Cystoscopy
A cystoscopy is a procedure to look directly inside the urethra and bladder using a thin, flexible or rigid instrument called a cystoscope. Common reasons to perform a cystoscopy include:
Evaluate blood in the urine (hematuria)— bladder tumors, stones, or inflammation.
Investigate urinary tract symptoms—frequency, urgency, painful urination, or difficulty emptying the bladder can be caused by bladder or urethral problems visible on cystoscopy.
Diagnose and monitor bladder cancer. Cystoscopy is the primary way to detect tumors and to follow patients after treatment for recurrence.
Assess recurrent urinary tract infections (UTIs). If infections are frequent or unusual, cystoscopy can reveal anatomic abnormalities, stones, or chronic inflammation.
Evaluate abnormal imaging or test results. If ultrasound, CT, or urine tests show suspicious findings, cystoscopy provides direct visualization and targeted biopsy if needed.
Remove small bladder stones or foreign bodies such as ureteral stents placed during ureteroscopy.
The procedure is usually done using lubricant for a flexible cystoscopy in the office. It may cause mild burning, urgency to urinate, or spotting of blood afterward. Rigid cystoscopy or procedures requiring biopsy or treatment may be done under general or regional anesthesia in the operating room.
A cystoscopy is oftentimes the only way to determine bladder pathology, specifically the presence or absence of a bladder tumor or cancer, urethral injury, presence of bladder stones or inflammation. Unfortunately there are no imaging studies or bladder tests that replace the cystoscopy. The direct examination of the bladder remains the gold standard for detecting bladder cancer and for doing any procedures in the bladder.
Common risks are temporary burning, blood in the urine, and urinary tract infection. Serious complications are uncommon.
There is very little preparation for a cystoscopy done in office. Most patients will not need to stop any medication, can eat and drink normally prior, and will be discarged immediately from the office.
Cystosocpy done in the operating room often requires other procedures such as a biopsy or removal of tumor, X-ray testing or ureteroscopy and removal of kidney stones. Anesthesia requires an evaluation and preoperative clearance. Most patients will need to adjust their medication around the procedure, specifically blood thinning medication. Your surgeon and scheduling team will help you determine what is necessary.
Most patients recover quickly. There is some burning with urination after the procedure that improves usually after an initial urination. You may be asked to take an antibiotic ad to rest on the day of the procedure. Other recommendations depend on other procedures that may be performed during the cystoscopy such as a ureteral stent removal.