Cystoscopy for Women | Johns Hopkins Medicine

What is cystoscopy?

Cystoscopy is a procedure that lets the healthcare provider view the urinary tract, particularly the bladder, the urethra, and the openings to the ureters. Cystoscopy can help find problems with the urinary tract. This may include early signs of cancer, infection, narrowing, blockage, or bleeding.

To do this procedure, a long, flexible, lighted tube, called a cystoscope, is put into the urethra and moved up into the bladder. Here, the healthcare provider can look closely at the inside of the urethra and bladder. He or she can also wash the bladder, and access the structures with special instruments used through the scope.

During a cystoscopy, the healthcare provider may remove tissue for further exam (called a biopsy). Some problems can be treated during the procedure.

Why might I need a cystoscopy?

A cystoscopy may be advised if your healthcare provider thinks you have a problem of the urinary tract. For example, a structural problem may lead to a blockage of urine flow or a back flow of urine. If untreated, this may lead to complications.

Cystoscopy may also be used after gynecologic surgery near the bladder to check for proper placement of sutures and support devices.

Some medical problems of the urinary tract that may be found during cystoscopy include:

• Cancer or tumor of the bladder
• Polyps or overgrowths of normal tissue
• Bladder stones, which are calcium crystals that can lead to infection, inflammation, bleeding, and blockages in the urinary tract.
• Scarring and damage caused by frequent urinary tract infections (UTIs)
• Abnormalities of the urinary tract that may be present at birth and may lead to a backflow of urine or kidney problems
• Injury of the urinary tract

There may be other reasons for your healthcare provider to recommend a cystoscopy.

What are the risks of cystoscopy?

Complications of cystoscopy may include:

• Infection
• Bleeding
• Urinary retention due to irritation and swelling from the procedure
• Bladder perforation (poking a hole in the bladder with the cystoscope)

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

Urinary tract infection may interfere with a cystoscopy.

How do I get ready for a cystoscopy?

• Your healthcare provider will tell you about the procedure and you can ask questions.
• You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
• The type of fasting (not eating or drinking anything) needed before the procedure will depend on the type of anesthesia used. Your healthcare provider will give you specific instructions regarding how long to fast. You may be given other instructions about a special diet to follow for a day or two before the procedure.
• If you are pregnant or think you might be, tell your healthcare provider.
• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, iodine, tape, or anesthetic agents (local and general).
• Make sure your healthcare provider has a list of all medicines (prescribed and over-the-counter), herbs, vitamins, and supplements that you are taking.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
• If local anesthesia is used, you will be awake during the procedure, but you may be given a sedative. You will need someone to drive you home afterwards.
• If you think you have a urinary tract infection, tell your healthcare provider, because cystoscopy should not be done. Your healthcare provider may check your urine for infection before doing the procedure. (Signs of infection include things like frequent urination, pain or burning when passing urine, fever, and urine that looks dark, cloudy, or reddish in color and smells bad.)

Based on your medical condition, your healthcare provider may request other specific preparation.

What happens during cystoscopy?

A cystoscopy may be done on an outpatient basis or during a hospital stay. Procedures may vary, depending on your condition and your healthcare provider’s practices.

Generally, a cystoscopy follows this process:

1. You will need to remove any clothing, jewelry, or other objects that may interfere with the procedure.
2. If you are asked to remove your clothing, you will be given a gown to wear.
3. An intravenous (IV) line may be started in your arm or hand.
4. Often an antibiotic is given before the procedure.
5. You may be given an IV sedative or anesthetic, depending on your situation and the type of scope that will be used. This will make you sleepy and not feel pain during the cystoscopy. If a sedative or anesthetic is given, your heart rate, blood pressure, breathing, and blood oxygen level will be monitored throughout the procedure.
6. You will be positioned on an exam table on your back with your knees up and spread apart. Your feet will be placed in stirrups.
7. A numbing medicine in the form of a gel will be put into your urethra. This may be mildly uncomfortable until the area is numb.
8. Once the urethra is numb and/or the anesthesia has taken effect, the healthcare provider will put the cystoscope into the urethra. You may have some discomfort when this is done.
9. As the cystoscope is passed through the urethra, the healthcare provider will check the lining. The cystoscope will be moved up until it reaches the bladder.
10. Once the cystoscope is in the bladder, the healthcare provider may put sterile water or saline into the bladder to help expand it and make the lining of the bladder easier to see. While the bladder is being filled, you may have the urge to urinate or feel mild discomfort.
11. The healthcare provider will check the bladder for any abnormalities. A long, thin tool may be passed through the cystoscope to take out a piece of bladder tissue for testing. A urine sample may be taken from the bladder, too.
12. The cystoscope will be carefully removed after the procedure has been completed.

What happens after a cystoscopy?

After the procedure, you may be taken to a recovery room for observation if sedation or anesthesia was used. Your recovery process will vary depending on the type of sedation that was given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. Cystoscopy is most often done on an outpatient basis.

You may go back to your usual diet and activities unless your healthcare provider tells you otherwise.

You will be encouraged to drink extra fluids, which dilutes the urine and reduces urinary discomfort, such as burning. Some burning with urination is normal after the procedure but should lessen over time. A warm sitz or tub bath may be urged to help ease urinary discomfort.

You may notice blood in your urine after the procedure. This is normal and should clear up over the next day or two.

Take a pain reliever for soreness or discomfort as advised by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

You may be given an antibiotic to take after the procedure. This is to help prevent infection. Be sure to take the antibiotic exactly as instructed.

Tell your healthcare provider if you have any of the following:

• Fever and/or chills
• Urinary frequency or urgency
• Inability to urinate
• Lower back pain
• Continued burning with urination or blood in the urine

Your healthcare provider may give you other instructions after the procedure, depending on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or problems
• How much will you have to pay for the test or procedure

Cystoscopy & Ureteroscopy – NIDDK

On this page:

• What are cystoscopy and ureteroscopy?
• Why do health care professionals perform cystoscopy?
• Why do health care professionals perform ureteroscopy?
• How do I prepare for a cystoscopy or ureteroscopy?
• How do health care professionals perform cystoscopy or ureteroscopy?
• What should I expect after a cystoscopy or ureteroscopy?
• What are the risks of cystoscopy and ureteroscopy?

What are cystoscopy and ureteroscopy?

Cystoscopy and ureteroscopy are common procedures performed by a urologist to look inside the urinary tract.

Cystoscopy is a procedure that uses a cystoscope to look inside the urethra and bladder. A cystoscope is a long, thin optical instrument with an eyepiece at one end, a rigid or flexible tube in the middle, and a tiny lens and light at the other end of the tube. A urologist fills the bladder with fluid and looks at detailed images of the urethra and bladder linings on a computer monitor.

Ureteroscopy is a procedure that uses a ureteroscope to look inside the ureters and kidneys. Like a cystoscope, a ureteroscope has an eyepiece at one end, a rigid or flexible tube in the middle, and a tiny lens and light at the other end of the tube. However, a ureteroscope is longer and thinner than a cystoscope so the urologist can see detailed images of the lining of the ureters and kidneys.

Cystoscope (left) and ureteroscope (right)

Why do health care professionals perform cystoscopy?

A urologist performs a cystoscopy to find the cause of, and sometimes treat, urinary tract problems such as

• frequent urinary tract infections (UTIs)
• blood in the urine, called hematuria
• urinary frequency, urinary urgency, or urinary incontinence
• urinary retention
• pain or burning before, during, or after urination
• trouble starting urination, completing urination, or both
• abnormal cells, such as cancer cells, found in a urine sample

During a cystoscopy, a urologist can see

• stones—solid pieces of material in the bladder formed by high concentrations of minerals in the urine
• abnormal tissue, tumors, or cancer in the urethra or bladder
• stricture, a narrowing of the urethra—a possible sign of an enlarged prostate in men or of scar tissue in the urethra
• secondary signs of obstruction (or blockage), such as an enlarged prostate gland
• other congenital or acquired abnormalities such as duplicated ureters, ureterocele, or diverticulum

During a cystoscopy, a urologist can sometimes treat problems, such as bleeding in the bladder and blockage in the urethra. A urologist may also use a cystoscopy to

• remove a stone in the bladder or urethra
• remove or treat abnormal tissue and tumors
• take a sample of the urethra or bladder tissue for a biopsy
• inject material into the wall of the urethra to treat urinary leakage or prevent vesicoureteral reflux
• inject medicines into the bladder to treat urinary leakage
• obtain urine samples from the ureters
• perform retrograde pyelography—an x-ray procedure in which a urologist injects a special dye into the urinary tract to create images of urinary flow, to show obstructions such as kidney stones and tumors
• remove a stent that was placed in the ureter after a ureteroscopy with biopsy or stone removal

Why do health care professionals perform ureteroscopy?

A urologist performs a ureteroscopy to find the cause of urine blockage in a ureter or to evaluate other problems inside the ureters or kidneys. During a ureteroscopy, a urologist can see

• a stone in a ureter or kidney
• problematic tissue, tumors, or cancer in a ureter or in the lining of a kidney

During a ureteroscopy, a urologist can treat problems such as urine blockage in a ureter. The urologist can also

• remove a stone from a ureter or kidney
• remove or treat abnormal tissue and tumors
• take a sample of ureter or kidney tissue for a biopsy

How do I prepare for a cystoscopy or ureteroscopy?

Your urologist will ask about your medical history to determine whether you need a cystoscopy or ureteroscopy. You may need to give a urine sample to test for a UTI. If you have a UTI, you may need to take antibiotics before either procedure.

Your urologist will also ask about any medicines you are taking, ask if you have any allergies, talk about anesthesia, give instructions for what to do before the procedure, and discuss what to expect afterward. In some cases, you won’t need special preparations for a cystoscopy. In other cases, your instructions may include

• when to stop certain medicines, such as blood thinners
• when to stop eating and drinking or, conversely, when to drink plenty of liquids
• when to empty your bladder before the procedure
• whether to arrange for a ride home after the procedure

To prepare for a cystoscopy or ureteroscopy, your urologist will talk with you about anesthesia, give you instructions for what to do before the procedure, and discuss what to expect afterward.

How do health care professionals perform cystoscopy or ureteroscopy?

A urologist can perform your cystoscopy during an office visit, in an outpatient center, or at a hospital. Ureteroscopies are usually performed in an operating room under anesthesia. A simple exploratory procedure takes about 15 to 30 minutes, including preparation. The procedure can be longer if your urologist performs additional work like taking a biopsy or removing stones from the bladder or ureters.

An anesthetic gel may be applied around the urethral opening, or a local anesthetic may be injected into the urethra.

Sedatives and general anesthesia are often given for a

• ureteroscopy
• cystoscopy with biopsy
• cystoscopy to inject material into the wall of the urethra or ureters
• cystoscopy to inject medicine into the bladder

Sedation helps you relax and be comfortable. General anesthesia puts you into a deep sleep during the procedure.

The health care team will monitor your vital signs and make you as comfortable as possible.

The urologist will position you and make sure the anesthesia is working. The urologist will then gently insert the cystoscope into your urethra and slowly guide it to the bladder. A sterile liquid called saline will be used to slowly fill the bladder, so the urologist has a better view of the bladder wall. As the bladder fills with liquid, you may feel some discomfort and the urge to urinate. The urologist may remove some of the liquid from the bladder during the procedure.

During a cystoscopy, the urologist will examine the lining of the urethra and bladder and may insert small instruments through the cystoscope to treat problems in the urethra and bladder or perform a biopsy.

View full-sized imageDuring a cystoscopy, a cystoscope is inserted through the urethra into the bladder.

During a ureteroscopy, the urologist will focus on viewing the ureter and lining of the kidney, known as the renal pelvis. The urologist may also insert small instruments through the ureteroscope to treat problems in the ureter or kidney, perform a biopsy, or cauterize a bleeding area.

View full-sized imageDuring a ureteroscopy, a ureteroscope is inserted through the urethra and into the ureter.

After either procedure, the urologist may remove the liquid from the bladder, or you may empty your bladder.

What should I expect after a cystoscopy or ureteroscopy?

You will be able to go home after almost any cystoscopy performed in an outpatient office setting. If it is performed in an operating room, you will most likely go home the same day as the procedure, depending on what type of anesthesia you receive. If you receive general anesthesia, you may have to wait 1 to 4 hours before going home. In some cases, you may need to stay overnight in the hospital.

Before leaving, try to use the restroom to make sure you can urinate. You’ll be given discharge instructions for rest, driving, and physical activities after the procedure.

Depending on your procedure and what was done, you may

• have a mild burning feeling when urinating
• see small amounts of blood in the urine
• have mild discomfort in the bladder area or kidney area when urinating
• need to urinate more frequently or urgently

These problems should not last more than 24 hours. Tell a health care professional right away if bleeding or pain is severe, if you cannot urinate, or if problems last more than a day.

Once you are at home, your health care professional may recommend you

• drink 16 ounces of water each hour for a few hours after the procedure
• take a warm bath to relieve any burning feeling
• hold a warm, damp washcloth over the urethral opening to relieve discomfort
• take an over-the-counter pain reliever
• take an antibiotic for 1 or 2 days to prevent an infection

If you had a ureteroscopy and needed a temporary stent placed in the ureter to drain urine while swelling goes away, the stent may cause some pain, discomfort in the kidney or bladder area, or the need to urinate frequently and urgently. The discomfort is generally mild. However, these sensations may be present during the entire time you have the stent. The stent may be left in the ureter for a few days to a week or more. Your urologist may need to perform a cystoscopy to remove the stent in the ureter.

What are the risks of cystoscopy and ureteroscopy?

The risks of cystoscopy and ureteroscopy include

• UTIs
• abnormal bleeding
• abdominal pain or a burning feeling or pain while urinating
• the inability to urinate swelling
• injury to the urethra, bladder, or ureters
• urethral narrowing due to scar tissue formation
• complications from anesthesia

Seek care right away

After a cystoscopy or ureteroscopy, call or see a health care professional right away if you

• can’t urinate and feel like your bladder is full
• have burning or painful urination that lasts more than 2 days
• see bright red urine or blood clots in the urine
• have a fever, with or without chills
• feel severe discomfort

Bladder cystoscopy in Moscow – what is it, how to do it, preparation, price

Pathology of the bladder is a widespread phenomenon, especially in older people. As a rule, diseases progress rapidly and
negatively affect the functioning of the body. Early detection of urinary tract pathologies will help get rid of the disease in a short time.
Therefore, urologists recommend that patients seek diagnostics at the slightest discomfort.

In the urology department of the K + 31 clinic, patients can undergo a wide range of modern diagnostic
studies, including endoscopic examination of the bladder.

What is a cystoscopy?

The method consists in the study of the bladder, its mucous membranes. For the procedure, a special device is used – a cystoscope. This is an endoscopic equipment equipped with a light source and a high-resolution video camera at the end.

The urologist inserts the instrument into the patient’s bladder through the urethra, the information obtained is displayed on the overview monitor. With the help of optical and digital magnification, the doctor examines the structure of the inner wall of the urinary and urethra, assesses the condition of the organs from the inside.

Indications for the diagnostic procedure

Cystoscopy is an important study to clarify the diagnosis after other examinations: ultrasound, laboratory tests, cystogram (x-ray of the bladder), etc.

Also the reason for the appointment of diagnostics will be:

• surgical treatment (scheduled) on the pelvic organs;
• chronic cystitis with frequent periods of exacerbation;
• Presence of sediment or blood clots in urine;
• changes in odor or color of urine;
• discomfort or pain during bowel movements;
• frequent urination;
• pain in the lower abdomen or back;
• sensation of incomplete emptying of the bladder.

These symptoms may indicate serious illness and should be checked by a specialist. Cystoscopy is prescribed for suspected cystitis, prostatitis, enuresis, urolithiasis, etc.

What does the diagnosis show?

During cystoscopy, the diagnostician receives the following information about the state of the genitourinary system:

• development of an inflammatory process;
• structural anomalies;
• stones, hernias;
• texture and color of the bladder mucosa;
• the presence of foreign bodies in the body;
• ulcerative manifestations, the presence of a blood trail, mucosal atrophy;
• consequences of trauma – ruptures, cracks, hematomas;
• neoplasms of various nature;
• strictures of the urethra.

The high information content of the study makes it indispensable for monitoring the treatment of complex pathologies and complications.

Cystoscopy manipulations

The use of a cystoscope offers a wide range of therapeutic options. With its help, during a urethrocystoscopy session, the doctor can:

• take tissue for subsequent biopsy;
• remove polyps and other small neoplasms;
• carry out coagulation of ulcerative areas and erosions in the study area;
• crush and remove small stones;
• remove foreign bodies;
• to introduce drugs.

In some cases, therapeutic manipulations are carried out urgently, for example, if the pathology was detected directly during the diagnosis.

Contraindications to the procedure

Like any medical intervention, cystoscopy has a number of limitations. It is not used for:

• inflammatory processes in the genitourinary system;
• urethral fever;
• profuse bleeding from the urethra;
• urethral injuries;
• hemophilia.

In order to completely rule out the presence of infection and carry out the procedure, the patient must provide the result of a urine test that was taken no more than five days ago.

Bladder cystoscopy in women

Due to the anatomical features (short and straight urethra), women tolerate this type of diagnosis more easily. Urethrocystoscopy is often prescribed and is a common method for clarifying diagnoses such as cystitis and inflammation.

Bladder examination in women may cause only mild discomfort as it is performed under local anesthesia. The exception is large uterine tumors. Such a pathology requires gentle research methods, therefore flexible endoscopy is used.

During pregnancy, cystoscopy in women is performed in a hospital for kidney drainage if blood is found in the urine.

Bladder cystoscopy in men

The length of the male urethra exceeds 20 cm, examination requires experience and caution from the doctor. To eliminate discomfort, the procedure is performed under anesthesia.

If examination is required in childhood, a special, flexible endoscope is used. Diagnosis is carried out by pediatric specialists with extensive practical experience.

Cystoscopy: preparation

In order to get the maximum information during the examination, the patient must be properly prepared for the procedure. For this you should:

• Refuse to eat 10 hours before diagnosis.
• Stop all liquids 4 hours before your procedure.
• Perform genital hygiene.
• Empty the bladder immediately prior to cystoscopy.

On the appointed day of the study, it is recommended to avoid sports, driving a car and any activity that requires increased concentration of attention.

If cystoscopy is used for therapeutic procedures, doctors prefer to put the patient to sleep with general anesthesia. Spinal anesthesia can also be used – in this case, the sensitivity is turned off only in the lower half of the body, the patient remains conscious.

The use of anesthesia is justified if the patient has a high sensitivity to pain or mental disorders that may interfere with the procedure.

How bladder cystoscopy is performed

On average, the procedure takes about a quarter of an hour. In the case of additional medical manipulations (taking a biopsy, removing the identified neoplasms), the time may increase.

Two types of endoscopes are used for examination: rigid and flexible. The first allows you to get a greater overview during the procedure, the second is less traumatic, easily penetrates into hard-to-reach places. The choice of endoscopic equipment is carried out by the doctor, based on the characteristics of the patient’s body and his diagnosis.

The algorithm for performing cystoscopy is as follows:

1. The patient changes into a sterile gown, lies on the couch on his back, legs bent at the knees.
2. Antiseptic treatment of the genitals is performed.
3. The doctor selects anesthesia (injects a gel with lidocaine or novocaine solution into the urethra, puts the patient into a medical sleep, etc. ).
4. The doctor inserts the endoscope through the urethra into the bladder and slowly advances it towards the bladder.
5. A sterile fluid (saline or water) is passed through the cystoscope, filling and distending the bladder. This allows the doctor to examine its inner surface.

After the procedure is completed, the patient remains in the clinic for half an hour under medical supervision, after which he can go home on his own. If general anesthesia was performed, the length of stay in the clinic increases.

Possible complications

Cystoscopy is a safe diagnostic method. However, if it is carried out by an inexperienced specialist or the patient ignores the basic rules of hygiene, complications may arise. These include:

• bladder wall puncture;
• the presence of blood in the urine for two days after the procedure;
• cystitis;
• urinary erosion;
• infectious diseases of the genitourinary organs.
• temporary urinary incontinence (in men).

If the test is performed correctly, discomfort and mild soreness will resolve within 48 hours.

If after the procedure there is severe pain during urination, body temperature rises, you should immediately seek medical help!

Cystoscopy in the K+31 clinic in Moscow

In the medical center, the procedure is carried out using modern equipment. The medical staff of the clinic guarantees the confidentiality of personal data and the high level of services provided at affordable prices. Experienced urologists and anesthetists at the K+31 clinic do everything in their power to ensure that the procedure is carried out quickly, with maximum comfort and painlessness for the patient.

The price of cystoscopy of the bladder in women and men is from 10,300 rubles.
The exact cost depends on the chosen method of anesthesia, the need for concomitant manipulations.

Make an appointment with a clinic specialist at a convenient time for you. Clinic staff will be happy to answer all your questions and provide the necessary assistance.

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Cystoscopy.!

content

1. What is cystoscopy and why is it performed?
2. How to prepare and how is the examination carried out?
3. What are the risks of cystoscopy?
4. What can interfere with cystoscopy and what should you be aware of?

1.What is cystoscopy and why is it performed?

A cystoscopy is a procedure that allows your doctor to examine the inside of your bladder. Cystoscopy uses a special thin instrument called a cystoscope. During cystoscopy, bladder stones and small growths can be removed. Thus, thanks to cystoscopy, the bladder avoids surgical intervention.

Cystoscopy is done to:

• Find causes of blood in the urine (hematuria), painful urination (dysuria), urinary incontinence, inability or sudden need to urinate;
• Look for urinary tract problems, such as blockage in the urethra;
• Remove foreign objects;
• Take tissue sample for biopsy;
• Insert catheters to help move urine from the kidneys to the bladder.

In addition, cystoscopy can detect problems in the bladder that are not visible on x-ray.

A must to check out!
Help with treatment and hospitalization!

2. How to prepare and how is the examination carried out?

How to prepare for a cystoscopy?

Tell your doctor before having a cystoscopy:

• Allergies to any medication, including anesthetics;
• About any diseases of the circulatory system and about taking blood-thinning drugs;
• About a possible or confirmed pregnancy.

How is a cystoscopy performed?

Cystoscopy performed by a urologist with the help of assistants.

You will need to undress and lie down on the examination table, you will be given a special diaper to cover yourself.

You may be given a sedative one hour before the test to help you relax. The genital area is treated with an antiseptic. The test is performed under general, local or spinal anesthesia.

After the anesthesia has taken effect, the lubricated cystoscope is inserted into the urethra and advanced towards the bladder. After the cystoscope has entered the bladder, a sterile fluid is pumped into the bladder to help expand it. The expansion of the bladder is necessary for a better view.

The residence time of the cystoscope in the bladder is from 2 to 10 minutes. But the study itself can take up to 45 minutes if additional tests, such as x-rays, are required.

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