Cystoscopy

What is a cystoscopy?

A cystoscopy is a procedure that allows your doctor to examine the lining of your:

• Bladder
• Urethra (Tube that carries urine out of the body)

How it works

A thin, hollow tube called a cystoscope is inserted into your urethra and slowly advanced into your bladder. This tube is equipped with a camera and light to check for any bleeding, blockages or growths

There are two types of cystoscopy:

1. Flexible cystoscopy uses a soft and flexible instrument. It is a basic diagnostic procedure that is done under local anaesthesia.
2. Rigid cystoscopy uses a wider cystoscope that does not bend. It can be used for diagnosis and treatment at the same time. This procedure is done under spinal or general anaesthesia.

Why do you need a cystoscopy?

If you're prone to frequent urinary tract infections, have unexplained blood in the urine or experience difficulty urinating, your doctor may recommend a cystoscopy. A cystoscopy is helpful in assessing and diagnosing:

• Bladder conditions, such as urinary tract infections, urinary incontinence (in both adults and children), overactive bladders, and pain while peeing.
• Bladder diseases, such as bladder cancer, bladder stones and bladder inflammation (cystitis).
• Prostate conditions such as an enlarged prostate.

Apart from spotting these issues, your doctor can help to remove small tumours during the procedure.

What are the risks and complications of a cystoscopy?

A cystoscopy is generally considered safe. However, there are some minor risks such as:

• Allergic reactions. You may develop a reaction to the anaesthetic used.
• Infections. In rare cases, a cystoscopy can introduce germs into the urinary tract, leading to infection. To prevent this, antibiotics may be prescribed before and after the procedure.
• Bleeding due to catheter insertion. Some blood in the urine may be expected in the first 24 hours.
• Stomach pain or soreness in the urethra. You may experience mild stomach discomfort or a burning sensation when urinating. These symptoms should not last more than 48 hours.

When to visit the UCC?

If you develop any of the following symptoms after cystoscopy, please call 6473 2222 to visit our UCC immediately:

• Fever
• Bloody urine that lasts for more than 48 hours
• Pain that persists for more than 48 hours

How do you prepare for a cystoscopy?

Before the procedure, your doctor will review your medical history. You may also undergo some scans and tests.

Once your cystoscopy is scheduled, your doctor will advise you on how to prepare. You may be asked to stop eating and drinking a few hours before the procedure, especially if you are undergoing sedation or general anaesthesia.

Note: If you are taking any medication or herbal supplements, you should inform your doctor. You may need to adjust or stop taking some medication before the procedure (e.g. aspirin, blood thinners).

What can you expect in a cystoscopy?

A cystoscopy is usually done as an outpatient procedure, so you should be able to go home on the same day of the procedure.

Depending on the type of cystoscopy you are doing, you will be given either local or general anaesthetic.

Before the procedure

On the day of the procedure, it is ideal to have a bath or shower ahead of time. However, you should not apply any lotions, perfumes, deodorants, or nail polish. You should also remove all jewellery, piercings, and contact lenses.

Right before the scope is done, you will be asked to empty your bladder to facilitate the procedure.

During the procedure

You will be lying down with your knees bent and your legs in stirrups.

• A sedative, local anaesthesia or general anaesthesia will be given at this point to make you comfortable.
• Your doctor will gently guide the cystoscope into the urethra and saline will be flushed into the bladder to stretch it. You may feel the urge to pee, but you'll need to hold it in.
• At this point, depending on the type of procedure you are doing, your doctor will examine the inner surfaces of the urethra and bladder using the camera of the cystoscope.
• Tissue samples may be taken or stones may be removed.

After the procedure

After the procedure is completed, you'll be monitored for 1 – 2 hours for the effects of the sedatives and anaesthesia to wear off.

In most cases, you will be able to return home to rest.

Note: Driving is strongly discouraged within 24 hours of a cystoscopy procedure as the sedatives and anaesthesia will take some time to fully wear off. Please make plans to have someone take you home afterwards.

Care and recovery after a cystoscopy

You should be able to resume your daily routine very soon after the procedure. However, you may experience some post-procedure side effects:

• Bright pink blood due to bleeding from the urethra
• More frequent urination for up to 48 hours
• A burning sensation when urinating

You can manage and relieve these side effects by:

• Holding a warm, moist washcloth over the opening to the urethra to relieve discomfort.
• Drinking plenty of fluids for the first 2 hours after the procedure to flush out the bladder and reduce irritation.