What is a Cystoscopy and Why Might You Need One

If you’re suffering from continuous (chronic) or recurrent bladder issues, your doctor may suggest you undergo a cystoscopy procedure. This examination uses a cystoscope, which is a thin tube with a camera and light on the end. The cystoscope is inserted into the bladder via the urethra, allowing inspection of the inside of the bladder to get a better idea of what may be occurring inside.

Why Do I Need a Cystoscopy?

Your doctor may recommend a cystoscopy for several reasons, but the most common are urinary issues such as the constant need to urinate or painful urination. There are other issues that may require a cystoscopy too, such as:

Cystoscopy can reveal various issues within the bladder, from cancerous tumours to noncancerous growths, blockages, enlarged prostate or issues with the ureters.  A cystoscopy can also be used to take a biopsy of bladder tissue for further testing.

Your doctor should clearly explain to you the purpose of your cystoscopy examination. If you’re unsure on why you’re undergoing a cystoscopy, do talk to your doctor.

Preparing for a Cystoscopy

Preparing for a cystoscopy can involve several different steps and procedures depending on your personal health status. If you’re suffering from a UTI or have weakened immune system, you may be may be required to provide a urine sample before your cystoscopy and be prescribed antibiotics before the procedure to help prevent a UTI from occurring as a result of the cystoscopy. As although the cystoscope is sterilised, it can transfer bacteria from the outside of your body or lower part of your urethra further into the urinary system, leading to an infection.

You should make sure that you are able take any regular medication before the procedure, as some of your medications may need to be temporarily paused in certain circumstances. This should be discussed with your doctor.

If you are going under general anaesthetic, you may need to arrange to be collected after your surgery as you may feel unwell and be unable to drive yourself home. You should allow yourself some time after the procedure to rest also and shouldn’t head straight back to work or for strenuous activity afterwards.

During recovery after cystoscopy, you may experience some urinary issues and pain. We recommend keeping some TENA incontinence products such as incontinence pads or underwear on hand, as these can help give you peace of mind, and make you feel more comfortable throughout your recovery.

Anaesthesia for a Cystoscopy

Not all cystoscopy procedures take place in the hospital or use the same type of anaesthetic. However you will have to undergo some form of anaesthetic, and should discuss your options with your doctor. The main types of anaesthetic options are:

  • Local Anaesthetic – If you’re being treated at your local doctor’s surgery, or as an outpatient, you’re likely going to be awake for the procedure. This will involve use of local anaesthetic to numb a very specific area of your body, meaning you will be able to eat and drink normally on the day of the procedure and go home straight afterwards.
  • Regional Anaesthetic – Regional anaesthesia will numb a larger area of the body and can be administered into the back, numbing you below the waist. This is a more significant anaesthetic, meaning you may need to stay at the hospital for a while after while the anaesthetic wears off.
  • General Anaesthetic – This form of anaesthesia will mean you are unconscious for the procedure. You may not be able to eat for some time beforehand and will need time to recover from the effects of the anaesthetic. You won’t be able to go home straight afterwards, as you’ll need time to recover.

Cystoscopy Procedure

If you’re nervous about your cystoscopy, it can be helpful to learn a little more about what the procedure entails, so that you’re not surprised by anything that happens.

The first thing you’ll need to do before the procedure begins is to empty your bladder. You will then change into a hospital gown and get comfortable on the treatment table. UTIs after cystoscopy can be problematic, so at this point you may be offered antibiotics to help prevent this.

You will then be administered with whichever anaesthetic was planned for you (local, regional, or general). A numbing gel will be applied to your urethra also. It’s important to note that you may still have some sensation unless you’re under general anaesthetic.

The doctor will then lubricate the cystoscope and will begin to insert it into the urethra. The sensation may burn slightly and may also feel similar to urinating. The type of cystoscope used can vary depending on the purpose of the examination. For an exploratory cystoscopy, a flexible scope will be used, but for a biopsy a slightly thicker rigid scope is used.

At this point the cystoscope will enter the bladder and a sterile liquid will be used to flood it. This helps your doctor to make their observations. When this fluid enters your bladder, it may feel strange, or like you need to urinate.

The whole process may only take 5 minutes whilst under local anaesthetic, but if you go under general anaesthetic, the procedure can take 15 to 30 minutes.

Are There Cystoscopy Risks?

Almost all types of medical procedure come with some sort of risk, and a cystoscopy is no different. A few of the most common side effects of a cystoscopy are:

  • Burning sensation when urinating
  • Needing to urinate more frequently (don’t attempt to resist the urge to urinate as any blood left in your bladder could clot causing a blockage.)
  • Blood in the urine

These typically last no more than 2-3 days after the cystoscopy examination.

More serious cystoscopy risks include:

  • Swollen Urethra (urethritis) – This is a common complication and can make urination very difficult or uncomfortable. If you’re still unable to urinate 8 hours after the procedure, seek medical assistance. 
  • Infection – While uncommon, it is possible to get a UTI from a cystoscopy. If you come down with a fever, nausea, or are experiencing pain in the lower back, you may have an infection. Contact your doctor for antibiotics to help clear the infection and aid your recovery.
  • Bleeding – If you are bleeding a lot or it isn’t stopping, seek medical assistance urgently.
  • High fever – If you develop a high fever, you should seek medical assistance urgently.
  • Blood or clots in the urine – You should also seek medical help of you notice bright spots of blood or clots of blood in the urine.
  • Stomach pain – If you experience stomach pain after a cystoscopy you should also seek medical help.

Recovery After Cystoscopy

Recovery is very important if you’ve had a cystoscopy, as this is what will help reduce the risk of complications or side effects from the procedure. 

There are a few things you can do to aid your recuperation. Ideally you should drink plenty of water and urinate as often as you need to. You can relieve some of the discomfort by laying a warm, damp washcloth over your urethra. Using TENA incontinence pants can also help give you deal with any incontinence issues that may occur after the cystoscopy procedure.

If you have been given permission by your doctor, you can take certain painkillers, but make sure they have given explicit permission.

If you were under general anaesthetic, recovery after cystoscopy can take a day or two. You may feel drowsy or tired and should not use heavy machinery or drive in this condition. Ideally you should have someone look after you during this period.

If you had a biopsy, you should not have sex or perform heavy lifting for at least two weeks and should ideally seek advice from your doctor before resuming these activities.

Your Cystoscopy Results

Cystoscopy results can take anything from a few days to a few weeks to come back, depending on the specific purpose of the procedure. Biopsies typically take the longest, and you should ask your doctor to be kept updated.

We hope that learning a little more about what a cystoscopy entails will make the whole process much less stressful and worrisome if you’re scheduled for this procedure. If you’re suffering from other urinary issues you can learn more about these issues them and how TENA can support you in dealing with them, whether it’s UTIs or incontinence.

Sources: 

  1. https://www.nhs.uk/conditions/cystoscopy/
  2. https://www.mayoclinic.org/tests-procedures/cystoscopy/about/pac-20393694 
  3. https://www.webmd.com/prostate-cancer/guide/cystoscopy