Cystoscopy

What Is A Cystoscopy?

A cystoscopy usually involves a flexible instrument known as a cystoscope (a thin tube with a camera and light at the end) that is inserted into the urethra (the hole where the urine is eliminated from the body) to examine the inside of the bladder.

What Is A Cystoscopy Used To Diagnose?

A cystoscopy is used to diagnose the following in the water pipe (urethra) and bladder:

• Inflammation
• Infection
• Stones
• Tumours (including bladder cancer)

Types Of Cystoscopy

There are 2 types of cystoscopy

Flexible Cystoscopy

•  This is done under local anesthesia in an outpatient treatment room.  The camera that is inserted is flexible meaning it is less invasive than a rigid cystoscopy allowing it to be performed in an outpatient setting.  Flexible cystoscopy is entirely diagnostic and can only be used to confirm a suspected diagnosis.

Rigid Cystoscopy

•  This is performed under general/regional anesthesia or sedation.  It is done in a theatre setting as a daycase.  The cystoscope is rigid and not flexible as in the case of a flexible cystoscopy.  The benefits for rigid cystoscopy are that it can be used for treatment; eg. removal of small tumours, stones, taking a sample for biopsy or injecting substances such as botulinum toxin into the bladder wall.

How Long Does Cystoscopy Take?

A flexible cystoscopy examination itself takes about five minutes and you will be able to go home straight afterwards.  The results will be discussed with you after your appointment

A rigid cystoscopy procedure itself takes only 5-10 minutes, but due the anesthesia or sedation the patient is required to spend at least half a day in the hospital.

What To Expect At Your Cystoscopy

The following steps explain what to expect at a cystoscopy appointment:

• A local anaesthetic jelly is used to numb and lubricate the urethra.
• The cystoscope is inserted into the bladder via the urethra (water pipe).
• The instrument is then moved up into the bladder
• Once the instrument is in place, the examination takes a few minutes to complete using the telescopic lens that is attached to the cystoscope. 
• Sterile water fills the bladder to ensure that all the lining can be inspected.
• If a rigid cystoscopy is being performed, treatments such as removal of tissue or tumours can be performed at this stage if necessary.

Recovering From Your Cystoscopy

There is limited recovery from flexible cystoscopy, and patients can go back to work afterwards if desired. 

Recovering from a rigid cystoscopy depends on whether a treatment has been performed or not.  In general patents will go home the same day, passing urine will be uncomfortable the first few times.  In general patients can return to work the following day.

What Are The Benefits Of Cystoscopy?

Flexible cystoscopy benefits are:

• It can be performed within a 30-minute appointment

• Results can be discussed during the appointment

• It is minimally invasive allowing patients to return to their normal lives immediately.

What Are The Risks Of Cystoscopy?

The risks of cystoscopy are: 

• Mild burning or bleeding on passing urine for a short period after the operation.
• Occasionally, infection of the bladder requiring antibiotics.

In rare cases the following risks can occur:

• Temporary insertion of a catheter.
• Delayed bleeding requiring removal of clots or further surgery.
• Injury to the urethra causing delayed scar formation.

In extremely rare instances, or those patients in high-risk groups the following may occur:

• Colonisation with MRSA
• Clostridium difficile bowel infection
• MRSA bloodstream infection

Is A Cystoscopy Painful?

A flexible cystoscopy is uncomfortable but the procedure itself only lasts 5 minutes

How Much Does A Private Cystoscopy Cost?

The fees for a private cystoscopy comprise hospital and consultant fees.  The consultant fees for the procedure are £550