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Overview

A cystoscopy is a procedure where a hollow tube fitted with a camera lens, called a cystoscope, is inserted into the urethra and then slowly and carefully advanced into the bladder.

The procedure allows the examining surgeon to directly visualize the urethra, lining of the bladder, and the openings of the ureters to assess if any pathology is present or not.

Indications

A cystoscopy may be performed to diagnose, monitor, and even treat certain conditions that affect the urogenital system. Indications for performing the procedure may include:

  • Investigating patient complaints related to the urinary or genital system such as blood in the urine, painful urination, or struggling to pass urine. The cause of frequent urinary tract infections is also investigated further with a cystoscopy.
  • Removing masses attached to the lining of the bladder or cutting adhesions that develop in the urethra due to persistent infections.
  • Diagnosing or ruling out conditions such as bladder cancer or bladder stones. Another instrument can be passed through the cystoscope to perform a biopsy and remove a tissue specimen for further analysis.
  • Discovering the presence of an enlarged prostate by visualizing a narrowing in the urethra where it passes through the prostate gland in males. 

Risks and Complications

Although a cystoscopy is a relatively safe and quick procedure there are certain complications that may occur in some individuals and can include the following:

  • Abdominal pain and a burning sensation when urinating may be experienced but these are self-limiting problems that resolve within a short period of time. Pain is usually managed with mild analgesics and over-the-counter medication for the duration of the symptom.
  • Blood may be present in the urine after the procedure is performed but this is very minimal. Severe bleeding may occur but this is a rare complication.
  • Post-procedural infections may occur due to the introduction of pathogenic organisms into the bladder. Due to strict sterile protocols that are in place, this is a very rare occurrence but it may develop in some cases. In patients who are at risk of developing an infection, antibiotics are prescribed to be taken before and after the cystoscopy is performed.
  • Erectile dysfunction has been reported in some men as well as decreased libido in both genders. These are also self-limiting issues though and tend to resolve within two to three weeks.

Signs and symptoms of a possible serious complication may include the following:

  • Developing a fever of more than 38.5 degrees C.
  • Having rigours or chills.
  • Not being able to pass urine at all after the procedure.
  • Burning or pain during urination lasting longer than two days after the procedure.
  • Persistent and/or severe abdominal pain and nausea.
  • Passing bright red blood or heavy clots in the urine.
Any patient who experiences these issues after having a cystoscopy performed on them should call the physician who performed the procedure or present to an emergency room to seek immediate medical attention.  

Suggestions

The following are suggestions made to patients who have had a cystoscopy performed on them to help relieve some of the possible discomforts they may experience after the procedure.

  • Drink plenty of water to help flush out the bladder. 
  • Apply a warm and moist washcloth over the opening of the urethra to help reduce any pain.
  • Taking a warm bath may also help, but some doctors may prefer that their patients don't do so after the procedure.

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