Cystoscopy

Cystoscopy is the procedure by which the bladder is examined by using a cystoscope. The cystoscope is a narrow tube, which is akin to a telescope, which has a light as well as a tiny camera attached to it. This procedure is carried out either as an aid for performing surgery inside the urinary tract, also known as transurethral surgery, or to check if there are any abnormalities in the bladder.

Cystoscopy can be used to examine the following areas:

• The bladder where urine collects and is stored
• The urinary channel or urethra, including the prostate gland in men
• The two small tubes, or ureters, that carry urine made in the kidneys to the bladder

A urologist, or a urologic surgeon, carries out the cyctoscopy. It involves viewing the urinary tract from within. The urologist can thus detect if there are any abnormalities and perform the surgical procedures required.

Cystoscopy is used for the evaluation and diagnosis of the following conditions:

• Chronic pain in the pelvic region
• Overactive bladder or urinary incontinence
• Hematuria, or blood in the urine
• Interstitial cystitis
• A high frequency in urinary tract infections
• Cancer of the bladder
• Urinary stones or osteophytes
• Pain during urination
• Blockage of the urinary tract due to urinary stricture, tumors, polyps or enlarged prostate

Some of the abnormalities that can be seen via cystoscopy are:

• Ureterocele, or the prolapse of the lower part of the ureter into the bladder
• Fistula, or an abnormal passage
• Tumors
• Ectopic ureter, or an abnormality of its position
• Diverticula, or sacs in the urethra
• Trabeculation, or fibrous tissue

How is the cystoscopy procedure performed?

While procedures that are simple can be carried out in the doctor’s office, using just local anesthesia, however, most cystoscopy procedures are carried out in the operating room of a hospital as an outpatient. Various types of anesthetics are used to make the cystoscopy procedure as comfortable and pain free as possible.

During the cystoscopy, the cystoscope, which is half the size of the urethra in diameter, and which can either be rigid or flexible, is inserted slowly into the urethra until it reaches the bladder. The camera that is attached to the end of the cystoscope enables the physician to view the images on a screen. After examining the urethra, a sterile liquid is introduced, which can be saline or water, inside the bladder, which enables better viewing of the bladder wall.

Other instruments can be inserted through the cystoscope, allowing the physician to carry out various procedures like the removal of a tumor in the prostate or bladder, removal of stones or osteophytes, and cauterization, or stopping bleeding by applying a small charge of electricity.

The urologist may also use a ureteroscope in order to examine the ureters. This process, also referred to as ureteroscopy, is used for the diagnosis and treatment of urinary stones that occur higher up in the urinary tract. Usually general or regional anesthesia is used for this procedure.

The cystoscopy procedure can take just a few minutes or perhaps around 20 minutes to be performed. However, if the urologist needs to remove a tissue sample for biopsy or a stone, it can take a longer time. After completion of the cystoscopy procedure, all the fluid that had been inserted is drained out and a narrow, flexible tube, or catheter, is usually inserted into the bladder.

Are there any side effects that arise from the cystoscopy procedure?

Some of the side effects that follow a cystoscopy are a burning sensation while urinating and hematuria. However, these are generally mild and are resolved in a few hours or days. Patients can usually go home directly after a cystoscopy procedure if local anesthesia has been used. In case general or regional anesthesia has been used, the patient may require a period of recovery which can be from 1-4 hours.