Cystoscopy is a medical procedure used to identify any abnormalities in the urethra or bladder. It is a quick and simple test that can be performed in a doctor’s office under local anesthesia.
A cystoscopy may be recommended by a urologist or gynecologist to investigate the cause of blood in the urine, urinary incontinence, or frequent infections, as well as to check for any other bladder abnormalities.
If any irregularities are found in the bladder or urethra, the doctor may perform a biopsy to confirm the diagnosis and begin appropriate treatment.
Indications for the procedure
Cystoscopy is used to:
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Diagnose tumors in the bladder or urethra;
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Identify infections in the urethra or bladder;
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Detect foreign bodies in the urinary tract;
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Assess prostate size in men and people assigned male at birth (AMAB);
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Identify and treat bladder stones, polyps, or tumors;
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Determine the cause of painful urination;
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Investigate the cause of blood in the urine;
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Evaluate urinary incontinence and inject medications to help control urine leakage;
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Treat urethral strictures or fistulas.
During the exam, if the doctor detects any abnormalities in the bladder or urethra, a small tissue sample may be collected and sent for biopsy to confirm the diagnosis and begin treatment if needed.
How to prepare
No special preparation is needed when cystoscopy is performed under local anesthesia, and patients can eat and drink normally beforehand. However, it is important to empty the bladder completely before the procedure. A urine sample may also be collected to check for possible infections.
If the cystoscopy is done under general anesthesia or sedation, the patient must fast for at least 8 hours before the procedure, and an anesthesiologist will be present. The use of blood-thinning medications (anticoagulants) should also be temporarily suspended, as advised by the doctor.
How the cystoscopy procedure is performed
Cystoscopy is a short procedure that usually takes about 15 to 20 minutes and is typically performed in a doctor’s office under local anesthesia. The instrument used is called a cystoscope, a thin, tube-like device with a small camera at its tip that can be flexible or rigid.
The type of cystoscope used depends on the purpose of the procedure:
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Flexible cystoscope: used when cystoscopy is performed only to view the bladder and urethra, as it allows greater mobility and clearer visualization of the urinary structures.
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Rigid cystoscope: used when tissue samples need to be collected for biopsy or when medications must be injected into the bladder.
Before starting the procedure, the doctor cleans the area and applies an anesthetic gel to prevent discomfort. Once the area is numb, the cystoscope is gently inserted into the urethra so the doctor can examine the urethra and bladder using the images from the camera.
During the exam, the doctor may inject saline solution to expand the bladder and improve visibility. In some cases, a special medication may be administered to make cancerous cells glow under light if bladder cancer is suspected.
Recovery time
After the procedure, most people can return to their normal daily activities. It is common to experience mild discomfort or pain in the urethral area after the anesthesia wears off, as well as a slight burning sensation or traces of blood in the urine. These symptoms usually disappear within 48 hours. If they persist, the doctor should be informed for further evaluation.
If general anesthesia was used, the patient should remain at the healthcare facility until the effects of the anesthesia have fully worn off.
It is also recommended to drink plenty of water after the procedure to help flush the bladder and reduce the risk of urinary tract infection.