Cystoscopy

Definition: What is a cystoscopy?

Cystoscopy refers to an examination that looks at the inside of the urinary bladder and the urethra using a camera. In order to perform this procedure, a device called a cystoscope is introduced into the urinary bladder through the urethra. The cystoscope contains a camera, a light source and special instruments. It can either be rigid or flexible and lets the specialist inspect the bladder for abnormalities, for example lesions of the bladder wall orbladder stones.

Indications: When to perform a cystoscopy?

Whenever physicians needs to investigate certain complaints and diseases, they will send the patient for a cystoscopy. Such symptoms include the presence of blood in the urine, recurring urinary tract infections or difficulties with emptying the bladder, for instance.

Male patients frequently undergo a cystoscopy as a diagnostic method to identify a benign growth of the prostate.

Furthermore, a cystoscopy may also serve to confirm a suspicion, for example urinary bladder tumors or urethral strictures. The term urethral stricture describes a narrowing in the urethra, either as a result of scarring or inborn defect. Strictures can lead to problems with passing urine and residual amounts of urine can stay back in the bladder and contribute to the development of bladder infections.

If a patient presents with cystitis, cystoscopy must not be performed during this period of time, in medical terms it is contraindicated.

Procedure and duration of a cystoscopy

Typically, a cystoscopy is done in an outpatient setting with local anesthesia. The procedure normally takes only five to ten minutes.

During the cystoscopy, patients are seated in a special chair which resembles a gynecologist's chair, designed to keep the legs spread apart. The first step is to disinfect the area surrounding the entrance to the urethra. After sufficient time to let me disinfection work, lubricant is injected into the entrance of the urethra to make it easier for the cystoscope to be inserted. This lubricant also contains a local anesthetic, which only needs a small amount of time to numb the urethra and make the examination less unpleasant for the patient.

Afterwards, the actual examination can start. At this point, the cystoscope is inserted and gently advanced until it reaches the urinary bladder. Then a sterile transparent solution is filled into the bladder to ensure that the bladder is adequately filled to illustrate the mucous membrane and the bladder wall better.

In the event that the physician detects a suspicious lesion or needs to remove a stone from the bladder, the cystoscope can be used as a tool. As it is equipped with several channels, one of which is a working channel for inserting small instruments like a forceps, it is possible to take biopsies, which are tissue samples, during the examination. However, cystoscopy is then usually done under general anesthesia in the hospital.

Cystoscopy in males

Cystoscopy is more challenging in men than in women. Because the length of the male urethra of about 20 cm, which is about 4 times longer than the female one, the cystoscope needs to pass a much longer distance. Moreover, male urethras are not perfectly straight, but rather have curvatures and narrow sections. Consequently, flexible cystoscopes are recommended for male cystoscopy, because they are easier to control and can be navigated through the curves more smoothly.

In addition, the prostate can be inspected during male cystoscopy. The prostate is located in front of the bladder and stretches around the urethra. In the majority of men it undergoes benign growth, which is termed benign prostatic hyperplasia. This condition is assessable and diagnosable by cystoscopy.

Cystoscopy in females

Cystoscopies in women are very uncomplicated due to their shorter and more straight urethra. This is advantageous, as no particular bends or curvatures must be passed, making it easier to perform as opposed to cystoscopies in males.

Alternatives to cystoscopy

There are alternative examination methods and they are based why a cystoscopy would be required.

For instance, if the bladder is examined for stones, physicians may perform an ultrasound or CT scan of the bladder as an alternative. In case a problem with bladder emptying is suspected, for example ultrasound can be used to check for residual urine formation. Should urethral strictures be suspected, the patient can undergo a retrograde urethrogram. In this procedure, a contrast agent is injected into the urethra through a catheter. An X-ray examination is performed simultaneously and makes any narrowing of the urethra visible.

The same technique is employed for cystography. However, in this case the contrast agent is injected into the urinary bladder to search the bladder for outpouchings, so-called diverticula, as well as other abnormal findings.

Side effects and follow-up care

Cystoscopy is an examination that bears only few risks. After the examination, you may feel pain while urinating for the first few days. During a cystoscopy, the urethral mucosa is irritated and small wounds are left, which are responsible for the pain. Small amounts of blood may be present in the urine at the beginning, turning it into a slightly reddish color. Larger injuries to the urethra are very rare.

For a short time following cystoscopy, some patients may experience uncontrolled leakage of urine, although this usually resolves within a few days.

Another risk is the introduction of pathogens into the bladder during the exam that can lead to inflammation. This type of urinary tract infection may require antibiotics, so you should let your doctor know if you develop a bladder infection.

It is generally recommended to have plenty to drink after the examination as this can help prevent a potential bladder infection.

Usually, the physician will schedule follow-up visits at specific intervals following the examination, which vary depending on the indication for the examination.

Which doctors are specialists for a cystoscopy?

Cystoscopies are carried out by urologists. They are experts in the medical field of urinary tract and urinary organs.

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of cystoscopies and are looking forward to your inquiry or wish for treatment.

Someone in need of a doctor prefers the best medical care as possible. That's why patients like to know where to find the most excellent treatment centre. Since this question cannot be answered objectively and a serious doctor would never claim to be the best, affected people can only rely on the doctor's expertise.

We help you find an expert for your disease. All doctors and clinics listed here have been checked by us for their outstanding specialization in the area of Cystoscopy. They await your inquiry or treatment request.