Cystoscopy refers to the direct visual examination of the inside of the bladder using a small telescope called a cystoscope. The cystoscope has a light at the tip to illuminate the bladder. There is a channel through which water flows and fills the bladder, stretching it out to allow better visualization. The cystoscope is inserted directly through the urethra so that it can also be seen. You may occasionally see cystoscopy called cystourethroscopy, but these are the same thing.
A number of specialized instruments have been created that are able to be passed through the cystoscope.These instruments allow your urologist to take biopsies, inject dyes, crush bladder stones, and use cautery inside the bladder. Before the invention of cystoscopy, these procedures would all have required making an incision in the abdomen and performing open surgery. A flexible cystoscope is a smaller scope that can be easily used in the office for diagnosis and follow-up. It does not require any anesthesia but has a limited ability to take biopsies, cauterize, and so forth. Often a patient will have a flexible cystoscopy in the office and then go to the operating room only if necessary for biopsy, resection, or further procedures. There is little risk to the patient from a simple cystoscopy.
After the procedure, you may notice some burning the first couple of times that you urinate after the test. Occasionally, some faint blood will be in the urine. If the burning or irritation persists beyond this, you should contact your doctor, as it could be the sign of a urinary tract infection. To help prevent this, many physicians will prescribe an antibiotic to be taken at the time of the procedure. When I first saw the cystoscope, I said to my doctor that there was no way that he was putting that instrument where he said he was putting it.
It looked like a garden hose to me. But of course, he eventually persuaded me that he needed to do the procedure and that it was best to do it in the office. He told me he would put some numbing jelly into my urethra, and that since the instrument was flexible it would follow the curves and that it was smaller than the opening that I urinated through. Well I didn’t think so, but I finally gave in. To tell you the truth, it wasn’t half as bad as I envisioned. Now I have the procedure performed every 3 months, and I don’t even think twice about it. (N. B., 58 years old)