Cystoscopy

Cystoscopy 

Definition

Cystoscopy (cystourethroscopy) is a diagnostic procedure that is used to look at the bladder (lower urinary tract), collect urine samples, and examine the prostate gland. Performed with an optic instrument known as a cystoscope (urethroscope), this instrument uses a lighted tip for guidance to aid in diagnosing urinary tract disease and prostate disease. Performed by a urologist, this surgical test also enables biopsies to be taken or small stones to be removed by way of a hollow channel in the cystoscope.

Purpose

Categorized as an endoscopic procedure, cystoscopy is used by urologists to examine the entire bladder lining and take biopsies of any areas that look questionable. This test is not used on a routine basis, but may benefit the urologist who is needing further information about a patient who displays the following symptoms or diagnosis:

Blood and urine studies, in addition to x rays of the kidneys, ureters and bladder may all occur before a cystoscopy. At the time of surgery, a retrograde pyelogram may also be performed. Additional blood studies may be needed immediately following surgery.

Precautions

While the cystoscopy procedure is commonly relied upon to gather additional diagnostic information, it is an invasive surgical technique that may involve risks for certain patients. Those who are extremely overweight (obese), smoke, are recovering from a recent illness, or are treating a chronic condition may face additional risks from surgery.

Surgical risk also increases in patients who are currently using certain drugs including antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta blockers; or cortisone. Those who use mind-altering drugs also put themselves at increased risk of complications during surgery. The following mind-altering drugs should be avoided: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

Description

Depending on the type of information needed from a cystoscopy, the procedure typically takes

Cystoscopy is a diagnostic procedure which is used to view the bladder, collect urine samples, and examine the prostate gland. This procedure also enables biopsies to be taken. The primary instrument used in cystoscopy is the cystoscope, a tube which is inserted through the penis into the urethra, and ultimately into the bladder.

(Illustration by Electronic Illustrators Group.)

10-40 minutes to complete. The patient will be asked to urinate before surgery which allows an accurate measurement of the remaining urine in the bladder. A well-lubricated cystoscope is inserted through the urethra into the bladder where a urine sample is taken. Fluid is then pushed in to inflate the bladder and allow the urologist to examine the entire bladder wall.

During an examination, the urologist may take the following steps: remove either bladder or kidney stones; gather tissue samples; and treat any suspicious lesions. In order to perform x-ray studies (retrograde pyelogram), a harmless dye is injected into the ureters by way of a catheter that is passed through the previously placed cystoscope. After completion of all needed tests, the cystoscope is removed.

Preparation

As procedure that can be completed in a hospital, doctor's office, or outpatient surgical facility, an injection of spinal or general anesthesia may be used prior to a cystoscopy. While this test is typically performed on an outpatient basis, a patient may require up to three days of recovery in the hospital.

Aftercare

Patients who have undergone a cystoscopy will be instructed to follow these steps to ensure a quick recovery:

A cystoscope helps the doctor examine the urethra, bladder, and prostate.

(Illustration by Argosy Inc.)

Patients may also be prescribed pain relievers and antibiotics following surgery. Minor pain may also be treated with over-the-counter, non-prescription drugs such as acetaminophen.

Risks

As with any surgical procedure, there are some risks involved with a cystoscopy. Complications may include: profuse bleeding; a damaged urethra; a perforated bladder; a urinary tract infection; or an injured penis.

Patients should also contact their physician if they experience any of the following symptoms following surgery: pain, redness, swelling, drainage, or bleeding from the surgical site; signs of infection that may include headache, muscle aches, dizziness or an overall ill feeling and fever; nausea or vomiting; strenuous or painful urination; or symptoms that may result as side-effects from the medication.

Normal results

A successful cystoscopy includes a thorough examination of the bladder and collection of urine samples for cultures. If no abnormalities are seen, the results are indicated as normal.

Key terms

Endoscopy — Examination of body organs or cavities through the use of an endoscope (a lighted optical instrument used to see inside body cavities), such as a cystoscope used to complete a cystoscopy.

Retrograde pyelogram — A pyelography or x-ray technique where radiopaque dye is injected into the kidneys from below, by way of the ureters, allowing further examination of the kidneys.

Ureter — The tube that carries urine from the kidney to the bladder, with each kidney having one ureter.

Urethra — A passageway from the bladder to the outside for the discharge of urine. In the female this canal lies between the vagina and clitoris; in the male the urethra travels through the penis, opening at the tip.

Abnormal results

Cystoscopy allows the urologist to detect inflammation of the bladder lining, prostatic enlargement, or tumors. If these are seen, further evaluation or biopsies may be needed in addition to the removal of some tumors.

Resources

Organizations

American Cancer Society. 1599 Clifton Rd., NE, Atlanta, GA 30329-4251. (800) 227-2345. http://www.cancer.org.

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cystoscopy /cys·tos·co·py/ (sis-tos´kah-pe) visual examination of the urinary tract with an endoscope.cystoscop´ic

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cys·tos·co·py (ss-tsk-p)

n.

A medical procedure in which a cystoscope is used to examine the bladder.

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cystoscopy

examination of the bladder by means of a cystoscope, which is introduced into the urinary meatus and passed through the urethra and into the bladder.

A catheter can be passed through the cystoscope into the bladder or, if necessary, beyond, into the ureters and kidneys. In this way samples of urine can be obtained for diagnostic purposes. Also, radiopaque fluids can be injected into the bladder or ureters for x-rays of the urinary tract. See also pyelography.