Cystoscopy

What is cystoscopy?

Cystoscopy is a procedure healthcare providers use to view the inside of your bladder and urethra (the tube that drains pee from your bladder out of your body). A urologist performs it with a lighted device with a camera or viewing lens (cystoscope).

Urologists use cystoscopies to diagnose and treat urinary tract problems. They can use it to rule out serious conditions, like bladder cancer, as a cause of your symptoms. Your urologist may also use a cystoscope to:

• Get urine samples from your ureters (the tubes that carry pee from your kidneys to your bladder).
• Inject dye for procedures that track urine flow.
• Inject medication to stop leaking pee.
• Remove a ureteral stent (a tiny tube that holds open your ureter) placed during an earlier procedure.
• Remove bladder stones, abnormal tissue, polyps or tumors.
• Take small pieces of bladder or urethral tissue for biopsy (examination in a lab).
• Treat urethral strictures or fistulas (holes that form between two areas).

What is cystoscopy used to diagnose?

A cystoscopy can diagnose:

• Bladder or urethral cancer.
• Bladder stones.
• Bladder control problems (urinary incontinence/leaking pee).
• Enlarged prostate (benign prostatic hyperplasia/BPH).
• Interstitial cystitis/bladder pain syndrome (ICS/BPS).
• Urethral strictures and urinary fistulas.
• Urinary tract infections (UTIs).

Why do healthcare providers perform cystoscopies?

Your healthcare provider may recommend a cystoscopy if you’re experiencing:

• Bladder control issues, such as urinary retention (being unable to empty your bladder all the way) or incontinence.
• Bladder stones.
• Blood in your pee (hematuria).
• Painful urination (dysuria).

How does cystoscopy work?

To perform a cystoscopy, a urologist will insert a cystoscope into your urethra and up to your bladder. There, they can look inside your bladder and use instruments to remove samples of tissue, or perform other tests or treatments.

What are the types of cystoscopes?

There are two types of cystoscopes:

• Flexible cystoscope: Your provider may use a bendable scope to gently follow the natural path of your urethra and examine the inside of your bladder and urethra.
• Rigid cystoscope: These cystoscopes don’t bend. Your provider may pass instruments through the tube to perform biopsies or remove tumors. This cystoscope is usually only used with sedation or general anesthesia.

Your healthcare provider will use the one that works best for your specific procedure.

Are you awake during a cystoscopy?

If your provider is performing the procedure to help them diagnose an issue, yes, you’ll likely be awake during cystoscopy. They’ll use a numbing gel so you don’t feel pain. If you’re getting treatment or if your provider is performing a biopsy during cystoscopy, you may need sedation or general anesthesia.

How should I prepare for a cystoscopy?

Before cystoscopy, tell your provider about any medications you’re taking and if you might be pregnant. Your provider will give you instructions on how to prepare. Following their directions closely can reduce your risk of complications.

Your preparation will mostly depend on the anesthesia type and why you’re having the procedure. Before a cystoscopy, your provider may ask you to:

• Give a sample of pee on the day of the procedure to check for a UTI. If you have an infection, you’ll likely need treatment before you can get a cystoscopy.
• Not eat anything for eight hours before the procedure (fast). This is usually only if you’ll be under general anesthesia.
• Stop taking medications before the procedure or take them with just a sip of water. Don’t stop taking medications unless your provider tells you to.
• Make arrangements for someone to drive you home after the cystoscopy if you’ll be sedated during the procedure.

What should I expect during a cystoscopy?

To perform a cystoscopy, a healthcare provider will:

1. Ask you to pee right before the procedure.
2. Put you under general anesthesia or sedation (in some cases).
3. Numb your urethra with gel.
4. Slide a lubricated cystoscope through your urethra to your bladder.
5. Inject sterile salt water through the cystoscope into your bladder. A stretched, full bladder makes it easier to see the bladder lining. You’ll probably feel like you need to pee.
6. Look at the inside of your bladder and urethra.
7. Insert small instruments through the cystoscope (in some cases). Your provider uses these tools to remove tissue samples or tumors, if needed.
8. Drain the injected liquid from your bladder or ask you to empty your bladder in the bathroom.

How long does a cystoscopy take?

A diagnostic cystoscopy usually takes about five to 10 minutes. The procedure may take longer if you’re having a biopsy or treatment.

Is cystoscopy painful?

A cystoscopy may feel uncomfortable, or you might feel like you need to pee. But general anesthesia or a numbing gel keeps you from feeling pain.

What should I expect after a cystoscopy?

Depending on the reason for the cystoscopy, you may have an outpatient procedure (go home the same day) or stay overnight in the hospital. When you go home, your provider may prescribe antibiotics to prevent infection. Take any medications as prescribed.

How long does it take to fully recover from a cystoscopy?

Most people recover within a day or two from a cystoscopy. It may take longer depending on whether you had additional procedures at the same time (like a biopsy). Ask your provider what to expect.

You may have belly pain, blood-tinged pee or pain and/or burning when peeing for the first day or two after the procedure. You might also feel like you need to pee often and urgently.

To ease these symptoms, you can:

• Apply a warm, damp washcloth over the urethral opening or relax in a warm bath.
• Drink several glasses of water every day to flush out your bladder.
• Take an over-the-counter (OTC) pain reliever, such as nonsteroidal anti-inflammatory drugs (NSAIDs).

What are the potential risks or complications of a cystoscopy?

A cystoscopy is a relatively low-risk procedure. Potential complications include:

• Infection (UTI).
• Bladder spasms. These can cause painful cramps and leaking pee.
• Damage to your bladder.
• Damage to your urethra, like scarring or narrowing.

What type of results do you get after cystoscopy?

Your urologist will make notes about anything they notice during the procedure. This includes blockages, narrowing of your urethra, bladder stones, abnormal tissue or growths. They’ll also note if everything looks normal. They might talk to you about the results soon after the procedure or schedule a follow-up appointment to talk about them.

If your provider took samples of tissue for biopsy, a lab will look at them under a microscope for cancerous cells.

When should I know the results of cystoscopy?

If you had a biopsy, it may take up to two weeks for your provider to get the results. If your provider is only doing a cystoscopy (no other procedures at the same time), they’ll know the results as they perform the procedure. Ask your provider when you should expect to see your results in your records or to hear from them.

When should I call my healthcare provider?

Most post-procedure problems like painful urination and blood-tinged pee get better within a day or two. Call your healthcare provider if problems last longer or you experience:

• Severe pain when you pee.
• Significant amounts of blood or blood clots in your pee.
• Painfully full bladder and inability to pee.
• Signs of infection (fever, pelvic pain, strong-smelling or cloudy pee).