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Cystoscopy

Cystoscopy is a test that looks at portions of the lower urinary tract through a viewing tube called a cystoscope. The cystoscope is inserted into the urethra, the tube through which urine travels out of the body. Cystoscopy usually is not recommended unless other preliminary tests have found there may be a urinary tract problem. The test is used for both diagnosis and treatment.

Diagnostic uses of cystoscopy include:

• inspecting the bladder for stones or tumors

• gathering urine samples from each kidney to look for infection or tumor cells

• evaluating the bladder lining

• evaluating an enlarged prostate gland

• evaluating urinary problems

• performing a bladder biopsy to remove a sample of bladder tissue to check for cancer or inflammation and

• taking x-rays of the kidney tube and kidney collecting system

Treatments that can be performed during cystoscopy include:

• removing bladder tumors

* crushing and removing stones found in the bladder

• removing an obstruction in the urinary tract and

• treating bleeding in the bladder

A urologist in a healthcare provider's office, hospital, or outpatient surgery facility can perform cystoscopy. To prepare you for cystoscopy, your healthcare provider may prescribe antibiotics to be taken before and after the procedure to prevent infection.

In addition, you should tell your healthcare provider:

• if you have any allergies to medications

• if you are currently taking or have recently taken any medications

• if you have bleeding problems that interfere with your body's ability to form blood clots

• if you are on medication like coumadin or aspirin to prevent blood clots from developing or

• if you think you might be pregnant

Before the procedure begins, you will be given a local, spinal, or general anesthetic. A local anesthetic is a gel that is applied to the urethra to numb the area, while a general anesthetic is given through a needle into a vein, to make you sleep during the procedure. A spinal anesthetic is given through a small tube that leads to the spinal column and numbs the body from the waist down.

If you have general anesthesia, you will be advised not to eat or drink anything for 12 hours before the procedure.

For the surgery, you will be asked to lie on your back, with buttocks at the end of the table, hips and knees fully bent, and feet supported. A sheet is draped over the abdomen. The urethra and surrounding area is carefully cleansed, and the anesthetic gel is applied to the urethral area. A thin, well-lubricated viewing instrument is then inserted into the urethra and slowly moved into the bladder. Sterile water is passed through this instrument to expand the bladder and create a clear view. The solution may be drained and then repeated before the procedure is completed.

If you are having cystoscopy with a local anesthetic, you will feel some sensation when the viewing instrument is passed through the urethra and again when it is removed. You also may feel a cool sensation when the sterile water fills the bladder. If a biopsy is taken, you may notice a tug or pinching feeling. The procedure is fairly painless, and most of the discomfort is from lying on the table. In fact, most patients report that having a cystoscopy is not nearly as uncomfortable as they had feared.

Cystoscopy usually takes 15 to 45 minutes to complete, and the viewing instrument usually is in the bladder for no more than 5 to 10 minutes.

At home after cystoscopy, it is NORMAL to have the following symptoms for several days:

• frequent urination with some burning after urination and

• urine that is red or pink in color with a few string-like blood clots

After your procedure, be sure to:

• drink 6 to 8 glasses of fluids to help reduce discomfort while urinating and prevent infection

• keep track of your fluid intake and urine output for the first 24 hours and

• take any medications as prescribed

There is no risk of losing sexual function after having cystoscopy. However, other problems can develop. Therefore, call your healthcare provider if you develop any symptoms that may indicate a COMPLICATION.

These symptoms include:

• being unable to urinate within 8 hours after the procedure;

* bloody urine with or without blood clots that does not turn clear after several times urinating

• fever

• chills or

• severe side or abdominal pain

Some of the many benefits of cystoscopy include:

• elimination of the need for further surgery

• very reliable results and

• the procedure is quick

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