A cystoscopy is a procedure that allows a doctor see the inside of a patient's bladder and urethra. This procedure is needed when patients experience urinary problems.
Cystoscopy: Understanding the Urinary System
The urinary tract system consists of the kidneys, ureters, bladder, and urethra. The kidneys are two bean-shaped organs located below the ribs toward the middle of the back. The role of the kidneys is to:
- Help make red blood cells
- Remove extra water and wastes from the blood (wastes come from the normal breakdown of active muscle and from the food that you eat)
- Convert the extra water and wastes from the blood to urine.
If your kidneys do not remove these wastes, the wastes will build up in the blood and damage your body.
Narrow tubes called ureters carry urine from the kidneys to the bladder, which is an oval-shaped chamber in the lower abdomen. Like a balloon, the bladder's elastic walls stretch and expand to store urine and flatten back together when the urine is emptied through the urethra outside of the body.
When Is a Cystoscopy Recommended?
Doctors may recommend a cystoscopy for any of the following conditions:
- Frequent urinary tract infections
- Blood in the urine (hematuria)
- Loss of bladder control (incontinence) or overactive bladder
- Unusual cells found in a urine sample
- Need for a bladder catheter
- Painful urination, chronic pelvic pain, or interstitial cystitis
- Urinary blockage such as prostate enlargement, stricture, or narrowing of the urinary tract
- Kidney stones in the urinary tract
- Unusual growth, polyp, tumor, or cancer.
Special Instruments Used During a Cystoscopy
Doctors will use a cystoscope for a cystoscopy. A cystoscope is as thin as a pencil, has a light at the tip, and has lenses like a telescope or microscope. A cystoscope can:
- Allow doctors to focus on the inner surfaces of the urinary tract
- Use optical fibers (flexible glass fibers) to carry an image from the tip of the instrument to a viewing piece on the other end
- Treat urinary problems through the extra tubes (that can be used to guide other instruments for procedures).
Preparing for Your Cystoscopy Procedure
All medical procedures have a small risk of injury. Therefore, patients will need to sign a consent form prior to the cystoscopy. Prior to the procedure, patients may also be asked to give a urine sample that will be checked for an infection. Therefore, patients should avoid urinating for one hour before this part of the cystoscopy.
Throughout the cystoscopy, patients will wear a hospital gown and a sterile drape that will cover the lower part of their body. In most cases, patients will lie on their back with their knees raised and apart. A nurse or technician will clean the area around the urethral opening and apply a local anesthetic.
During the Cystoscopy Procedure
A cystoscopy does not require any cuts or incisions. The procedure will entail the following steps:
- The doctor will gently insert the tip of the cystoscope into the urethra and slowly glide it up into the bladder. Relaxing your pelvic muscles will help make this part of the cystoscopy easier.
- A sterile liquid (water or saline) will flow through the cystoscope to slowly fill your bladder and stretch it so that the doctor has a better view of the bladder wall.
- As your bladder reaches capacity, you will feel some discomfort and the urge to urinate. You will be able to empty your bladder as soon as the cystoscopy is over.
- To end the procedure, the doctor may find and remove a kidney stone or take a biopsy (a small tissue sample for examination under a microscope).
In most cases, the entire cystoscopy, including preparation, will take about 15 to 20 minutes.
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