Cystoscopy

Cystoscopy is a procedure that allows gynaecologist to examine the inside of your bladder and urethra using a thin, flexible tube with a camera (cystoscope). It helps diagnose or treat urinary problems.

Your doctor may suggest this procedure if you have:

• Blood in your urine (haematuria)
• Frequent urinary tract infections (UTIs)
• Bladder pain, incontinence, or difficulty urinating
• Suspicious growths, stones, or blockages
• Unusual cells in a urine test

This procedure is not suitable if:

• You have an active UTI or pelvic infection
• You cannot tolerate the positioning (e.g., severe arthritis)

Benefits

• Accurate diagnosis: Directly visualizes bladder/urethral issues.
• Minimally invasive: No incisions needed.
• Therapeutic options: Can remove small stones, take biopsies, or treat blockages during the procedure.

Risks and Complications

• Common:
  • Mild burning during urination (1–2 days)
  • Light pink urine for 24–48 hours
• Uncommon:
  • UTI (antibiotics may be prescribed preventatively)
  • Temporary urinary urgency/frequency
• Rare:
  • Bleeding requiring treatment
  • Urethral/bladder injury (<1%)

Before the Procedure

• Medications:
  • Stop blood thinners (aspirin/warfarin) 3–7 days prior to procedure.
  • Take antibiotics if prescribed.
• Before the procedure:
  • Urine test to rule out infection.
  • Fast for 2–4 hours if sedation is used.
  • Arrange a ride home if receiving sedation.
• What to wear: Loose, comfortable clothing.

During the Procedure

1. Position: Lie on your back with knees bent (similar to a pelvic exam).
2. Anaesthesia:
   1. Local anaesthetic gel applied to the urethra (numbing).
   1. Optional sedation or general anaesthesia for complex cases.
3. Procedure steps:
   1. The cystoscope is gently inserted through the urethra into the bladder.
   1. Sterile fluid fills the bladder for better visibility (may cause pressure).
   1. Exam takes 5–15 minutes; biopsies/treatments add time.
4. After: You can usually leave within 30–60 minutes.

Recovery

• Immediately after:
  • Mild stinging when urinating (drink extra water to flush).
  • Pink-tinged urine is normal for 1–3 days.
• At home:
  • Hydration: Drink 6–8 glasses of water daily for 2 days.
  • Avoid: Sex, strenuous exercise, baths, and swimming for 48–72 hours.
  • Pain relief: Use over-the-counter painkillers (e.g., paracetamol) or a warm compress.
• Return to work: Most resume normal activities in 1–2 days.

Results

• Preliminary findings: Discussed immediately after the procedure.
• Biopsy results: Ready in 1–2 weeks (follow-up appointment needed).

Frequently Asked Questions

Q: Does cystoscopy hurt?

A: Most feel pressure and a brief sting. Local anaesthetic gel minimizes discomfort. Sedation is optional for anxiety.

Q: Can I drive home afterward?

A: Yes, if only local anaesthesia is used. With sedation, arrange a ride.

Q: Will it affect my sexual function?

A: No. Temporary discomfort during sex may occur for 3–5 days.

Q: What if I see blood clots in my urine?

A: Light bleeding is normal. Contact your doctor if bleeding is heavy (red urine beyond 48 hours) or you pass clots.

Q: Can cystoscopy spread cancer?

A: No. It detects existing abnormalities; it does not cause cancer.

eGynaecologist Advice:

• You should follow aftercare instructions to prevent infection and drink plenty of fluids. It is also important to avoid irritants like caffeine and alcohol after the cystoscopy procedure.
• You should seek gynaecological consultation if you develop fever (>38°C) or chills, inability to urinate for >8 hours, heavy bleeding (bright red urine with clots) or severe abdominal pain.