Patient education: Cystoscopy (The Basics)

What is a cystoscopy? — A cystoscopy is a procedure that lets a doctor see inside your bladder and urethra. The urethra is the tube that transports urine out of your bladder (figure 1). During cystoscopy, a doctor puts a thin tube with a tiny camera on the end into the urethra and moves it up into the bladder (figure 2). The tube is called a "cystoscope."

Your doctor might want you to get a cystoscopy for many reasons. Examples include:

●To check for a blockage in your bladder or urethra – This can be caused by scar tissue, a kidney stone, or a tumor.

●To check for the cause of frequent urinary tract infections ("UTIs")

●To check for the cause of blood in your urine

●To take a tissue sample from your bladder – A doctor can then check the sample for signs of a problem, such as cancer. This is called a "biopsy."

●Before you have certain types of surgery, such as a hysterectomy

●To check for problems with your prostate, if you have one

How do I prepare for a cystoscopy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. Usually, you don't need any tests before a cystoscopy. But if you have a high risk of UTIs, your doctor might do a urine test to check for signs of infection. If you already have a UTI, your doctor will wait for it to go away before doing a cystoscopy. In some cases, you might get an antibiotic medicine before your procedure to help prevent infection.

You will also get information about:

●Fasting – This means not eating or drinking anything for a period of time. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a cystoscopy? — Most of the time, a cystoscopy is done in the doctor's office, and you will be awake. Sometimes, you might get a cystoscopy as part of another surgery or procedure. If so, you might be asleep, and you might be in an operating room.

For a cystoscopy in an office:

●Just before the procedure, your doctor will ask you to empty your bladder. They might ask you to collect a small urine sample for testing.

●You will lie on your back on a bench, with your feet in stirrups. This keeps your legs bent and apart.

●You will get anesthesia medicines, including medicine to numb your urethra. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●Your doctor will insert the cystoscope into your urethra and move it up into your bladder. They will use a lubricant on the cystoscope to help it slide in easily. The tiny camera on the end will send pictures to a screen that your doctor can see.

●Once the cystoscope is in your bladder, your doctor will fill the bladder with a sterile solution. This lets them see inside the bladder more easily. This might make it feel like you need to urinate.

●If needed, your doctor will use the cystoscope to take small tissue samples for testing. This is called a "biopsy."

What happens after a cystoscopy? — This depends on what type of anesthesia you got. If you had local or regional anesthesia, you will be able to return to your normal activities very soon after the procedure. Your doctor might also discuss the results of the cystoscopy with you before you go home. You will likely need to urinate right after the procedure.

If you had general anesthesia, the staff will watch you closely as your anesthesia wears off. Your doctor will likely schedule a follow-up appointment on another day to discuss the results of the cystoscopy. As you recover from the general anesthesia:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of cystoscopy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Damage to the urethra or bladder

●Bleeding

What else should I know? — For a short time after your cystoscopy, you might:

●Have some pain or discomfort when urinating, or feel like you need to urinate suddenly. These should only last for a short time.

●See a small amount of blood in your urine the first few times you urinate

These side effects should go away within a day or 2. Call your doctor if they last 3 days or more, you are in pain, or you get a fever.

More on this topic

Patient education: Cystoscopy – Discharge instructions (The Basics)
Patient education: Urinary tract infections in adults (The Basics)
Patient education: Bladder cancer (The Basics)
Patient education: Bladder pain syndrome (interstitial cystitis) (The Basics)
Patient education: Blood in the urine (hematuria) in adults (The Basics)

Patient education: Urinary tract infections in adolescents and adults (Beyond the Basics)
Patient education: Bladder cancer diagnosis and staging (Beyond the Basics)
Patient education: Diagnosis of interstitial cystitis/bladder pain syndrome (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)