed

Cystoscopy is performed with a cystoscope. Cystoscope is a special tube with a small camera on the end (endoscope). There are two types of cystoscopes:

Standard, rigid cystoscope
Flexible cystoscope

The tube can be inserted in different ways. However, the test is the same. Which cystoscope your health care provider uses depends on the purpose of the exam.

The procedure will take about take 5 to 20 minutes. The urethra is cleansed. A numbing medicine is applied to the skin lining the inside of the urethra. This is done without needles. The scope is then inserted through the urethra into the bladder.

Water or salt water (saline) flows through the tube to fill the bladder. As this occurs, you may be asked to describe the feeling. Your answer will give some information about your condition.

As fluid fills the bladder, it stretches the bladder wall. This lets your provider see the entire bladder wall. You will feel the need to urinate when the bladder is full. However, the bladder must stay full until the exam is finished.

If any tissue looks abnormal, a small sample can be taken (biopsy) through the tube. This sample will be sent to a lab to be tested.

Open Article Detail

How to Prepare for the Test

Ask your provider if you should stop taking any medicines that could thin your blood.

The procedure may be done in a hospital or surgery center. In that case, you will need to have someone take you home afterward.

How the Test will Feel

You may feel slight discomfort when the tube is passed through the urethra into the bladder. You will feel an uncomfortable, strong need to urinate when your bladder is full.

You may feel a quick pinch if a biopsy is taken. After the tube is removed, the urethra may be sore. You may have blood in the urine and a burning sensation during urination for a day or two.

Why the Test is Performed

The test is done to:

Check for cancer of the bladder or urethra
Diagnose the cause of blood in the urine
Diagnose the cause of problems passing urine
Diagnose the cause of repeated bladder infections
Help determine the cause of pain during urination

Normal Results

The bladder wall should look smooth. The bladder should be of normal size, shape, and position. There should be no blockages, growths, or stones.

What Abnormal Results Mean

The abnormal results could indicate:

Bladder cancer
Bladder stones (calculi)
Bladder wall decompression
Chronic urethritis
Congenital (present at birth) abnormality
Cysts
Diverticula

Some other possible diagnoses may be:

Irritable bladder
Polyps
Prostate problems, such as bleeding, enlargement, or blockage
Traumatic injury of the bladder and urethra
Ulcer
Urethral strictures

Risks

There is a slight risk for excess bleeding when a biopsy is taken.

Other risks include:

Bladder infection
Rupture of the bladder wall

Considerations

Drink 4 to 6 glasses of water per day after the procedure.

You may notice a small amount of blood in your urine after this procedure. If the bleeding continues after you urinate 3 times, contact your provider.

Contact your provider if you develop any of these signs of infection:

Chills
Fever
Pain
Reduced urine output

References

Duty BD, Conlin MJ. Principles of urologic endoscopy. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 7.

National Institute of Diabetes and Digestive and Kidney Diseases. Cystoscopy and ureteroscopy. www.niddk.nih.gov/health-information/health-topics/diagnostic-tests/cystoscopy-ureteroscopy/Pages/default.aspx. Accessed June 14, 2016.

Smith TG, Coburn M. Urologic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 73.