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Cystoscopy Procedure at Our Los Angeles Center

Cystoscopy is a procedure that provides minimally invasive access to the urethra and the interior of the bladder for diagnostic evaluation, biopsy and certain types of surgical treatment. A narrow tube carrying a fiber-optic instrument is inserted into the urethra and up into the bladder to provide a clear view of all the tissues in these areas through a special eye piece. There is no external scarring with this procedure since the scope is gently introduced into the urethra and there is no incision required.

Who Is a Candidate for Cystoscopy?

This procedure is used to treat both men and women. Patients who have problems such as a urinary tract infection that recurs or doesn’t respond to conventional treatment may benefit from examination with a cystoscope to identify the underlying cause. Other symptoms that can be investigated might include:

  • Painful urination or chronic pelvic pain
  • Inability to urinate
  • Blood in the urine
  • Frequent or urgent urination
  • Urinary incontinence
  • Suspicious cells discovered in a urine sample

 

This procedure is of particular interest to patients who wish to avoid open surgery to the urethra or abdomen to diagnose or treat disease. A cystoscopy is an outpatient procedure and most patients can return to normal activities very quickly.

Patients with a damaged or very narrow urethra may be poor candidates for cystoscopy. Sometimes, special instruments can be used to gently widen the urethra and create enough room for the scope. Cystoscopy also carries a risk of infection – even though the equipment used is sterilized. Patients with a compromised immune system may be at risk for serious systemic infection and may not be good candidates for the procedure. Whether the risks outweigh the benefits is determined on a case by case basis.

What Procedures Can Be Done Via Cystoscopy?

An urologist can use the scope to identify and/or treat a broad range of conditions, including:

  • Abnormalities such as ulcers, polyps or lesions (tumors that may or may not be cancerous)
  • Bleeding in the bladder
  • Narrowing of the urethra (from swelling, infection, scarring or birth defect)
  • Blockages in the bladder or urinary tract (growths, foreign objects, stones, etc.).
  • Prolapse of the pelvic organs (in women)
  • Enlarged prostate (in men)

 

Besides looking at the urethra and bladder, a cystoscope can be used in tests that explore problems with the prostate, kidneys and ureters (the tiny tubes that deliver urine from the kidneys to the bladder). The scope can be used to introduce a number of different instruments. For example:

  • A video camera to show an image of what the urologist is looking at in excellent detail on a large monitor
  • An electrocautery tool that allows the surgeon to stop any bleeding found in the bladder by closing off blood vessels with a tiny electric charge
  • Biopsy tools to take samples of tissue or urine for further analysis
  • A catheter to introduce contrast dye that shows up well in x-rays
  • Surgical tools such as laser devices for the removal of small polyps, tumors and urinary tract or bladder stones
  • A stent to keep the ureter open so urine flows freely from the kidney to the bladder

 

Procedure Overview

This procedure may be done under local, spinal or general anesthesia to make you as comfortable as possible. Once the anesthesia is administered, the scope is lubricated and inserted slowly and carefully into the urethra and up into the bladder, examining all tissues along the way. The bladder is irrigated with water or saline solution to extend it and allow a thorough investigation of the interior. A complete visual examination may be followed by x-rays, biopsy, removal of bladder stones, stent placement or other tests and procedures as explained by the urologist prior to treatment. Simple examination with the cystoscope is usually over in a matter of minutes. More complex procedures can take longer. Most patients are up and walking within an hour or two (earlier if only a local anesthetic is used).

This procedure can cause temporary issues with urination. Some patients may need a catheter in place for a short period of time, but this is removed before they go home. Common side effects of cystoscopy include:

  • Temporary difficulty urinating due to swelling in the urethra or weakening of the bladder muscles
  • Very small amount of blood in the urine

 

Rare side effects may include:

  • Infection (this is usually prevented or treated with medications)
  • Perforation of the urethra, bladder or ureter that requires surgical repair
  • Scarring of the urethra, causing difficulty urinating (most often seen in men undergoing removal of a portion of the prostate)

 

The risk of complications is lower with cystoscopic treatment than with open surgery and the recovery time is much shorter. This makes cystoscopy the preferred method for diagnosing and treating urinary tract disorders for most patients.

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