Cystoscopy
 
Having a cystoscopy
 
Your consultant has recommended that you have a cystoscopy and this leaflet provides some information about the procedure. If it doesn't answer all your questions, or if you have any worries, please do not hesitate to ask your consultant or nurse for more information.

It is natural to feel a bit nervous about having any medical procedure, but often knowing what to expect can help.
 
What is a cystoscopy?
 
A cystoscopy is an examination of the inside of the bladder (the baglike organ that stores urine in the body) using a thin, flexible, tube-like telescope called a cystoscope. This instrument is carefully passed up the urethra (the tube that carries urine out of the body) and into the bladder. A cystoscopy is useful for finding out what is causing your symptoms, or as a check-up for certain bladder conditions. During the procedure, the doctor may take a biopsy - a sample of the lining of the bladder - for examination in the laboratory.

Cystoscopy is routinely performed as an outpatient or day case, requiring no overnight stay in hospital. A general anaesthetic is rarely required, although a local anaesthetic jelly is usually applied to the area. In some cases, a sedative injection may be given.
 
About the procedure
 
A cystoscopy usually only takes about five minutes to perform, but you will need to allow about 45 minutes for your appointment. The procedure will not hurt, although it may be a bit uncomfortable.
 
Preparing for the procedure
 
There are no special preparations for having a cystoscopy. You may eat and drink as usual on the day of the procedure.
 
Consent
 
Before you have your cystoscopy, you will be given a consent form to sign. By doing this, you confirm that you understand what will happen during the procedure, and give your permission for it to go ahead.

Many patients feel uncomfortable with the idea that a procedure may involve risks, but to make an informed choice, you need to know about the possible risks before you give consent.
 
What are the risks?
 
Cystoscopy is generally a safe procedure. For most people, the benefits of having a clear diagnosis, or quick and effective treatment, are much greater than any disadvantages. However, like all invasive medical procedures, there are some risks. These can be divided into the risk of side-effects and the risk of complications.
 
Side-effects
 
These are the unwanted, but usually mild and temporary, effects of a successful procedure. After a cystoscopy, you may feel a small amount of discomfort, which will settle in a few hours. Passing urine afterwards may sting and it is quite normal for the urine to contain some blood (especially if a biopsy is taken) but these symptoms should settle down within 48 hours.
 
Complications
 
Your doctor will be very experienced at performing this type of procedure, but, even so, a few cystoscopies are not successfully completed and may need to be repeated.

Other complications are uncommon, but occasionally a urinary tract infection or inflammation may develop, requiring treatment with medicines.

It is also possible for the urethra or bladder to be damaged or perforated during the procedure. This can lead to bleeding and infection, which may require treatment with medicines or surgery. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. You should ask your consultant to explain how these risks apply to you.
 
What to expect
 
You will be asked to empty your bladder just before you have your cystoscopy. The procedure will be carried out in a private room, where you will be asked to remove your lower clothing and put on a hospital gown. To help ensure you are as comfortable as possible, and to provide reassurance, a nurse will stay with you throughout.

When anaesthetic jelly is used, it will be squeezed into the urethra using a syringe without a needle. This may sting at first and will then take effect in two to three minutes. The cystoscope will then be carefully passed into your urethra.

Men may be asked to try and pass urine while the cystoscope is being inserted. This is simply to help relax the muscles - no urine will actually be passed.

Once the end of the cystoscope is in the bladder, salt water will be passed through it to fill the bladder up and make the whole of the lining visible. A tiny light and lens enable the doctor to see if any disease is present.

If necessary, the doctor will take a biopsy of the bladder lining for analysis, using specialist instruments that can be passed inside the cystoscope. This procedure is quick and painless.

After the examination, the cystoscope is removed quickly and easily.
 
After the cystoscopy
 
As your bladder will be full, you will probably wish to pass urine again.

You will rest in a full-length chair or on a bed until you feel ready to go home. The nursing staff will be on hand to make sure you are comfortable. If you have had a sedative, you may doze off during this time.
 
Going home
 
If you have a sedative, the effects may last longer than you expect, so you should not drive, operate machinery or drink alcohol for 24 hours after your examination. This means that you will have to arrange for someone to take you home and stay with you for the first 24 hours.

Once home, it's sensible to take it easy for the rest of the day. Most patients feel able to resume normal activities on the following day.

Drinking plenty of water can help reduce the mild stinging that is normal on passing urine for a day or two after this procedure. It can also prevent the development of infection or inflammation. If you develop a high temperature, pain, persistent burning or bleeding, please contact your doctor promptly.
 
Results
 
If you have a biopsy, the results will be ready several days later and will usually be sent in a report to the doctor who recommended the test. Other findings can be discussed before you leave the hospital. After having a sedative, it may be a good idea to have someone with you when you are told the results, as you may not remember them afterwards.


This leaflet describes standard treatment. Your experience may differ slightly. If you have any unanswered questions or concerns, please do feel free to raise them at any time when you come to the hospital.
 
Further information
 
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
 
 
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