How does a patient prepare for a cystoscopy?

Before the procedure is recommended, the urologist will ask about the patient’s medical history, current prescription and over-the-counter medications, and allergies to medications, including anesthetics. The urologist will explain what the patient can expect after the procedure.

The patient may need to give a urine sample to test for a urinary tract infection (UTI). If the patient has a UTI, the urologist may treat the infection with antibiotics before performing a cystoscopy.

The urologist or nurse may ask the patient to drink plenty of liquids, and to urinate immediately before the procedure.

What happens during a cystoscopy procedure?

The cystoscopy procedure usually takes about 30 minutes and is done on an outpatient basis. The urologist will recommend that the patient empty his or her bladder before the procedure begins. The step-by-step process may be similar to this:

  1. The patient will be lying on an exam table. The urologist may place some gel or a local anesthetic in the patient’s urethra to aid in reducing any discomfort while the procedure is taking place.
  2. The urologist will gently insert the cystoscope through the urethra into the bladder. The patient may feel discomfort or a pressure sensation. The cystoscope is a long, thin tube with a lens on one end that the urologist looks through or, on a camera-equipped scope, visualizes on a monitor. The other end of the cystoscope that is inserted into the urethra has a tiny lens with a light that allows the urologist to look inside the urethra and bladder. There are two types of cystoscopes. One has a flexible insertion tube, while the other is stiff.
  3. Once the cystoscope is inserted, the urologist will need to instill some sterile water or a normal saline solution from the cystoscope into the bladder. The water/saline fills and stretches the bladder so the urologist can get a better view of the bladder wall.
  4. As the liquid enters the bladder, the patient may again feel some discomfort as well as the urge to urinate. If necessary, the urologist can remove some of the liquid from the bladder during the procedure. Once the procedure is over, the urologist may drain the patient’s bladder, or ask the patient to use the bathroom to urinate before he or she leaves the office.

During the brief procedure, the urologist examines the lining of the urethra as the cystoscope passes through it and then into the bladder. Once the cystoscope reaches the bladder, the urologist examines the lining of the bladder. During the procedure, the urologist can remove a bladder stone or take a biopsy if needed.

Sometimes a monitor is set up in the doctor’s office so that both the urologist and patient can watch the procedure as it is taking place.

What does the urologist look for during a cystoscopy?

The urologist will be looking for anything that appears unusual. The bladder wall should be smooth, and there should not be any blockages in the lower urinary tract. During a cystoscopy, the urologist is able to see:

  • Bladder stones: A small stone-like mass that forms from minerals in the urine. It usually forms when urine does not completely leave the bladder and the minerals in the urine crystallize. If not treated, they can cause pain and lead to blood in the urine. A stone can also cause a blockage so that urine cannot leave the bladder.
  • Abnormal tissue, polyps, tumors, or cancer in the urethra or bladder
  • Stricture, or a narrowing of the urethra: This could be a symptom of an enlarged prostate in men or of scar tissue in the urethra.

During the cystoscopy, can the urologist treat some problems?

During a cystoscopy, the urologist may be able to treat minor problems such as bleeding in the bladder or blockage in the urethra. The urologist may also use a cystoscopy to:

  • Remove a small stone in the bladder or urethra.
  • Remove or treat abnormal tissue, polyps, and certain tumors.
  • Inject medication into the urethra wall or the bladder to treat urinary leakage.

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