A cystoscopy is a procedure that allows the inside of the bladder to be inspected in order to diagnose and treat urethral and bladder disorders.
A narrow tube called an "cystoscope" is passed up the urethra. This allows the doctor to see inside the bladder, take specimens and pictures if required.
Two types of cystoscopy are carried out, flexible and rigid. Rigid cystoscopies are usually carried out under general anaesthetic; flexible cystoscopies are usually carried out using a local anaesthetic jelly applied to the urethra.
The day before your test the doctor will obtain your consent to the procedure. Before you give consent you should have received a full explanation of the reasons for the test, the risks and the benefits. An anaesthetist will visit you before the procedure to examine you and decide the best type of anaesthetic for you (general, spinal or local) depending on the exact type of cystoscopy you are having.
Outpatient flexible cystoscopies
Sometimes, flexible cystoscopy is performed as a day case. For this you will be asked to come in to hospital in the morning, have the procedure under local anaesthetic and go home the same day. It is possible that you will not be able to drive after the investigation if you need to have an injection to relax you. It is advised that you do bring somebody with you to take you home afterwards.
You will be asked not to eat or drink for a few hours before the procedure. If you are in hospital, you will be asked to have a bath and put on a theatre gown. Staff will check that you have the correct identification bands on and will run through a checklist to ensure that you are correctly prepared.
At some point, theatre staff will collect you from the ward area and take you for the investigation on a trolley.
Once you are in theatre, further checks will be made by theatre nursing staff that you are prepared for the investigation. You will be taken to the anaesthetic room where the anaesthetist will administer the anaesthetic if you are to have a general anaesthetic. From there, you are taken into theatre for the procedure.
In theatre there will be the doctor who will perform the procedure, a nurse to help this doctor, another nurse assisting plus the anaesthetist and possibly an anaesthetic assistant.
You will be moved from the trolley onto the theatre table, your legs carefully placed in stirrups. At this point the doctor will apply local anaesthetic gel to the urethra, clean the skin around your urethra after which sterile towels will be placed over your stomach and legs. It takes a little while for the local anaesthetic to work. If you are conscious there will be somebody to talk to, hold hands with if necessary, throughout the preparation and the actual investigation. When you have been prepared, the doctor will proceed with the main investigation.
If you are having local anaesthetic, you will be aware of what is happening. You may feel a little discomfort as the cystoscope is introduced, particularly at the point when it enters the bladder but this should be momentary. You can ask questions if you wish during the procedure. Please tell the doctor if you find the procedure to be more uncomfortable than you think it should be.
When the doctor is finished you will be taken to the recovery area where a nurse will look after you until you are ready to return to the ward.
On the ward nursing staff will continue to monitor your pulse and blood pressure and keep you comfortable. If you require pain control, they will administer this for you. If you have had a local or spinal anaesthetic, you can eat and drink immediately. If you have had a general, it is advisable to start with a few sips of water.
It is likely, that if you have bad a spinal anaesthetic, you will need to lie flat initially, gradually sitting up as you feel able. Some patients do get a headache after spinal anaesthetic. Painkillers will be available if you need them.
Most patients have no problems after a cystoscopy. You may experience some mild discomfort, for example, a slight burning when you pass water but this should improve over a couple of days. Sometimes, patients notice a little blood in their water. This is usually the result of small specimens of the bladder being taken during the investigation for examination in the laboratory. Occasionally, a patient does get a water infection after cystoscopy. If you experience temperature, pain, continuing burning or bleeding please contact your doctor.
Your results will be discussed with you prior to your discharge or at your next outpatients clinic appointment.