A cystoscopy is a diagnostic and sometimes therapeutic procedure that allows doctors to view the interior of the lower urinary tract, which includes the urethra, prostate (in men), bladder neck, and bladder. This procedure utilizes a specialized instrument known as a cystoscope—a narrow tube equipped with a lighted camera at its head. During a cystoscopy, the device is gently inserted through the urethra and advanced into the bladder. This process provides the physician with a direct visual of the urinary tract, enabling them to identify any abnormalities from the urethra to the bladder.
One of the significant advantages of a cystoscopy is its ability to help diagnose a range of urological conditions that might not be evident through other imaging methods such as CT scans or ultrasounds. For example, cystoscopy can be instrumental in diagnosing bladder cancer, especially when blood is present in the urine (hematuria). The procedure is also used to investigate chronic pelvic pain, recurrent urinary tract infections (UTIs), urinary blockage, and urinary stones. According to the Mayo Clinic, this direct approach allows for more precise evaluation of issues that may not be clearly visible through non-invasive imaging.
If abnormalities are detected during the cystoscopy, the doctor can use small instruments passed through the cystoscope to perform a biopsy. This involves removing a small sample of tissue for analysis, which helps confirm diagnoses such as cancer or chronic inflammation. The ability to collect a tissue sample during the procedure makes cystoscopy a valuable tool for timely and accurate diagnosis.
Preparation for a cystoscopy typically includes urinating prior to the procedure and sometimes taking an antibiotic to prevent infection. Depending on the reason for the cystoscopy, the procedure may be done using local, regional, or general anesthesia. The decision regarding which type of anesthesia to use depends on the complexity of the procedure and the patient’s comfort. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) offers guidance on what to expect before, during, and after the procedure.
During the procedure, patients might feel mild discomfort or a sensation similar to needing to urinate as the cystoscope moves through the urethra. However, the discomfort usually subsides once the instrument is in the bladder. For more complex evaluations or treatments, such as removing bladder stones or tumors, more comprehensive sedation might be used to ensure the patient’s comfort.
Post-procedure care involves observing for potential side effects such as a burning sensation during urination, blood-tinged urine, or frequent urination for a day or two following the cystoscopy. These symptoms are typically mild and resolve without intervention. Patients are advised to drink plenty of fluids to help flush the urinary system, which can minimize discomfort. However, if symptoms persist or if fever and severe pain occur, it is important to contact a healthcare provider, as these could indicate infection or other complications.
Risks of cystoscopy are generally low but may include urinary tract infections, bleeding, or injury to the urethra or bladder. It is essential to follow post-procedural care instructions and attend any recommended follow-up visits to ensure recovery is proceeding as expected. The Cleveland Clinic provides a comprehensive overview of the potential risks and how they are managed.
Cystoscopy serves as a crucial procedure for evaluating and managing lower urinary tract issues. It bridges the gap between non-invasive imaging and more invasive surgical exploration, offering a clear view that helps physicians make informed treatment decisions. For those dealing with persistent urinary symptoms or conditions not clearly diagnosed by other means, cystoscopy can provide much-needed clarity and guidance toward appropriate treatment.
