Uses, Side Effects, Procedure, Results

If you’re having any issues in your bladder or urethra, a cystoscopy might be necessary. A cystoscopy is an interventional procedure that provides a view of the interior of the bladder and/or urethra, the tube that carries urine from the bladder to outside the body. The test is used for diagnosing and treating medical conditions that affect these organs.

This article will explain more about what you can expect with a cystoscopy, what the procedure and recovery can entail, and what happens when you get the results.

What Is a Cystoscopy?

A thin tube (cystoscope) is inserted into the urinary opening, threaded through the urethra, and into the bladder. A small camera attached to the cystoscope relays a live video feed to a monitor, which your healthcare provider can view.

Purpose of Test

A cystoscopy can be used to investigate symptoms that involve the urethra or the bladder. You may need to have a cystoscopy to determine the cause of concerns, such as:

• Blood in the urine
• Painful urination
• Urinary retention (inability to urinate)
• Recurrent bladder infections
• Frequent urination
• Pelvic pain

The procedure can be done based on symptoms or after an abnormality of the urethra or bladder has been discovered on an X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan, which are non-invasive tests. Cystoscopy provides your healthcare provider with a different view that can help lead to a diagnosis.

Cystoscopy provides your healthcare provider with a different view that can help lead to a diagnosis. Upon visualizing the inside of your urethra and bladder, your healthcare provider may be able to identify structural abnormalities, areas of inflammation, growths, or ulcerations and diagnose several conditions on sight, including:

• Prostate enlargement
• Bladder cancer
• Urethral strictures (regions of urethral narrowing)
• Bladder stones
• Interstitial cystitis
• Ulcerations inside the urethra or bladder
• Growths or cancer

If a diagnosis cannot be made based on appearance alone, your healthcare provider may obtain a sample of abnormal tissue for biopsy during the procedure so that it can be evaluated.

If cystoscopy is being done for therapeutic reasons, it may be to visualize the bladder or urethra to allow for the removal of small growths and bladder stones or to treat urethral strictures.

Limitations

A cystoscopy cannot identify every problem involving the bladder or urethra. For example, it often does not find the cause of urinary incontinence or neurogenic bladder. A cystoscopy also does not help diagnose kidney disease.

Risks and Contraindications

In most cases, a cystoscopy is a safe, standard procedure without complications. However, rare complications can occur, such as an infection or injury. Complications related to general anesthesia are not common, but they can include respiratory or cardiac problems when they occur.

Before the Test

If you have a cystoscopy, your healthcare provider will discuss the procedure with you ahead of time. You may or may not need a biopsy or treatment during your procedure, which will dictate if you have it done at your healthcare provider’s office or elsewhere.

Your healthcare provider and medical team will discuss your specific situation with you and explain the plan and what you need to do to prepare. For example, you may be asked to provide a urine sample before ruling out any urine infection. You may also be asked to avoid urinating for about half an hour before the test so that your healthcare provider can send a urinalysis.

Location

The level of anesthesia that will be used, if used at all, will mainly dictate where your procedure is done. This decision depends on how complicated your condition is and the findings of your preliminary tests.

Most cystoscopy procedures are performed in your healthcare provider’s office with local anesthesia. But if they anticipate that your procedure may take longer than average or may involve painful or extensive removal of tissue or repair of strictures, you will likely need to have your cystoscopy done under sedation or general anesthesia in a hospital or surgical center.

Timing

You should expect to spend about an hour or so at the healthcare provider’s office if you are having a simple procedure done there. If you are having a cystoscopy under general anesthesia, anticipate spending approximately half a day at the hospital or surgical center.

Cystoscopy without anesthesia might take only 10 to 20 minutes. The time can vary based on the reason you’re getting the test done and what is discovered during the procedure. Your medical team can give you a more specific estimate based on your symptoms and preliminary imaging tests.

What to Wear

You will be asked to wear a gown for the procedure, so you can wear anything you want on the day of the test.

Food and Drink

If you are having general anesthesia, you will be asked to abstain from food and drink for about 8 hours before your procedure.

Cost and Health Insurance

As with most tests, your insurance may require a pre-authorization request. The staff at the facility where your cystoscopy will be done will take care of this, but you can check with them and your insurance company ahead of time to confirm. You may need to pay a co-pay, and you can verify the amount with your health insurance carrier in advance.

If you are paying for the procedure completely out of pocket, you should expect to pay several hundred dollars for a simple diagnostic procedure and several thousand dollars for a procedure that includes a biopsy or therapeutic treatment.

What to Bring

You should bring your order form (if provided), your health insurance card, a form of personal identification, and payment to cover the co-pay or the cost of the procedure, as applicable. If you are getting general anesthesia, you should also make sure you have someone who can drive you home after your procedure.

What to Expect on the Day of the Surgery

You will meet with the urologist, who is the healthcare provider who will perform your test. You will also have other team members involved in your care, and they may include a surgical assistant, a nurse, and an anesthesiologist or anesthetist.

You will likely have more people involved in your procedure if you are having it done in an operating room and fewer people if you have it done in a healthcare provider’s office.

Before the Surgery

You will be asked to fill out several forms before your test. These will include an agreement to pay for the test or to authorize your health insurance to pay for it, a patient privacy form, and a consent form stating that you understand the purpose and risks of the procedure.

You will then be asked to undress from the waist down, put on a gown, and empty your bladder. When your medical team is ready to perform the test, you will lie on an exam table and place your feet in stirrups.

Local anesthetics used for a cystoscopy are typically in the form of a gel or other jelly-like substance. If you are to receive this, it will be inserted into the urethra. The healthcare provider will wait a few minutes for the anesthetic to effectively numb the area before inserting the cystoscope.

If your procedure is done under general anesthesia, you will have an IV placed in your arm or hand, and the anesthetic will be injected. You will also be hooked up to oxygen level and heart rate monitors, which will be checked throughout the procedure.

During the Procedure

The cystoscope will then be inserted into the urinary opening. It will make its way to your bladder, with your healthcare provider’s help, via the urethra. Both may be of interest to your healthcare provider, who will pause at times to view them on the monitor.

Your healthcare provider may use a flexible or rigid cystoscope, which are generally the same size. There are advantages to each. Rigid cystoscopes tend to have a better camera and allow your healthcare provider to have more control over removing a mass or a stone, while flexible cystoscopes tend to produce less discomfort. Your cystoscopy may involve a white or blue light to visualize the bladder and urethra. Blue light cystoscopy may be better for detecting bladder cancer.

A solution of saline or sterile water will be inserted into your bladder via the cystoscope once in position. The solution expands the bladder, allowing your healthcare provider to get a more detailed view. You may feel some pressure at this point.

If your healthcare provider finds an abnormal growth, a biopsy may be done during your cystoscopy. While your healthcare provider may have anticipated the need for this in advance, the decision to perform a biopsy may also be made in the moment. It only takes seconds for your healthcare provider to obtain a tissue sample, and you may feel a slight pinch or a cramping sensation during the biopsy.

If you need to have a procedure to remove a mass or a bladder stone or to expand a stricture, it will be performed at this time. This is generally planned in advance.

At the end of the cystoscopy—which generally takes half an hour or less, unless a biopsy or treatment is being performed—your healthcare provider will remove the cystoscope and you should not need any stitches or bandages.

After the Procedure

As long as you are feeling fine, you will be discharged once your team verifies that you are able to empty your bladder. You will be directed to a restroom or provided with a bedpan; ask for assistance, if needed.

If you have general anesthesia, it will take an hour or so to feel awake. Staff will ensure you can walk without assistance before allowing you to head home with someone who can drive you.

If a tissue sample was collected, it will be sent to a lab for testing.

Recovery

After the procedure, you may experience a slight burning sensation when you urinate and see a small amount of blood in your urine. You may also feel the need to urinate frequently, even though the amount you produce each time may be low. This is normal and can be expected for up to 24 hours after the procedure.

Managing Side Effects

Call your healthcare provider promptly if you experience significant bleeding, incontinence, urinary retention, or if you see blood clots in your urine. In addition, if you develop fevers or chills or if your urine appears cloudy, you may have a urinary infection, and you should call your healthcare provider.

Interpreting Results

Your test results are based on your healthcare provider’s observation of your bladder and urethral anatomy during the test and the biopsy results, if applicable. Your healthcare provider may discuss the results with you during the test itself or immediately afterward, or they may schedule a follow-up appointment later to discuss the results and next steps in detail.

Follow-Up

The follow-up plan depends on your results. For example, if you have a urethral stricture, this may need to be repaired with a procedure.

If it is discovered that you have cancer of the bladder, you may need to have chemotherapy, radiation, surgery, or a combination of these treatments. Treatment will depend on what is causing your symptoms.

Summary

Your healthcare provider may recommend a cystoscopy if you have bladder or urethra issues. This procedure is generally well-tolerated and allows them to look inside your bladder and urethra to see what may be causing your symptoms. This will enable them to make an accurate diagnosis and provide appropriate treatment to relieve your symptoms.

A Word From Verywell

Any surgical procedure, even a minor outpatient one like a cystoscopy, can cause anxiety or uncertainty. This is normal. If you’re finding that your anxiety or fear significantly impacts your everyday life, talk with your healthcare provider about ways to manage your anxiety before the procedure and the day of. They may be able to show you some stress management or relaxation techniques or prescribe you some anti-anxiety medications that can help.