Cystoscopy

A cystoscopy is an examination of the inside of the bladder and urethra, the tube that carries urine from the bladder to the outside of the body. In a woman, the urethra is just above the vagina, and in a man, it is the opening at the end of the penis. The test is also referred to as a cystourethroscopy, or more simply, a bladder scope.

A cystoscope is a thin, long instrument with an eyepiece on the external end and a tiny camera and light on the end that is inserted through the urethra, and into the bladder. The cystoscope magnifies images from the camera onto a screen where your doctor can see them. The cystoscope also has extra channels within the sheath to insert other small instruments that can treat or diagnose urinary problems.

Reasons for Carrying out a Cystoscopy

A cystoscopy is carried out to assess and diagnose a range of urinary conditions. These include:

• Frequent urinary tract infections
• Blood in the urine (haematuria)
• Overactive bladder (a frequent and urgent need to urinate)
• Chronic pelvic pain
• Painful urination
• Interstitial cystitis (pain bladder syndrome)
• Unusual cells found in a urine sample
• A urinary blockage caused by an enlarged prostate gland
• Bladder diseases such as bladder cancer, bladder stones, non-cancerous growths and small tumours

Types of Cystoscopy

There are 2 types of cystoscopy that can be performed. They are as follows:

Flexible Cystoscopy

A flexible cystoscopy uses a thin, flexible cystoscope that has a camera or eyepiece at the end that allows for visual inspection of the lining of the bladder or urethra. It can be used to take biopsies of the lining of the bladder, or remove ureteric stents that would previously have been placed.

A flexible cystoscopy differs from a rigid cystoscopy due to the soft nature of the tube that allows the procedure to be carried out under a local anaesthetic rather than a general. You do not need to be in any particular position when having a flexible cystoscopy and the doctor will help you find a comfortable position. Flexible cystoscopies are usually performed to look inside your bladder.

Rigid Cystoscopy

A rigid cystoscope is slightly wider than a flexible cystoscope and as the name suggests, it does not bend. Rigid cystoscopies are generally carried out if you are likely to require treatment for a problem in your bladder.

You will need to lie on your back with your knees up and apart, with your feet in stirrups. As the procedure is more invasive than a flexible cystoscopy, you will be given a general anaesthetic, meaning you will be asleep throughout the procedure and will not feel any pain.

Preparing for a Cystoscopy

If you are having a rigid cystoscopy, you should not eat anything after midnight the evening before your cystoscopy. This is to ensure you do not feel nauseas or vomit with the general anaesthetic. You can drink water up to 4 hours before your operation.

You will attend a pre-assessment appointment at the hospital at least a week before your procedure to check your vitals such as blood pressure and pulse is normal. This will also give you the opportunity to discuss any concerns you have about the procedure.

During the Procedure

Flexible Cystoscopy

During a flexible cystoscopy, you will be given a local anaesthetic or sedation to ensure you feel relaxed during the procedure and do not feel any discomfort. You can lie in any position, but most frequently, people lie on their back. 

You will initially have the perineum (genital region) thoroughly washed, followed by sterile drapes applied. The cystoscope is lubricated and inserted into the urethra. This is then passed into the bladder where it is drained and filled with a sterile solution so the doctor can see the entire bladder wall. The bladder is then examined and drained once the procedure is complete. A flexible cystoscopy is generally used for very minor procedures and takes no more than 5 minutes.

Rigid Cystoscopy

You will be given a general anaesthetic to help you sleep throughout the whole procedure. As with a flexible cystoscopy, the area will be washed and the cystoscope inserted into the urethra and passed into the bladder. The same process of expanding the bladder with saline solution will also be applied. The bladder is then viewed with a tiny video camera so images can be seen on a monitor in the operating room. The cystoscope has channels that allow other instruments to be passed through so the doctor can perform more complex procedures such as stone removal, cauterisation and biopsies for suspected tumours.

The entire procedure takes approximately 15-30 minutes to complete, and once you have recovered from the anaesthetic, you will be allowed to return home. You will need to have someone to drive you home.

After your Cystoscopy

You should be able to return to your normal activities fairly soon after your cystoscopy, although it might be a couple of days if you had a rigid cystoscopy.

Complications with a Cystoscopy

It is entirely normal to feel a little discomfort after your procedure, particularly a burning sensation when urinating. You may also see a bit of blood in your urine for a day or two, particularly if you had a biopsy, but this is nothing to be concerned about, unless it continues for longer than a few days. Drinking lots of water can help ease any burning and bleeding.

Some patients do develop more serious complications; these include:

Swollen Urethra

This is the most common complication that can make urination difficult. Contact your doctor if you cannot urinate for more than 8 hours after your procedure.

Infection

Infection is rare, but can happen if germs enter the urinary tract. Symptoms of an infection include:

• Lower back or side pain
• Nausea
• Fever
• Foul smelling urine

The above could indicate a urinary tract infection (UTI). If you think you have an infection, contact your doctor as you may require antibiotics.

Bleeding

A little bleeding for a couple of days is entirely normal, but you should contact your doctor if any of the below symptoms are coupled with bleeding:

• Unable to urinate, even when you feel you need to
• Persistent abdominal pain
• Bright red blood or clots of tissue in your urine
• A fever above 30oC (100.4oF)

Need Help?

At One Healthcare we can book you in to see a specialist Urological surgeon for an initial consultation, usually within 48 hours.  Cystoscopy is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Cystoscopy treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Hatfield Hospital.

Why One Hatfield

• Modern purpose-built hospital opened in December 2017
• 0% and low finance options**
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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