Flexible Cystoscopy
A common procedure in urology practice is a cystoscopy which involves inspection of the inside of the bladder. What does the procedure involve? Can I have surgery using this technique?
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This is commonly done for blood in the urine but may also be used to give information in cases of urinary blockage, or prostate trouble. Cystoscopy was traditionally done using a rigid metal tube which gave a good view of the bladder but was unacceptably painful except under general anaesthesia, particularly for men. More recently the flexible cystoscope has allowed most patients to benefit from this technique using only local anaesthetic, with a minimum of discomfort. |
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What does the procedure involve?
The whole procedure, which takes around twenty minutes, can be comfortably done in the outpatient department. You will be asked to remove your clothing from the waist down and to lie on a couch under a blanket. After this the genital region is cleaned with a gentle antiseptic and a local anaesthetic jelly is inserted into the urethra (urinary pipe). For women the procedure uses a similar position to a cervical smear, while men simply lie on their back.
The telescope, which is about half the diameter of a pencil, is passed into the bladder under direct vision. This can cause a little soreness in men as it goes through the prostate, but so far I have not had a male patient afterwards who has decided he would have preferred a general anaesthetic. Once the instrument is in the bladder there is only minimal discomfort (you can even have a look at your own bladder, although this is not compulsory!).
The bladder is inspected and if any abnormal areas are seen a tiny piece may be removed for examination (a biopsy). After the procedure you will empty your bladder and then discuss the findings.
Most people will have a little burning for a few hours on passing urine and some blood may be passed with the urine.
Occasionally an infection may occur and if you are thought to be at risk of this an antibiotic will be prescribed for a day or two.
If you have any fevers, shivering or severe pain following the cystoscopy you must contact Mr Muir or your family doctor.
Can I have surgery using this technique?
Some procedures are easily done under local anaesthesia.
These include retrograde examination of the ureter, removal of ureteric stents and Laser treatment of small recurrent bladder tumours.
Any of these techniques would be discussed in detail prior to proceeding and might need a separate visit with a few hours in hospital
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