What is Cystoscopy ?

Cystoscopy can be defined as the process of viewing a persons urinary passage and the urinary bladder through an instrument introduced through your urinary passage.The instrument which is used for this purpose is called a Cystoscope.Cystoscopy is an endoscopic procedure i.e there is no need for cutting or removal of tissue.It is not an open surgery so no scars are left behind on your body.

Cystoscope

The Cystoscope is provided with lenses which allow the doctor to see the inner surface of the urethra ( the tube which carries the urine from inside the body to the outside) and the urinary bladder ( the organ which is used to store the urine ).The cystoscope is as thick as a pencil and it has a opening at the end of the tube for the light.A cytoscope may be ridgid or flexible.

A flexible Cystoscope has flexible glass fibres which are used to transmit light from one end of the tube to the other.A cystoscope also has channels through which other small instruments can be introduced and used for specific purposes. Eg.Taking a biopsy.

Purpose of a Cystoscopy

When you have a urinary problem, your doctor may ask you to get a Cystoscopy done.It can be done with local anaesthesia with minimal discomfort or it may be done using other forms of anaesthesia.

The following conditions may require a Cystoscopy to be done :

Repeated attacks of urinary tract infection.
The presence of blood in the urine.(Haematuria)
Involuntary leakage of urine from the urethra.(Incontinence)
Abnormal urinary substances found in the urine examination.
Painful urination not responding to conservative management.
Blockage of urine due to enlargement of the prostate,narrowing of the urinary passage or rather the urethra.
Stone in the urethra or the urinary bladder.
Any unusual growth in the urinary tract.

Do I have to get admitted for the procedure ?

If the procedure is to be done under local anaesthesia,you don’t need an admission for the procedure. If a procedure in addition to Cystoscopy is to be performed or planned then you may require admission as the doctor who is responsible for giving anaesthesia will come and see you the day before the surgery.

Preparation for the procedure

The nurse who is rseponsible for taking care of you in the ward will carry out the instructions as per the advice of the doctor.( Eg.shaving of your private area,giving test injections etc)
You may have to be without food for a few hours before the surgery.
As any medical procedure whether minor or major is involved with some amount of risk,you may have to sign a consent form expressing your consent for the surgery.Do not hesitate to ask your doctor about any doubts or fear you have about the surgery.You will be made to wear a hospital gown before getting shifted to the operation theatre.
After all this is done ,you will be shifted to the operation theatre complex.A nurse in the operation theatre will receive you inside the theatre and would check regarding the items required for the operation.
Finally, the anaesthesia doctor will do a check if you are fit for surgery and shift you inside the operating room.

Inside the operating room

Once you are inside the operating room, you will be made to lie on your back after the anaesthesia has been given.
Mostly, you will be made to lie on your back with your knees raised and apart.
The lower part of your body will be covered by clean towels.Before this , a nurse or the doctor will clean your private area with anti-septic solution .
After this, your doctor will gently pass the Cystoscope through your urinary passage.Relaxing your pelvic muscles will make this part of the test easier.A sterile solution usually normal saline will flow through the instrument to help the doctor have a better view of the urinary passage.
As your bladder gets filled,you will feel some discomfort and urge to pass urine.If you are feeeling uncomfortable during any course of the examination, you can let the doctor know about it.He will see to that you are comfortable.
Once your doctor is satisfied, he will remove the instrument.In certain cases, the doctor might find something unusual e.g a stone or a growth in the urinary tract.In this case, the procedure might get prolonged as the doctor will remove the stone or take a sample of the tissue for biopsy as the case may be.But in most of the cases, the entire examination will take about 15 – 20 minutes.
In some cases, the doctor may also decide to place a tube to drain the urine from the urinary baldder for 1 or 2 days.This tube is called a catheter.

After the procedure

The nurse in the recovery area will receive you from inside the operating room and see to that you are comfortable.Your temperature,blood pressure and pulse may be monitored for a few minutes (15 to 30 minutes ).You can pass urine if you want to and the sister will guide you regarding the location of the toilet.
You might have some burning sensation while passing urine and you might pass red coloured urine due to blood.This is very natural to happen after an instrument has been put into your urinary passage.So do not get alarmed.Once you start taking water, it will automatically settle within 1 or 2 days after the procedure.
You have to take adequate fluid intake to feel better ( 2 to 3.5 litres/ day, two glasses every 2 – 3 hours).
You can also ask your doctor and have a warm bath which will make you feel fresh and energetic.
If you have severe pain or bleeding,you can always let the doctor know about it and he wil tell you what to do.
Your doctor may give you some anti-biotics for a few days following the procedure to prevent infection.If you have severe pain or fever with chills/rigors, let your doctor know about it immediately.
In most of the cases,you will be able to eat normally and can do your normal activities after Cystoscopy.In some cases, you might have to be admitted for a day for observation.If such is the case, you will be discharged on the next day if your doctor feels so.