Cystoscopy

What is a cystoscopy?

Cystoscopy is a procedure to examine the inside of the urethra and the bladder. The doctor uses a cystoscope during the examination. A cystoscope is a thin, long optical instrument with a light and lens attached at the end of it. The cystoscope projects the magnified images of the inner lining of the urethra and the bladder on the screen.

The cystoscope is gently passed through the urethra towards the bladder. Cystoscopy is used to diagnose and treat different problems of the urinary tract system.

Types of cystoscopies

There are two kinds of cystoscopies:

Rigid cystoscopy

Rigid cystoscopes do not bend. Surgeons use this cystoscope to view the inner lining of the bladder and the urethra. It helps in biopsies and other procedures.

Rigid cystoscopy helps to:

• Crush and remove bladder stones.
• Remove tumors.
• Repair bleeding blood vessels.
• Remove obstructions.
• Treat excessive bleeding.

Rigid cystoscopy can be uncomfortable especially in men. Doctors administer spinal anesthesia or general anesthesia during this procedure.

Flexible cystoscopy

In a flexible cystoscopy, the cystoscope is thin and flexible. It has a light and a camera attached to it and helps to project images on the screen. Since it is flexible and thin, it can easily pass through the urethra. It helps to diagnose a problem and also decide if the previous treatment was successful.

Preparation for cystoscopy

Depending on the type of cystoscopy, the doctor may suggest an outpatient procedure or ask the patient to stay the night in the hospital. Preparation also depends on the type of anesthesia.

• In rigid cystoscopy, a general or spinal anesthetic is used. So, there will be eating and drinking restrictions before the surgery.
• Give your urine sample to detect UTIs. In case of an infection, treatment is needed before a cystoscopy.
• Empty your bladder before the cystoscopy.
• Give a list of your medications, vitamins, and other supplements that you are taking.
• You have to stop taking certain medications like blood thinners or anticoagulants.
• Patients who are pregnant must inform their doctors.

Procedure

Flexible cystoscopies are diagnostic procedures and usually take 5 minutes. Rigid cystoscopy is mainly done for diagnostic and treatment purposes. It will take longer.

The procedure:

• Empty the bladder.
• Lie down comfortably with your feet placed on the stirrups and knees bent.
• In rigid cystoscopy, the doctor uses spinal or general anesthesia. You will be under sedation. In a flexible cystoscopy, an anesthetic gel is used to numb the area.
• The cystoscope inserts a sterile solution into the bladder. It inflates the bladder and helps the doctor to look inside. At this time, you may feel an increased urge to urinate.
• The lubricated cystoscope is gently inserted. The magnifying lens attached to the cystoscope sends images of the inner lining of the urethra and the bladder. The cystoscope projects the images on the video screen.
• The cystoscope helps to insert other instruments to collect tissue samples or remove tumors.
• After the procedure, the doctor drains the liquid. You can also go to the restroom and empty the bladder.

What happens after a cystoscopy?

After the procedure, patients must rest in the recovery room for some time until the effects of anesthesia or sedation wear off. After recovery, patients can go home. It is normal to feel some discomfort and pain after a cystoscopy. You will feel like urinating more often. This goes away within the first two days. Other symptoms include:

• Light bleeding from the urethra.
• You may notice some blood in the urine or the toilet paper.
• Burning sensation while urinating.

For biopsy tests, the doctor sends tissue samples to the laboratory for testing. The doctor will reach you once the results come back.

Is cystoscopy painful?

No, cystoscopy is not painful. You may feel some pain when the anesthetic injection is pushed. Some patients may feel a slight pinch during sample collection for biopsy. Other than that, patients will feel nothing during the procedure.

When will you get your biopsy results?

It generally takes one to two weeks to get the biopsy results. If it delays, you can contact the doctor for your test results.

Rigid versus flexible cystoscopy

A flexible cystoscopy is mainly done to diagnose the problem. It is not recommended for treatments. It takes less time to perform. The cystoscope is more flexible and allows the doctor to view it more easily. A local anesthetic is applied. The patient is awake during the procedure and aware of his/her surroundings. She/he can also see the images of cystoscopy projected on the screen. Since there is no general or spinal anesthesia, there is no need to fast before the surgery. They can go home after some rest. Some patients, however, have to come back for a rigid cystoscopy for treatment.

A rigid cystoscopy is more invasive and is performed mainly to treat the problem. It requires general or spinal anesthesia. There are eating and drinking restrictions. Patients must rest for a while before going home. Patients must ask someone to drive them home after the procedure.

When should you go for a cystoscopy?

Your doctor can ask you to do a cystoscopy if you are experiencing:

• Hematuria or blood in the urine.
• Bladder incontinence.
• Overactive bladder.
• Frequent UTIs (urinary tract infections).
• Cystitis (bladder inflammation).
• Dysuria (pain during urination).
• Bladder stones.

Reasons to perform a cystoscopy

Urologists perform cystoscopies to diagnose and treat several medical conditions.

Cystoscopy diagnoses and detects:

• Urethral cancer.
• Bladder cancer.
• Benign prostatic hyperplasia.
• Urinary fistulas.
• Urinary tract infections.
• Urinary incontinence.
• Urethral strictures.
• Bladder stones.
• Painful urination.
• Pelvic pain.
• Bladder tumors.
• Blockages.
• Noncancerous growths.

Cystoscopy treatments:

• Collect urine samples.
• Uses a dye to check the urine flow.
• Inject medicines to prevent urine leakages.
• Removing ureteral stents placed during a previous procedure.
• Collect sample tissues from the urethra and bladder for biopsy.
• Treat urethral strictures.
• Remove tumors or polyps.
• Remove bladder stones.
• Treat fistulas.

Surgery options

Cystoscopy is an outpatient procedure. Typically, there is no need for patients to stay in the hospital. A flexible cystoscopy that is done mainly for diagnostic purposes may take only five to 10 minutes. Rigid cystoscopies may take a longer time to perform. Some patients have to stay overnight in the hospital for observation or due to some complications. Your healthcare provider may decide to have the cystoscopy in an outpatient facility or a hospital.

Small clinics

Pros

• Outpatient surgeries in small clinics are less stressful.
• Low cost of services.
• Convenient services.
• Predictable scheduling.
• Reduces overnight costs of staying in a hospital.
• One-to-one services.

Cons

• There may be issues of cleanliness or safety.
• Less accessibility to emergency care services.
• Low success rates.

Big hospitals

Pros

• Proper infrastructure to handle critical patients.
• A big pool of healthcare providers.
• Varied equipment.
• Multiple specialties.
• Tie-ups with insurance companies.
• High success rates.

Cons

• High cost of surgery.
• Long waiting time.
• Lack of personalized care.

Cost of surgery

The cost of cystoscopy depends on various factors:

• The outpatient facility or hospital where the procedure is done.
• The type of procedure.
• Condition of the patient.
• The overall health of the patient. Elderly patients may need to stay in the hospital for observation.
• Whether the patient has insurance coverage.
• Fees for hospital staff.
• Consultation fees of the surgeon and the surgical team.
• Charges for instruments used in the procedure.
• Post-operative care.

Post-op care and things to keep in mind

Follow the instructions regarding post-operative care.

Once you go home:

• Drink enough water to flush out the irritants from the bladder. Doctors recommend 16 ounces of water during the first 2 hours post-surgery.
• Take warm baths to relieve pain and burning sensation. Ask the doctor if you are permitted to take baths.
• Apply a damp warm cloth on the urethral opening to ease discomfort.
• Take your medications.
• Ask your doctor for follow-up visits.

Cystoscopy complications

Some people develop complications like:

• Urethritis or swollen urethra.
• Urinary tract infections.
• Foul-smelling urine.
• Excessive bleeding.
• Abdominal pain.
• Pain during urination.
• Bladder or urethral injuries.
• Anesthesia complications.
• Hyponatremia (abnormally low levels of sodium in the body).
• Bladder damage.

When to call a doctor?

• Urinary retention. Inability to completely empty the bladder.
• Severe pain in the urethra.
• Serious bleeding.
• High fever and chills.
• Urethral scarring.
• Spasms and cramps.
• Urinating less than normal.
• Pelvic pain.
• Cloudy urine.

Best option

A cystoscopy surgery is normally done in an outpatient surgical center. It is less invasive and patients can go home the same day of the procedure. Though it is a safe procedure, there might be complications. The success of a surgery or procedure depends on various factors like the general health of the patient, medical condition, etc. It also depends on the surgical management of the disease and the skill of the surgeon. At goficure, our team of medical advisors provides all details regarding hospital consultation, cost of surgery, hospital stay, complications, and post-operative care. Goficure helps patients to find the best hospitals, surgeons, and doctors in the city.

Why choose goficure?

• Priority treatment for patients.
• Safety and confidentiality.
• Affordable charges.
• Transparent payments.
• Medical insurance.
• Transportation facilities.
• Specialist doctors and surgeons.
• Trustworthy diagnosis and treatment.
• High success rates.
• Fast service.

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