A cystoscopy is a routine procedure used to diagnose any problems with the urethra, bladder, or ureters. After diagnosing the condition, your urologist might also perform a cystoscopy operation to treat the underlying cause of your symptoms.
The urologist can diagnose and treat conditions like bladder control issues, bladder or urethral cancer, enlarged prostates, etc. Keep reading to learn more about this procedure.
Also Read: Overactive Bladder Syndrome: Symptoms, Causes & Treatment
What is Cystoscopy?
Also known as cystourethroscopy or cystopanendoscopy, it is a procedure to look inside the bladder and urethra using an endoscope*. The procedure of probing inside the bladder usually takes 5 to 20 minutes in total except for the preparation and examination after the procedure. A cystoscopy is an outpatient procedure, which makes it convenient for people to add it in their schedule.
*An endoscope is a thin tube made of metal/silicone/rubber with a camera and light source attached to its tip.
Type of cystoscopies
There are two types of cystoscopies, which use different kinds of cystoscopes.
Flexible cystoscopy:
This procedure is performed with the help of a thin and flexible cystoscope made of rubber/silicone for diagnostic purposes. There are less chances of injury or discomfort during the procedure when this cystoscope is used.
Rigid cystoscopy:
This procedure is performed using a metal cystoscope which is straight and does not bend. Both operative and diagnostic cystoscopies can be performed using this cystoscope. The endoscope used in this process has a glass tube which projects clearer images.
Candidates for a Cystoscopy
People who notice the following symptoms are likely candidates of a cystoscopy if medicines don’t work:
- ning sensation or pain during urination
- Frequent urinary tract infections (UTIs)
- Inability to empty the bladder
- Chronic pelvic pain
- Enlarged prostates
- Urinary fistulas or urethral strictures
A diagnostic cystoscopy may reveal stones in the bladder, constricted urine pathways due to enlarged prostate glands, cancer of the urethra or bladder, etc. The doctor will then perform a cystoscopy operation to extract stones or outgrowths, treat anal fistulas, or place a small stent to open the passageway.
Treatments using Cystoscopy
A cystoscopy is used to probe and look inside the bladder and urethra to find out the cause of multiple problems. Your doctor may perform a rigid/flexible cystoscopy to:
- Place or remove a ureteral stent (a hollow tube to keep the ureter open)
- Remove stones from the bladder
- Perform a biopsy
- Remove outgrowths or cysts
- Treat fistulas or strictures in the urethra
- Diagnose your condition
- Get urine samples from the ureters*
* Ureter connects kidneys to the bladder and is used to transfer urine to the bladder.
Cystoscopy procedure
You will be asked to empty your bladder and placed on a table on your back; your feet may be placed in a stirrup with your knees bent. The doctor will then start the procedure by inserting anaesthesia in jelly through the urethra to numb the area; alternatively, you may also be given a sedative intravenously.
After some time, the doctor will insert the cystoscope into your urethra and work their way to the bladder. They will then fill up your bladder with clear, sterile liquid to see the insides of your bladder. During this part, the doctor will keep an eye out for any abnormalities—growths, polyps, cysts, cuts, and tumours—in your urethra or bladder.
The doctor may also take a tissue sample to conduct a biopsy or perform a small surgery to remove any outgrowths or cysts. In a diagnostic cystoscopy, your doctor will not perform any surgery but may take a tissue sample. If the doctor has an inkling about any tumour or outgrowth in your urethra or bladder, they will perform an operative cystoscopy. Sometimes the patient will be asked to come in later for an additional cystoscopy to perform the operation after the first one.
What to expect after a cystoscopy surgery?
Cystoscopy can be uncomfortable, but you should not feel any pain during the procedure. Slight discomfort or a burning sensation may linger after cystoscopy when you urinate, and that is normal. You may also notice some blood or slightly pink urine; don’t be alarmed.
As this is an outpatient procedure, you can walk out of the hospital on the very same day after consulting with your operative doctor. The doctor will ask you to drink plenty of fluids and urinate 2-3 times right after the procedure before releasing you.
You should not feel any discomfort, pain, or burning for more than a day or two; consult the doctor if the discomfort persists.
Potential risks
A cystoscopy operation is usually a safe procedure, but some people may get a UTI or sustain damage to the bladder or urethra due to the cystoscope (rare). You should consult your doctor immediately if you notice any of the following:
• Blood clots in urine or blood red urine
• Inability to urinate after going home
• Abdominal pain and nausea
• High fever and/or chills
Bottom line
A cystoscopy is an efficient procedure for diagnosing and treating bladder problems. Most patients can get back to their normal lives, including work, intercourse, and exercise, soon after the procedure. The doctor recommends people to drink plenty of fluids after the procedure to get back to normal. A cystoscopy surgery in India costs range from INR 20,000 to INR 75,000 depending on the location and the expertise of the doctor; flexible cystoscopy is slightly more expensive than rigid cystoscopy because a flexible cystoscope deteriorates after each use, and it is also slightly more comfortable than the rigid cystoscope.
In case of diagnostic cystoscopy, the doctor usually discusses their findings and further treatment process with the patient after the procedure. They may also operate in the same session if need be. Sometimes the doctor may call you back for consultation after obtaining the biopsy results.
FAQs:
How do I know if I really need a cystoscopy?
First, you need to understand what is cystoscopy, and then you can clearly identify the signs. If you are facing symptoms like frequent urination, painful urination, bloody urine, or recurring infections, you may be prescribed a cystoscopy. If you are wondering what is cystoscopy, here is the answer: it is an inspection of your bladder and urethra, where they use a thin scope to check for infections or abnormalities. Cystoscopy can give you an accurate diagnosis of your condition. If your symptoms persist, consult a doctor and understand the benefits of a cystoscopy.
Can cystoscopy detect early-stage bladder cancer?
You must be wondering, “what is cystoscopy’s role in detecting bladder cancer?” Well, cystoscopy gives doctors a clear and direct visualization of your bladder tissue. A cystoscopy can identify even small tumors or abnormal changes early on. It is an essential tool in screening for cancer. Cystoscopy is more precise and accurate than an imaging test.
Will I be awake during the procedure?
This is a common question among patients, second only to “what is cystoscopy?”. Having knowledge of the test can help you feel more at ease. Cystoscopy is performed with local anesthesia, which means you’ll stay conscious during the procedure. If the case is complex, doctors may sedate the patient. Cystoscopy is minimally invasive, so you need not worry. Your doctor will, ideally, explain the entire procedure beforehand. You can learn the safety measures and preparation steps associated with the procedure to ease your worry. Remember that cystoscopy gives an accurate diagnosis, so it is an essential test.
How often can a cystoscopy be done safely?
Cystoscopy can be safely done multiple times in your lifetime. The frequency of the test will be determined by the severity of the patient’s condition and the risk factors that trigger an infection in the bladder. If you have a history of bladder cancer, the frequency of cystoscopies may be higher. While it is a relatively safe procedure, it comes with certain risks; you can develop an infection or irritation. Long-term effects, however, are minimal.
Can lifestyle choices reduce the need for cystoscopy?
Some lifestyle changes could potentially reduce your risk of conditions that need a cystoscopy. Apart from this, you can exercise regularly, consume a healthy diet, manage your weight, stay hydrated and avoid habits like smoking. All these lifestyle changes can support urological health, potentially lowering the need for a cystoscopy.
Is cystoscopy different for men and women?
Cystoscopy for women is generally easier and quicker. Women have a shorter, straighter urethra, making it easier for doctors to perform the test. In men, the urethra can be longer and curved. Men also have a prostate gland, which can make the process last longer. Cystoscopy for men may also be more painful. Women and men can both undergo flexible or rigid cystoscopy; there is no difference in those factors.
How reliable are cystoscopy results compared to urine cytology or imaging?
A cystoscopy gives a more accurate diagnosis, making it more reliable than a urine cytology or imaging. Urine cytology can detect low-grade tumors, but has high specificity. Imaging can detect larger bladder tumors, but proves ineffective against small or flat lesions. Cystoscopy is also more reliable when it comes to evaluating the bladder lining.
