Cystoscopy
Cystoscopy is one of the most common procedures in urologic practice. It is a means by which your physician can do a "physical examination" of the urethra and the bladder. It is actually more than that, given the fact that we are also able to perform bladder biopsies, wash the bladder for cytology, as well as assess the size of a man's prostate prior to considering surgery, and more.
The cystoscope is a fiber optic instrument that is inserted through the urethra into the bladder. The procedure is generally done under local anesthesia, either in the office or an outpatient surgical center. In this case, local anesthesia implies using a gel, impregnated with lidocaine. This gel is injected (no needles) into the urethra. It works on contact with the lining of the urethra. While it does not totally numb the urethra, it does decrease the discomfort, measurably. Patients, who are anxious about having a local anesthesia, can opt for conscious sedation. Cases done with sedation must be done at the outpatient surgery center
The scopes we use come in two major classes, rigid and flexible. Generally speaking, the rigid scopes are used in women, and the flexible in men. When biopsies are in order, or if other studies need to be accomplished at the same time (retrograde pyelograms e.g.) the rigid will be used in men as well. In these instances, sedation may be required.
If the procedure is to be done under local, the patient is allowed to eat prior to coming to the office, or surgical center. They may also leave the facility unaccompanied, and go back to work if necessary. When sedation is utilized, fasting for 8 hours prior is the rule, as is having a ride home. One should not plan on going to work after receiving sedation for any procedure. These procedures are short, usually lasting less than 15 minutes. After completing the procedure, your physician will discuss the findings.
For simple cystoscopy, the risks of the procedure are nil. You will receive an antibiotic pill on the day of the procedure, making the risk of post procedure infection very small. Following the procedure it is common to have a bit of burning on urination. A small amount of blood in the urine is also common.
Should you be unable to urinate following the procedure, phone the office. Likewise, if your temperature rises to >101° F, a call is appropriate. Otherwise, be patient, and your symptoms should abate.
Talk to your physician about any other procedures that might be mentioned along with the cystoscopy, and whether or not they are appropriately done in the office, or the surgery center, awake, or asleep. We will attempt to make this procedure as painless, both physically and mentally, as possible.