What is a cystoscopy?
Cystoscopy is a procedure that lets your doctor examine the lining of your bladder and urethra using a hollow tube (cystoscope) with a lens. The cystoscope is inserted into your urethra and gently moved into your bladder.
There are two main types of cystoscopes: flexible and rigid. The type you'll have depends on the reason for your procedure.
- Flexible cystoscope: Your provider may use a bendable scope to carefully follow your urethra's natural path and examine the inside of your bladder and urethra.
- Rigid cystoscope: This non-bendable scope allows your provider to pass instruments for biopsies or tumor removal. It is typically used under sedation or general anesthesia.
Why might I need a cystoscopy?
Cystoscopy is used to diagnose, monitor and treat conditions affecting the bladder and urethra. Your doctor may recommend it to:
- Investigate symptoms like blood in urine, incontinence, overactive bladder or painful urination. It can also help identify the cause of frequent urinary tract infections, though it's typically not done during an active infection.
- Diagnose bladder conditions such as bladder cancer, bladder stones or inflammation (cystitis).
- Treat bladder conditions by using special tools through the cystoscope to remove small tumors or other issues.
- Diagnose an enlarged prostate (benign prostatic hyperplasia) by detecting the narrowing of the urethra as it passes through the prostate.
Your doctor may also perform ureteroscopy during the same procedure, using a smaller scope to examine the ureters, the tubes that carry urine from your kidneys to your bladder.
How to prepare for a cystoscopy
Before your cystoscopy, inform your healthcare provider about any medications you're taking and if there's a chance you might be pregnant. Your provider will give you specific preparation instructions—following these carefully can help minimize complications.
Preparation varies based on the type of anesthesia and the reason for the procedure.
Your provider may ask you to:
- Provide a urine sample on the day of the procedure to check for a UTI. You'll likely need treatment before the cystoscopy if an infection is found.
- Fast for eight hours before the procedure, typically if general anesthesia is used.
- Adjust your medications, taking them only with a sip of water if instructed. Only stop medications if your provider advises it.
- Arrange for someone to drive you home if you'll be sedated during the procedure.
The cystoscopy procedure
You may get a cystoscopy in the hospital or as an outpatient procedure. It can take as little as 10 to 20 minutes or much longer, depending on whether your doctor will examine your urethra and bladder or if you will receive other treatments.
Before the procedure
You'll be asked to empty your bladder, then lie on your back on a table. You'll likely be positioned with your knees bent and feet in stirrups. Your doctor will apply a numbing medicine around the opening to your urethra to help reduce discomfort. For help relaxing, you may also receive a sedative intravenously.
If you are having a procedure done alongside your cystoscopy, you may be given general anesthesia.
During the procedure
During a cystoscopy, your doctor will carefully insert a flexible or rigid cystoscope into your urethra. They will slowly direct the cystoscope into your bladder. Often, they will fill your bladder with salt water, or saline, to help them see the lining of your bladder and any abnormalities more clearly. The saline solution may make you feel as if you need to urinate.
For some cystoscopy procedures, you will also receive a special dye to help examine urinary flow.
If needed, your doctor will insert very small instruments through the cystoscope to remove cells for biopsy, perform injections or carry out other procedures.
If you are awake, you may feel some discomfort when the doctor inserts the cystoscope. You may also feel a slight pinch when cells are taken for biopsy.
After the procedure
After your cystoscopy, your healthcare team will monitor you to make sure you don’t have complications. You will need to recover while any anesthesia wears off. Your healthcare providers may ask you to drink two cups of water per hour for a few hours after the cystoscopy.
Depending on the type of anesthesia you had, you may need someone to drive you home. In some cases, you may stay overnight in the hospital.
You may have blood in your urine or pain when urinating for a day or two after the cystoscopy. Be sure to drink plenty of water to continue flushing out your bladder. A warm, damp cloth held over the urinary opening may relieve discomfort. You may also take over-the-counter pain relievers as directed by your provider. Your provider may also prescribe an antibiotic to keep you from getting an infection after the procedure.
Your provider will tell you which symptoms to watch for after your cystoscopy. In general, always call the office if you have:
- Signs of an infection
- Fever
- Severe pain
- Blood clots in your urine
- Bright-red urine.
Also, call if you have difficulty emptying your bladder or if bleeding persists beyond a day or two.
Understanding the results
Your doctor will let you know about the outcome of your cystoscopy. For simple procedures, such as stent retrieval, you’ll learn whether it was successful almost immediately.
If you had a biopsy, it may take a few days for results to become available. If cancer is found, your doctor will refer you to an oncologist for a treatment plan.