Cystoscopy

These instructions apply to flexible cystoscopy in the Ambulatory Care Clinic at Richmond Hospital, Delta Hospital, UBC Hospital and False Creek Surgical Centre.

 

Why?

 

Cystoscopy is one of the most commonly performed minor procedures in urology. It can be done for diagnostic purposes or to perform minor procedures with in the lower urinary tract (bladder and urethra). Cystoscopy allows for direct visualization of the inside of the bladder and urethra. In males, the prostatic urethra can be evaluated, but the prostate tissue itself cannot - therefore cystoscopy is not a test to check for prostate cancer. We have the latest fully digital cystoscopes which are flexible and small to minimize patient discomfort. As such, our patients experience essentially no pain with flexible cystoscopy. Also, we have Narrow Band Illumination capablility to increase the detection of bladder cancers.

 

Information on the anatomic and functional status of the urinary tract can be learned. The most common diagnostic indications for cystoscopy are:

  1. Hematuria (blood in the urine)
  2. Urinary dysfunction: slow stream, urinary frequency, incontinence, etc.
  3. Rechecks for bladder cancer

 

Minor procedures such as retrieval of ureteral stents, removal of small stones, urethral dilation and removal of small bladder tumors can also be performed.

 

Preparation

 

There is NO SPECIAL PREPARATION for your flexible cystoscopy. Fasting and stopping medications (including blood thinners) are NOT required unless specifically requested. Please have breakfast or lunch before the test. Empty you bladder before coming in.

 

How is the test done?

 

The test itself should take 5 minutes or less, but you will need to arrive early to register at admitting and change for the procedure. The total time at the hospital is usually between 1-2 hours.

 

You will change into a gown to keep your regular clothes dry because the water we use to fill the bladder may spill. The steps are:

  1. Enter the cystoscopy suite
  2. Lie flat on your BACK
  3. Women will need to assume the 'frog leg' position (similar to when you have a pap smear): feet together, knees bent. We will ask you to let your knees fall outward to introduce the scope.
  4. The cystoscope will be introduced into the urethra. The diameter of the scope is roughly half the size of the urethra so there is never any difficulty inserting it unless the urethra is tight.
  5. In order to minimize discomfort, we recommend you take long, slow deep breaths and relax the pelvic floor - much as if you are urinating. This will allow the cystoscope to pass through the urinary sphincter more easily.
  6. The urethra and bladder will be inspected.
  7. You may be given an antibiotic if you are thought to be at increased risk of infection.

 

What to expect after your cystoscopy

 

You should be able to resume to full normal activities immediately after your cystoscopy. Most people have some mild discomfort the first few times they urinate after the procedure and nothing more. The following MAY occur and should be considered normal:

  1. Mild discomfort the first few times you urinate after the procedure
  2. Blood in the urine. If you required a urethral dilation, you may have more blood which should settle in 1-2 days

You should not have:

  1. Heavy bleeding, or bleeding which persists more than a few days
  2. Fever
  3. Persistent pain with urination including pressure in the area of the bladder or flank pain

If you have these symptoms, you may have a bladder infection. These occur in 1% or fewer of patients undergoing cystoscopy.

 

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