Cystourethroscopy

Alternative names
Cystoscopy

Definition

Cystoscopy is a procedure that enables your health care provider to view the inside of your bladder and urethra in great detail using a specialized endoscope (a tube with a small camera used to perform tests and surgeries) called a cystoscope.

How the test is performed

There are 2 types of cystoscopes, the standard rigid cystoscope and the flexible cystoscope. The method for insertion of the cystoscope varies, but the test is the same. The choice of which scope to use depends on the purpose of the exam.

If the standard rigid cystoscope is used, you lie in the lithotomy position (on your back with your knees up and apart). The flexible cystoscope may be easier to insert than the standard rigid model. It does not require the lithotomy position for insertion.

The procedure usually takes between 5 and 20 minutes. The urethra is cleansed and a local anesthetic is applied. The scope is then inserted through the urethra into the bladder.

Water or saline is inserted through the cystoscope and fills the bladder. As this occurs, you are asked to describe the feeling to your provider, which provides information about your condition.

As the fluid fills the bladder, it stretches the bladder wall, enabling the physician to view the entire bladder wall. You will feel the need to urinate when the bladder is full. However, it must remain full until the examination is complete.

If any tissue appears abnormal, a small specimen can be taken (biopsy) through the cystoscope to be analyzed.

How to prepare for the test

You must sign an informed consent. You will wear a hospital gown during the procedure. You should make arrangements for travel home from the hospital.

Infants and children:
The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

How the test will feel

You may feel slight discomfort as the cystoscope is passed through the urethra into the bladder. You will feel an uncomfortable, strong need to urinate when the fluid has filled the bladder.

You may feel a pinch if a biopsy is taken. After the cystoscope is removed, the urethra may be sore and you may feel a burning sensation during urination for a day or two.

Why the test is performed

     
  • Diagnose and evaluate urinary tract disorders  
  • Check for cancer of the bladder or urethra  
  • Diagnose an enlarged prostate (men)  
  • Help determine the cause of pain during urination  
  • Diagnose recurrent bladder infections

Normal Values

The bladder wall should appear smooth. The bladder should be normal size, shape, and position. There should be no obstructions, growths, or stones.

What abnormal results mean

     
  • Prostate abnormalities:       o Enlarged prostate       o Prostate obstruction       o Bleeding prostate  
  • Cysts  
  • Urethral strictures  
  • Calculi (bladder stones)  
  • Tumors  
  • Polyps  
  • Diverticula  
  • Ulcer  
  • Bladder wall decompression  
  • Congenital abnormalities  
  • Chronic urethritis  
  • Irritable bladder  
  • Traumatic injury of the bladder and urethra

What the risks are
There is some risk of infection. There is a slight risk of the following Complications:

     
  • Excessive bleeding (from biopsy)  
  • Rupture of the bladder wall (with the cystoscope or during biopsy)

Special considerations

You may notice a small amount of blood in your urine following this procedure. If the bleeding continues after 3 voids (urinations), contact your health care provider.

There is also a chance of infection. If you develop pain, chills, fever, or reduced urine output, contact your provider.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.