Cystoscopy

What is a cystoscopy?

A cystoscopy is a medical procedure that allows your doctor to look at the interior lining of the bladder and the urethra (the tube that drains urine from the bladder to the outside), using a telescope called a cystoscope.

Why is a cystoscopy performed?

• This procedure may be carried out in order to obtain a diagnosis or treat problems that involve the bladder and the urethra. 
• Your doctor may perform this procedure if you have symptoms such as recurrent infection, pain, bleeding, blockage symptoms difficulty or frequent urination or incontinence. It is also used to evaluate patients with bladder cancer, an enlarged prostate or urethral stricture disease.
•  We can also remove a stent from your ureter (the tube between your kidney and bladder) using this technique. 

A cystoscopy can be performed using two different cystoscopes:

• A flexible cystoscope is a thin, flexible tube with a fibre-optic end that allows your doctor to view the inside of your bladder on a video screen and is generally used to make a diagnosis. This procedure can be performed under local anaesthetic.
• A rigid cystoscope is a slightly wider scope that does not bend. Using this scope allows the doctor to perform procedures that are unable to be performed with a flexible scope. Your doctor will do this procedure if they anticipate they may need to take biopsies or treat abnormalities in the bladder. It is done under general or spinal anaesthetic. 

Admission to hospital overnight is not normally required, but may be necessary if further procedures are needed. 

What to expect during a cystoscopy?

• The rigid procedure will require either a spinal anaesthetic or general anaesthetic. 
• The scope will be inserted into your urethra and passed into the bladder.  Your bladder will be emptied and partly filled with sterile water. This allows the doctor to fully inspect all of the bladder lining. 
• The following procedures may be attended during your cystoscopy:
  • Biopsy of abnormal tissue
  • Removal of stent 
  • Dilation of a urethral stricture
  • Injection of Botox
  • Removal of foreign bodies
  • Hydro-distention (stretch) of the bladder

Prior to your procedure

Please discuss with your doctor or nurse: 

• Which medications you will need to stop prior to your procedure (e.g. aspirin, iron, diabetic medications, herbal medications, fish oils, anti-inflammatory medications etc.). It is important that you mention all medications you take in case special precautions are required 
• if you have ever had any bleeding problems 
• if you have an artificial heart valve 
• if you are required to attend pre-operative tests 
  • You may  require a pre-operative urine test 7 to 10 days prior to your procedure.  A request for this test should be provided to you prior to your procedure date. You may also be asked to provide a urine sample on the day of procedure. You will be informed on the day if this is required.

After your procedure

• You will be transferred from recovery to a ward where your observations will be monitored. 
• Dependent upon the procedures that have occurred, you may go home on the same day as long as you are accompanied by a responsible adult.  Your treating team will advise you in regards to the expected length of stay prior to your procedure.
• You may resume your normal daily routine, including work, the day after your procedure unless otherwise instructed. 
• Resume normal eating habits unless otherwise instructed. 
• If you have had sedation or general anaesthetic, or at least 24 hours after your procedure you should not: 
  • drive a car, motorcycle or ride a bicycle 
  • drink any alcohol 
  • make any important decisions or sign important papers 
  • walk home 
  • use hazardous machinery, including the stove 
  • engage in sports or heavy lifting 
  • travel alone by public transport (bus, train or plane) 
• You may feel some stinging or burning and have blood stained urine for 1-3 days. 
• As with any procedure, there is also a risk of infection. Drinking plenty of water afterwards can help minimise the chance of infection and these symptoms. 
• Please contact either your GP or the hospital in which you had your procedure, if you experience any of the following symptoms after your procedure: 
  • Fevers, chills or sweats 
  • Worsening pain or discomfort on urination 
  • Unable to or difficulty passing urine 
  • Excessive bleeding 

A follow up appointment may be made for you to discuss any further treatment. Please check if this is required prior to discharge.

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