Cystoscopy

In a cystoscopy we examine the bladder with an instrument called Cystoscope.

What is a cystoscope?

The Cystoscope is passed into the bladder through the urethra.There are two types of instruments:

• Flexible cystoscope is a thin, flexible, fibre-optic telescope. It is about as thick as a pencil. As its name suggests it can be used to look at all the angles in the bladder as it is flexible & can bend in various directions.

• Rigid cystoscope is a thin, solid, straight telescope.

The inside of the urethra & the bladder are seen on the TV monitor. Both types of cystoscope have side channels from where instruments can be passed into the bladder to take biopsies from the lining of the bladder.

A flexible cystoscopy is done under local anesthesia & is used commonly for DJ stent removals after a patient has undergone a prior procedure. It is also used to perform Surveillance cystoscopies in patients who are on follow up for bladder cancer following TURBT. Small biopsies if needed are taken in the same sitting under local anesthesia. As this is a Daycare procedure most patient are able to go back home the same day. However one needs to realize that in case a bladder shows a recurrence of the tumor on surveillance cystoscopy the patient is to be called back to the OT again for TURBT under G.A. This maybe accomplished in the same sitting if the patient is already PAC (anesthesia) fit.

Indications for Cystoscopy

Diagnostic

A cystoscopy may be done to help to find the cause of symptoms such as:

  • Frequent urinary tract infections.
  • Blood in your urine (hematuria).
  • Incontinence.
  • Unusual cells found in a urine sample. (Urine for Cytology showing malignant or atypical cells).
  • Dysuria -persistent pain when you pass urine.
  • Difficulty in passing urine (which may be due to prostate enlargement or a stricture (narrowing) of the urethra).

Surveillance (Follow up)

Cystoscopy may also be done to monitor progress of conditions after treatment for a bladder tumor. This helps to detect any early recurrence, which can be treated before it spreads further.

Cystoscopy maybe normal. However, this helps to rule-out certain causes of your symptoms & helps make the diagnosis.

Therapeutic or to do certain procedures

By using various instruments, which are passed down the side channels a doctor, can:

  • Remove a stone from the bladder.
  • Obtain a urine sample from each of the ureters. This helps to check for infection, tuberculosis or tumor, which involves only one kidney.
  • Remove small polyps or tumors from the lining of the bladder.
  • Insert a stent (a small tube) into a narrowed ureter. This helps the flow of urine if there is a narrowing.
  • RGP – Retrograde pyelography – perform a special x-ray of the ureters and kidneys. This helps diagnose problems in the kidney & ureter.

Cystoscopy – The procedure.

Cystoscopy is usually done as an outpatient or day case. It is usually done while you are awake. Some people are given a sedative to help them to relax.

The opening to your urethra (at the end of the penis or the outside of the vagina) and the nearby skin will be cleaned. Lignocaine jelly is used to provide local anesthesia. This helps the cystoscope to pass into the urethra with as little discomfort as possible.

We then gently introduce the cystoscope up into the bladder & look carefully into the bladder. As your bladder fills you will feel the urge to pass urine which may be uncomfortable.

A cystoscopy takes about 5-10 minutes if it is to just look inside the bladder. It may last longer if the doctor does a procedure, for example, take a biopsy (small sample) from the lining of the bladder. The cystoscope is then gently pulled out. If you had a biopsy taken, the sample is sent for histopathological examination. It can take 5-7 days for the report of the biopsy to be made available. After the report is available the report can be discussed with Dr Manav Suryavanshi at Urofort (+91-9910103545) or our hospital (Urology Coordinator – +91-9560398967) with prior appointment.

In some cases a general anesthesia is given when a cystoscopy is done, particularly if a rigid cystoscope is used.

Side-effects or possible complications?

Most cystoscopies are done without any problem. For the next 24 hours you may have a mild burning feeling when you pass urine, and feel the need to go more often than usual. Also, the urine may look pink due to mild bleeding, particularly if a biopsy was taken. Occasionally, a urine infection develops shortly after a cystoscopy. This can cause a fever (high temperature) and pain when you pass urine. Rarely, the cystoscope may damage or perforate the bladder.

Inform Urology Helpline +91-9560398928 or your Urologist if:

  • Pain or bleeding is severe.
  • Any pain or bleeding lasts longer than two days.
  • You develop symptoms of infection.

For More Information

Meet us at

Medanta Kidney & Urology Institute

Medanta – The Medicity

Sector 38, Gurgaon, Haryana – 122001, India

For appointment Call+91-9910103545

Email – info@urofort.com

Web address – www.manavsuryavanshi.com