Cystoscopy

March 17 20:03 2019 Print This Article

Internal examination of the bladder using a viewing instrument called a cystoscope. Cystoscopy can detect bladder stones. tumours, and inflammation or other disorders of the bladder lining. Patients are asked to drink extra fluids before the test, and a sedative is usually given about an hour beforehand. Local anaesthetic is used to numb the urethral outlet and is instilled into the urethra (which drains urine from the bladder). The cystoscope is then inserted carefully through the urethra into the bladder and rotated to allow inspection of the entire bladder lining. As it is withdrawn, the interior of the urethra and, in men its indentation by the prostate, can be inspected.

During cystoscopy urine specimens and BIOPSY samples from the bladder lining and prostate may be collected; stones crushed and removed; some tumours removed or treated with diathermy (heat) or laser; dye for retrograde pyelography) injected into the openings of the ureters; some urethral obstructions treated; or transurethral prostatectomy (partial removal of the prostate gland) performed.

Cystoscopy takes about 20 minutes longer, if treatment procedures are perfomed. Afterwards the patient is asked to wait until he or she has passed urine, which usually causes some stinging and may be bloodstained. High fluid intake is advised for the next 24 hours. The most common adverse consequence of cystoscopy is bladder infection, and antibiotics are often prescribed to avoid this. Injury to the bladder or urethra by cystoscopy is a rare consequence of this test.

A cystoscopy may be recommended when a disorder of the urinary tract is suspected. Both flexible and rigid cystoscopes can be used for carrying out various procedures, although the rigid cystoscope allows a greater variety of devices to be passed down its side channels.Urinary tract disorders may include structural problems that can lead to a blockage of urine flow or a back flow of urine. If untreated, structural problems may lead to potentially serious complications. You will need to drink plenty of fluids before the procedure. Depending on the reason for your cystoscopy, you may also need to use enemas and/or laxatives to clear your bowels. A cystoscopy to help with a diagnosis will usually be arranged by your GP. Cystoscopy is a very safe procedure.  There are, however, some risks and complications, which are unlikely, but possible.  Some risks may be associated with the type of anesthetic used.  Some risks are seen in any type of surgery, such as infection and bleeding.

Purpose

Cystoscopy may be prescribed for patients who display the following conditions:

  • Remove tissue samples for biopsy.
  • Evaluate problems of the urinary tract, such as frequent, repeated urinary tract infections that do not respond to treatment.
  • Urinary blockage such as from prostate enlargement, stricture, or narrowing of the urinary tract.
  • Stone in the urinary tract.
  • Blood in the urine ( hematuria ).
  • Bladder or kidney stones.
  • Symptoms of interstitial cystitis.

How To Prepare?

  • Tell your doctor if you have allergies to any medications, including anesthetics.
  • Distension of the bladder with fluid is particularly painful, and if it needs to be done, as in the case of evaluating interstitial cystitis, general anesthesia is required.
  • You should make arrangements for someone to take you home from the hospital.
  • Tell your doctor if you are or might be pregnant.
  • Patients may be asked to give a urine sample before cytoscopy to check for infection and to avoid urinating for an hour before this part of the procedure.

What the risks are?

  • Cystoscopy generally is a very safe procedure. If a general anesthetic is used, there is a small risk of death from the anesthetic.
  • Rupturing of the bladder wall [slight risk].
  • Bleeding sometimes occurs, but it usually stops on its own.
  • A mild infection in the urinary tract may occur after cystoscopy, but it can usually be prevented or treated by taking antibiotics before and after the procedure.
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