Treatments

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.

Key points

• Minimally invasive
• Performed using a flexible or rigid cystoscope
• Can diagnose issues like infections, stones, and tumours

Why choose Urocare?

At Urocare London, our commitment to excellence in urology is driven by the expertise and dedication of our leading specialist, Mr. Maneesh Ghei. Located at leading private hospitals in London, Urocare London offers the convenience and accessibility you need. 

What is a Cystoscopy?

A cystoscopy is an essential medical procedure that allows doctors to examine the interior surfaces of the bladder and urethra. This is facilitated by the use of a cystoscope—a slender instrument fitted with a camera and a light. The device is carefully inserted into the urethra and guided into the bladder, transmitting images back to a screen for a real-time view. This process is invaluable for diagnosing, monitoring, and sometimes treating conditions affecting the urinary tract.

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)

Who is Cystoscopy suitable for?

Cystoscopy is recommended for individuals presenting symptoms that suggest urinary tract issues. These symptoms can include persistent urinary tract infections, painful urination, frequent urges to urinate, blood in the urine, or unexplained pelvic pain. Additionally, individuals with a history of bladder stones or tumours may undergo regular cystoscopies to monitor their condition or the effectiveness of previous treatments.

Types of Cystoscopy

There are 2 types of cystoscopy:

Flexible Cystoscopy

This is done under local anaesthesia 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 anaesthesia or sedation. It is done in a theatre setting as a day case. The cystoscope is rigid, not flexible. The benefits of rigid cystoscopy are that it can be used for treatment, e.g., removal of small tumours and stones, taking a sample for biopsy, or injecting substances such as botulinum toxin into the bladder wall.

Is Cystoscopy a major operation?

Cystoscopy is generally not considered a major operation. It is frequently performed on an outpatient basis, especially the flexible type, which is less invasive and does not typically require sedation.

A rigid cystoscopy might necessitate a brief hospital stay because it often involves more complex manipulations or treatments that require anaesthesia. However, both procedures are relatively quick and involve minimal recovery time compared to more invasive surgeries.

How does Cystoscopy work?

• Preparation: Patients are prepared for the procedure, which includes the application of a local anaesthetic jelly to numb and lubricate the urethra, reducing discomfort.
• Insertion: The cystoscope is inserted through the urethra and into the bladder. The scope’s flexibility or rigidity depends on the specific procedure planned.
• Examination: The doctor manoeuvres the cystoscope to view different areas of the bladder lining. Images are sent to a monitor, providing a clear, real-time view.
• Bladder Filling: Sterile water or saline is introduced through the cystoscope to expand the bladder and improve the visibility of the bladder walls.
• Intervention (if using a rigid cystoscope): If abnormalities are detected or if prior tests indicate the need for treatment, procedures such as biopsies, stone removal, or tumour treatments can be performed during a rigid cystoscopy.

How long does a Cystoscopy operation last?

• Flexible Cystoscopy: This procedure is typically very quick, lasting about five minutes. Most patients are able to leave the clinic immediately afterwards without any significant downtime.
• Rigid Cystoscopy: While the procedure may only take 5 to 10 minutes, the preparation and recovery due to anaesthesia or sedation can require patients to remain in the hospital for about half a day.

What to expect after a Cystoscopy operation

Recovery from a cystoscopy is typically straightforward:

• Flexible Cystoscopy: Patients might experience mild discomfort, such as a burning sensation during urination or slight bleeding, but these symptoms are usually brief.
• Rigid Cystoscopy: Recovery might include temporary urinary discomfort and slight hematuria (blood in urine). Depending on the extent of any additional procedures performed, most patients can resume normal activities by the next day.

Side effects of Cystoscopy

The most common side effects include:

• Mild burning during urination
• Small amount of blood in the urine
• Temporary mild urinary frequency or urgency.
• Infections are less common but can occur, necessitating antibiotic treatment. 

Rare complications might include more significant bleeding, injury to the urethra or bladder, or, very rarely, more severe infections.

Alternative treatments to Cystoscopy

For some conditions, non-invasive imaging tests such as ultrasound, CT scans, or MRI can be alternatives to cystoscopy. These methods can help visualise the urinary tract without the insertion of a scope. However, they may not provide as detailed a view as a cystoscopy, which allows for direct visualisation and the ability to perform interventions if needed.

Frequently asked questions