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Cystoscopy

Introduction

A cystoscopy is a procedure that uses a special instrument, called a cystoscope, to examine the inside of the bladder. It is usually carried out for a number of reasons for example, to help make a diagnosis or to carry out minor surgery. A cystoscope is a thin telescope (viewing tube) that is passed into your body and allows the doctor to look inside your bladder and other parts of your urinary system. The cystoscope has side channels down which small surgical instruments can be passed and used to carry out various procedures for example, a thin grabbing instrument may be used to take a small tissue sample.      

Why is it necessary?

A cystoscopy may be carried out to diagnose the cause of symptoms such as:

You may also have a cystoscopy if you have a condition that affects your urinary system, such as a bladder tumour or a blocked urethra (the tube which drains the bladder when you urinate). Other conditions that a cystoscopy may be used to detect or monitor include:

 Procedures carried out using a cystoscopy

A doctor can carry out a number of procedures by using a variety of different surgical instruments which can be passed down the side channels of the cystoscope. These include:

How is it performed?

A cystoscopy is usually done as an outpatient or day case. However, if surgery is being carried out, or a large sample of tissue taken, you may have to stay in hospital overnight. A cystoscopy is usually done while you are awake, although some people are given a sedative to help them relax. During the procedure, you will lie on a couch, on your back, and the cystoscope will be pushed in through your urethra (urine tube) as gently as possible. You may have a local anaesthetic to numb the lining of the urethra, to help the cystoscope pass in with as little discomfort as possible. Occasionally, a general anaesthetic may be given, particularly if a rigid cystoscope is being used. The doctor will look carefully at the lining of the urethra and bladder. A saline solution (sterile salt water) may be passed down a side channel in the cystoscope to slowly fill your bladder. This gives the doctor a better view of the lining of the bladder. However, as your bladder fills, you will feel the urge to pass urine which may e uncomfortable. A cystoscopy will take about 5-10 minutes, if it is being done to simply look inside your bladder. However, it will take longer if the doctor has to carry out a procedure - for example, take a biopsy (small tissue sample) from the bladder lining. After the procedure, the cystoscope will be gently removed. Your doctor may tell you what s/he saw inside your bladder straight after the test. If you have had a biopsy taken, the sample is sent away to be tested and examined under a microscope. It can take several days for the report of the biopsy to come back to the doctor.

Recovery

Following a cystoscopy, you should recover quite quickly. If you have not had a general anaesthetic, you will be allowed to go home the same day. If you have had a general anaesthetic, then you may need to stay in hospital over night. If you have had surgery or a large tissue sample taken, you may need to stay in hospital a little longer. For about a day or so after the cystoscopy, you may experience some mild discomfort and have a slight burning  sensation when you pass urine. You will possibly need to urinate more frequently and may pass a little blood in your urine (turning it slightly pink in colour) particularly if a biopsy was taken. Sometimes, the after effects of a cystoscopy may last a little longer. Occasionally, after a cystoscopy, you may develop a urine infection. You should tell you GP if, after having a cystoscopy, you have: