Cystoscopy: what this examination is and how it is performed

Cystoscopy is an examination of the bladder from the inside; people are often embarrassed to ask about it, but it is a routine examination. Below is a brief explanation of what this examination shows and how it is performed.

What cystoscopy is

Cystoscopy is a medical examination method, an inspection of the inner surface of the bladder, a type of endoscopy. It is performed with an endoscope — a catheter with optical and lighting systems, which is inserted through the urethra.

Cystoscopes can be rigid or flexible. Which one is used depends on the purpose of the examination; the procedure itself is the same. It lasts approximately 5–20 minutes.

Why bladder cystoscopy is performed and what it shows

The reasons are as follows: to check for bladder or urethral cancer, to find the cause of blood in the urine, the cause of urination problems, recurrent bladder infections, or pain during urination. During the examination it is possible to:

• look at the urethra and bladder from the inside;
• see the ureteral orifices and determine whether a kidney is bleeding and which one;
• check whether pus is being released from one ureter or both;
• take a piece of altered tissue (a biopsy) and send it to the laboratory;
• catheterize the ureter and obtain the discharge from each kidney separately.

The normal picture: the bladder wall is smooth, the size, shape, and position are usual, and there are no obstructions, growths, or stones. Abnormalities can vary — bladder cancer, stones, scars and urethral narrowing, cysts, diverticula, a foreign body, polyps, prostate problems, trauma, or an ulcer of the wall.

How the examination is performed

The urethra is cleaned and an anesthetic is applied — without needles. Then the instrument is inserted and water or saline is supplied through the tube: the bladder fills, the walls stretch, and the doctor sees them fully. At this point there is a strong urge to urinate, but the bladder remains full until the end of the examination. If the tissue looks altered, a small sample is taken through the tube.

Preparation is simple: ask the doctor whether blood-thinning medications need to be temporarily discontinued. If the procedure is performed under anesthesia in a hospital or surgical center, a person is needed afterward to take you home.

Sensations: discomfort when the tube is passed through the urethra, a strong urge when the bladder is full, a brief pinch during biopsy. Afterward — soreness of the urethra, a small admixture of blood in the urine, and burning during urination for one to two days.

Cystoscopy and ultrasound

Before other diagnostic methods such as ultrasound appeared, cystoscopy was of particular importance for the early recognition of bladder tumors and for determining the location, type, and size of a foreign body in the bladder cavity. Cystoscopy provides an examination of the inner surface of the bladder and allows a biopsy to be taken.

Possible complications and when to consult a doctor

The risks are small, but they exist: excessive bleeding during biopsy, bladder infection, rupture of the bladder wall. A small amount of blood in the urine after the procedure is expected. If blood is still present after you have urinated three times, contact a doctor.

Tell the doctor if after the examination you develop chills, fever, pain, or a decreased amount of urine.

Cystoscopy itself is not a reason to call an ambulance; 103/112 — if the condition has sharply worsened and is life-threatening (for example, loss of consciousness, severe bleeding, difficulty breathing); chills, fever, pain, and decreased urine after the examination should be discussed with a doctor.

This is reference material: it explains what is done and why, but does not replace a doctor's consultation — discuss questions about your referral with a urologist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer