A cystoscopy is used to evaluate bladder symptoms of frequency, urgency, bladder pain, hematuria (blood in the urine) or chronic bladder infections. During this procedure, a small scope will be placed into the bladder and the bladder will be distended with sterile water. As the bladder is being distended, your provider will be looking at the walls of the bladder and urethra (bladder neck) for evidence of bladder tumors, stones, polyps, and evidence of inflammation. We will also be evaluating how much fluid your bladder can comfortably hold and how well you empty your bladder. Prior to the procedure, your urine will be checked to make sure no infection is present. You may also be asked to complete a bladder voiding diary and bring these results to your appointment. You will be prescribed an antibiotic to take prior to the procedure and for 2-3 days afterwards to prevent a urinary tract infection. You may also be prescribed a bladder antispasmodic or mild antianxiety medication if you are experiencing significant bladder discomfort. Please check with the office if you have not received any prescriptions prior to the procedure. If you normally take antibiotics before procedures due to a recent joint replacement or leaky heart valve, you will also need to take a special antibiotic before this procedure.
If the procedure is being done in the office, please arrive at your appointment with a comfortably full bladder. You may eat and drink normally prior to your appointment. You will empty your bladder before the procedure, and we will measure how much urine is left in your bladder after voiding. We will then clean your bladder neck opening with an antiseptic solution and apply a local anesthetic gel. We will then place the small scope into the bladder and look around as the bladder is filled. At the end of the procedure, we will usually empty your bladder for you or have you empty your bladder in the toilet. We will record any abnormalities.
The risk of the procedure is a bladder infection, injury to the bladder neck and bladder, and blood in the urine temporarily. You may also experience some increased urgency, frequency and burning with urination for a few days. It is important to complete the course of antibiotics that have been prescribed for you. Most patients experience some mild pressure and discomfort during the procedure, but it is usually well tolerated. If you experience extreme discomfort, the procedure can be stopped and completed on another day in the hospital under anesthesia. Following the procedure, you will meet with your physician to discuss the findings and treatment options.