A cystoscopy, or bladder scope, is a medical procedure that examines the lining of your urinary bladder and the urethra. The urinary bladder is an organ that stores the urine before it is emptied when you relieve yourself, a process doctors refer to as ‘voiding’. The urethra is the tube where the urine passes from the bladder and out of the body.
Cystoscopy is performed using a thin tube with a light source and camera at the end. This tube is inserted up to the bladder so that the doctor can visualise the inside of the bladder.
What is a cystoscopy for?
Patients who experience recurrent urinary tract infections (UTIs), blood in urine, and difficulty in urinating are advised to undergo a cystoscopy.
Cystoscopy is used to:
Check for the causes of problems involving the urinary tract and pelvic pain
Remove tissue samples for laboratory testing
Remove bladder stones, insert or remove a stent and administer medicine into the bladder
During a cystoscopy, the urologist looks out for any of the following:
Abnormal masses or tissues
Abnormal outpouching of the bladder or urethra
Bladder stones
Inflammation of the bladder or urethra
Types of cystoscopy procedures
There are 2 main types of cystoscopy procedures: flexible cystoscopy and rigid cystoscopy. Both involve passing a thin viewing tube called a cystoscope along the urethra and into the bladder, but they are done in slightly different ways.
Flexible cystoscopy
This involves a thin and flexible cystoscope, that is inserted while you are awake.
Rigid cystoscopy
A wider and rigid cystoscope is used for this procedure. It is performed either while the patient is sedated or with the lower half of the body numbed.
Preparing for a cystoscopy
There is no limitation to eating or drinking before the procedure. Just that you’ll have to empty your bladder before the procedure starts. You will then be asked to change into a hospital gown, and the procedure takes place while you’re lying down.
The doctor will first apply a local anaesthetic at the urethra. A thin tube will be inserted gently through the bladder. Saline will then be infused through the tube to stretch the bladder. This is done so that the doctor can visualise the bladder more clearly. After a few minutes, the tube will be removed.
You can choose to do the procedure under sedation, if so, you would need to fast 2 – 4 hours before the procedure.
You can go home after the procedure. Hospital admission is not necessary for a cystoscopy.
Depending on the type of cystoscopy you are going for, flexible or rigid cystoscopy, the procedure and necessary preparations may vary.
Flexible cystoscopy
You can usually eat and drink as normal before the procedure
You’ll be asked to change into a hospital gown before the procedure begins
The procedure is done with you laying down flat on a special couch
Your genitals are cleaned with antiseptic and a sheet is placed over the surrounding area
An anaesthetic gel is applied to your urinary tract to numb it. Then the cystoscope is inserted and gently moved towards your bladder
Water may be pumped into your bladder to see the insides more clearly
Rigid cystoscopy
You may be asked to stop eating and drinking a few hours before the procedure
You’ll be asked to change into a hospital gown before the procedure begins
General anaesthetic may be injected into your hand, which will make you fall asleep. Otherwise, a spinal anaesthetic may be administered, which only numbs the lower half of your body
The procedure is done with you laying down flat on a special couch and your legs supported
Your genitals are cleaned with antiseptic and a sheet is placed over the surrounding area
The cystoscope is inserted and gently moved towards your bladder
Water may be pumped into your bladder to see the insides more clearly
It will take about 24 hours for the anaesthetic to wear off, therefore limiting the activities you can do including driving.
Is a cystoscopy painful?
You may be given anaesthetic if you are undergoing a rigid cystoscopy procedure. While both flexible and rigid cystoscopy procedures are not painful, you may feel some discomfort or the urge to urinate while the procedure is ongoing.
Cystoscopy recovery
After the procedure, you may feel sore or have a burning sensation at the urethra for up to 48 hours. You may also find some blood mixed with your urine for up to 24 hours. These symptoms should improve within the next 1 – 2 days and you should be able to resume work or most of your usual activities.
Cystoscopy side effects, risks and complications
Cystoscopy is generally considered safe. There is a small risk of developing infection of the urinary bladder, bleeding while urinating or a reaction to the anaesthetic used. To reduce your risk for complications, your doctor will advise you to drink plenty of fluids after the procedure.
Visit the Urgent Care Centre immediately if any of the following symptoms show up after the procedure:
Fever
Bloody urine lasting more than 48 hours
Pain persisting for more than 48 hours
Complications from a cystoscopy are rare. They include:
Urinary tract infections. These are infections of the bladder, kidneys or small tubes connected to them that may be due to germs that are introduced into the body during the procedure
Inability to empty bladder. Sometimes it might be difficult to pee after a cystoscopy. This could indicate a swelling of your urinary tract or prostate.
Bleeding and bladder damage. In rare cases, blood in the urine could mean injury or damage to the bladder.
Pain. Abdominal pain and a burning sensation when urinating may be felt after the procedure.
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