A cystoscopy is a medical procedure intended to locate irregularities within a woman’s urethra or bladder.^[1]Matulewicz RS, DeLancey JO, Meeks JJ. Cystoscopy. JAMA. 2017;317(11):1187. Retrieved May 24, 2022, from https://jamanetwork.com/journals/jama/fullarticle/2612619 During a cystoscopy, the physician performing the procedure uses a very thin instrument with a light source to look for any problems. The physician will fill the patient’s bladder with sterile fluid to expand the bladder walls to make it easier for the camera to see.

It’s important for anyone expecting to undergo this procedure soon to know how to prepare for it and what to expect afterward.

Preparing for a Cystoscopy

Patients should drink plenty of fluids the day before a cystoscopy. This will hydrate the patient and help flush waste through the bladder, so it is as clear as possible before the examination.

A doctor will typically ask the patient for a urine sample before performing the cystoscopy. Patients who have urinary tract infections or weak immune systems may need to complete a round of antibiotics before undergoing a cystoscopy.

The test will require the use of anesthesia, and different patients may receive different types of anesthesia. If a patient requires general anesthesia, she will likely need to fast for several hours before the cystoscopy. General anesthesia renders a patient completely unconscious, and food in the patient’s stomach can cause life-threatening complications while under the effects of general anesthesia. ^[2]Dongare, P. A., Bhaskar, S. B., Harsoor, S. S., Garg, R., Kannan, S., Goneppanavar, U., Ali, Z., Gopinath, R., Sood, J., Mani, K., Bhatia, P., Rohatgi, P., Das, R., Ghosh, S., Mahankali, S. S., Singh … Continue reading

Other patients may require only a regional or local anesthetic. A dose of regional anesthesia will take the form of an injection in the spine that numbs the patient from the waist down. Local anesthesia will numb only the area of the body that houses the bladder, and the patient will be awake during a procedure. Patients who undergo general or regional anesthesia should expect a hospital stay of at least a few hours following a cystoscopy.

A Note About Anesthesia

Doctors have a legal requirement to fully inform their patients about the risks of any procedure or treatment option, and this includes anesthesia.^[3]Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical treatment. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, … Continue reading Once you have decided on the route you prefer to take for your cystoscopy, it is imperative that you follow your doctor’s preparation instructions. If you forget something or otherwise fail to follow your doctor’s directions, tell your doctor immediately so he or she can make the necessary adjustments.

The Cystoscopy Procedure

When the time comes for the patient to undergo a cystoscopy, the doctor will first instruct the patient to empty her bladder and put on a hospital gown. If the patient receives general anesthesia, she will lose consciousness at this point and awaken after the procedure ends. Patients who receive local or regional anesthesia may also receive sedatives for the duration of the procedure.

The doctor will then numb the urethra with an anesthetic spray or gel. After lubricating the test device with gel, the doctor will insert it into the patient’s urethra. Patients who are conscious of their cystoscopy procedures may feel a sensation like needing to urinate or a slight burning.

Types of Cystoscopy Procedures

Doctors generally perform two types of cystoscopies:

• Investigatory
• Biopsy

An investigatory cystoscopy will involve the use of a thin, flexible scope to easily move around the inside of the urethra and the bladder to look for problems.^[4]Kadi, N., & Menezes, P. (2011). ABC of flexible cystoscopy for junior trainee and general practitioner. International journal of general medicine, 4, 593–596. https://doi.org/10.2147/IJGM.S20267 If a more in-depth cystoscopy is necessary for biopsy, the doctor may instead use a rigid scope to allow the insertion of other surgical instruments into the bladder.

During a biopsy, the doctor will extract a cell sample from the target area to have it tested for cancer. A cystoscopy performed with a larger, more intrusive instrument may lead to more severe recovery symptoms.

Patients who receive local or regional anesthesia should expect the cystoscopy to last about five minutes. Procedures with general anesthesia usually take 30 minutes or longer.

Common Postoperative Recovery Symptoms

A cystoscopy can leave a patient with several uncomfortable symptoms that can last several days or longer. One of the most common symptoms reported by patients is a persistent need to urinate or more frequent urination for two or three days after a cystoscopy.

It’s important to remember not to hold it in for longer than necessary during this time. Some cystoscopy procedures may cause bleeding inside the bladder or urethra, and holding it in can cause a blood clot or blockage.

Blood in the urine is another common symptom after a cystoscopy, especially if the doctor performed a biopsy during the procedure. Excessive bleeding or the appearance of bright red blood or bloody tissues in urine are major problems. Patients who experience this, high fever, persistent stomach pain or the need to urinate (but cannot) should contact their doctors immediately.

In some cases, a cystoscopy can lead to a swollen urethra or an infection.^[5]Jaclyn A Cusumano, PharmD, Matthew Hermenau, PharmD, Melissa Gaitanis, MD, Michelle Travis, DNP, MSN, APRN, FNP-BC, CUNP, Kerry L LaPlante, PharmD, FIDSA, FCCP, Timothy Y Tran, MD, Kevin W McConeghy, … Continue reading A swollen urethra is very common after a cystoscopy and can make urination more difficult. However, this should subside within about eight hours.

If you cannot urinate more than eight hours following a cystoscopy, call your doctor. The appearance of an infection may simply require a round of antibiotics.

Any Other Questions on ‘What Is a Cystoscopy?’

The team at Arizona Gynecological Consultants takes patient satisfaction very seriously and strives to provide the highest standard of care possible. If you have questions about a cystoscopy procedure, reach out to us for more information about preparation and what to expect during and after the procedure.

Dr. Kelly Roy, MD

Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS

Dr. Kelly Roy is a specialist in surgical gynecology and advanced laparoscopy (and hysteroscopy). She is a long-time resident of Arizona and obtained her Bachelor of Science degree in Biomedical Engineering at Arizona State University before finishing her Doctorate of Medicine at the University of Arizona in 1997.

Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.

Well known for her teaching and surgical ability, she is on the faculty at the residency program at both Banner University Medical Center and Saint Joseph’s Hospital in central Phoenix and is a Clinical Assistant Professor of Medicine at the University of Arizona College of Medicine, Phoenix Campus. Dr. Roy has taught advanced surgical techniques to medical students, residents, fellows and colleagues for over 15 years.

Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.

Read More About Dr. Kelly Roy, MD   |   WebMD Profile   |   Health.USNews.com Profile |  Current Obstetrics and Gynecology Reports: TFA with the Sonata System