Cystoscopy

How the Test is Performed

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

• Standard, rigid cystoscope
• Flexible cystoscope

The way the cystoscope is inserted varies, but the test is the same. Which cystoscope your health care provider uses depends on the purpose of the exam.

The procedure usually takes 5 - 20 minutes. The urethra is cleansed. A numbing medicine is applied to the skin lining the inside of the urethra, without using any needles. The scope is then inserted through the urethra into the bladder.

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

As fluid fills the bladder, it stretches the bladder wall. This lets your health care 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 cystoscope and sent to a lab to be tested.

How to Prepare for the Test

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

If the procedure is performed in a hospital or surgery center, make arrangements for someone to take you home afterward.

How the Test Will Feel

You may feel slight discomfort when the cystoscope 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 cystoscope 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

• Check for cancer of the bladder or urethra
• Diagnose and evaluate urinary tract disorders
• Diagnose 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

• Bladder stones (calculi)
• Bladder wall decompression
• Chronic urethritis
• Congenital (present at birth) abnormality
• Cysts
• Diverticula
• Irritable bladder
• Polyps
• Prostate problems:
  • Bleeding prostate
  • Enlarged prostate
  • Obstructed prostate
• Traumatic injury of the bladder and urethra
• Tumors
• Ulcer
• Urethral strictures

Risks

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

Other risks include:

• Bladder infection
• Rupture of the bladder wall

Considerations

Drink 4 - 6 glasses of water per day after your cystoscopy.

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 health care provider.

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

• Chills
• Fever
• Pain
• Reduced urine output

Alternative Names

Cystourethroscopy; Endoscopy of the bladder

References

Duffey B, Monga M. Principles of endoscopy. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 8.

Coburn M. Urologic surgery. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 73.

Update Date: 6/18/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.