Cystoscopy is a diagnostic procedure that uses a cystoscope, which is an endoscope especially designed for urological use to examine the bladder, lower urinary tract, urethra and prostate gland. It can also be used to collect urine samples, perform biopsies, diagnose prostate disease, control bleeding and remove small stones.
A cystoscopy is performed to examine the length of the urethra, the bladder neck, bladder lining as well as the center of the prostate in men. Cystoscopy may be prescribed for patients who have these following conditions:
A cystoscopy typically lasts less than two minutes. The cystoscope is passed through the urethra into the bladder after lidocaine jelly is used to numb the area. There may be some very minimal discomfort as the scope is inserted. Water is then trickled in to inflate the bladder which allows the urologist to examine the entire bladder wall.
During a cystoscopy the urologist may gather tissue samples, remove bladder stones or kidney stones, dilate a urethral stricture, cauterize regions of active bleeding or fulgurate patches of chronic cystitis. For a biopsy, special forceps are inserted through the working channel of the cystoscope to quickly obtain a tiny tissue sample.
After removal of the cystoscope, the urethra may be minimally sore, and patient should expect to feel a mild burning sensation while urinating for one to two days following the procedure. A small amount of blood is common with wiping soon after or even with urination. Antibiotics are prescribed to prevent infection. Discomfort after a cystoscopy should be minimal afterwards but it is helpful to drink plenty of water which keeps the urine dilute and less irritating. You may take over-the-counter, acetaminophen (Tylenol), ibruprofen (Advil), or Azo (found OTC at any pharmacy). Taking a warm bath or just holding a warm, damp washcloth over the area can be soothing. It is rare to have any discomfort or burning that lasts after the first day.
A successful cystoscopy includes a thorough examination of the bladder and collection of urine samples for cultures. If no abnormalities are seen, the results are indicated as normal. A normal cystoscopy means that the bladder wall appears smooth and the bladder is normal in size, shape, and position, without obstructions, growths, or stones.
The Urologist can tell the patient what was seen inside the bladder right after the procedure. If a biopsy sample was taken, it will take ten days to two weeks to be examined and the pathology results to be received.
Cystoscopy allows the urologist to detect inflammation of the bladder lining, prostatic enlargement, or tumors. If these are seen, further evaluation or biopsies may be needed. Cystoscopy with bladder distention can also evaluate for evidence of interstitial cystitis. Bladder stones, urethral strictures, diverticula, or congenital abnormalities can also be detected.
Blood and urine studies, in addition to x rays of the kidneys, ureters, and bladder, may be performed along with a cystoscopy to obtain as much diagnostic information as possible.
There are imaging studies that can provide some information about the lining of the bladder, however, none of these provide as much information as direct visualization by cystoscopy.