Cystoscopy in Delhi, India

There are two types of cystoscopies; the choice depends on the purpose of the diagnosis or treatment. They include:

• Rigid Cystoscopy

  This method uses cystoscopes made of metals that do not bend. This type is used when the doctor needs to pass instruments through the tube to collect samples or remove tumours from the bladder/transurethral prostate surgeries.

• Flexible Cystoscopy

  Flexible Cystoscopy uses special bendable scopes made of fibre optics to examine the bladder and urethra.

Before a urologist performs Cystoscopy, he may ask the patient about his medical history, allergies, and precautions to take before the procedure. The doctor may recommend:

• Stop using medicine such as blood thinners before the procedure
• When to consume food and drinks
• When to empty the bladder before the procedure or to give a urine sample for laboratory test

Before the procedure, the doctor might ask the patient to:

• Take a dose of prophylactic antibiotics to prevent infection
• Give a urine sample

Cystoscopy procedures can take 15 to 30 minutes. Before the procedure, the doctor asks the patient to empty the bladder. The doctor will also monitor the patient's vital signs and try to make them comfortable.

1. • Sedative or anaesthesia

     Before beginning the procedure, the doctor can give a sedative (makes the patient feel sleepy and relaxed, aware of surroundings) or anaesthesia (no awareness). Both medications are given through a vein in the arm.

   • Local anaesthesia

     Anaesthetic jelly is inserted into the urethra (urinary passage) a few minutes before the procedure to make it numb. The patient will be fully awake and aware of the procedure, but will not have pain.

   • Inserting the cystoscope

     The doctor will carefully insert the cystoscope into the urethra using a small sheath. In special cases, larger scopes can be needed to take samples or to pass instruments into the bladder.

   • Examining the urethra and bladder

     The cystoscope has a lens attached to one end that magnifies the inner surfaces of the urethra and bladder. This is connected to a camera system, and the magnified images are viewed on an HD/UHD monitor screen. This helps to examine the bladder and urethra for different causes and conditions.

   • Bladder filled with the sterile solution

     The doctor will fill the sterile solution into the patient's bladder as it inflates the bladder and helps the doctor to get a better look inside. The solution can make a person feel the need to urinate; the patient can do so after the procedure is completed.

   • Tissue samples

     The doctor can collect tissue samples from the bladder for testing.

The doctor may recommend a cystoscopy if a person experiences:

1. Issues with the passing of urine or control of urine
2. Bladder stone
3. Haematuria (blood in urine)
4. Dysuria (pain during urination)
5. Recurrent urinary tract infection

It is a diagnostic procedure, used to diagnose, monitor, evaluate and treat health conditions affecting the bladder and urethra. The doctor may recommend a patient cystoscopy to: 

• Analyse the causes of signs and symptoms

  Cystoscopy procedures can help to determine the underlying causes of recurrent urinary tract infections. The signs and systems can include blood in the urine, overactive bladder, or painful urination.

• Treat bladder diseases

  Cystoscope tubes can be used to pass instruments in the urinary tract to treat a few conditions. Small bladder tumours, bladder stones, enlarged prostate and foreign bodies can be removed through the procedure of Cystoscopy.

• Diagnose urinary bladder diseases and other conditions

  The procedure can be conducted to diagnose bladder cancer, bladder stones, bladder inflammation, urinary fistulas, or recurrent urinary tract infections.

• Retrograde Pyelography

  This is an x-ray procedure, in which a special radiopaque dye is injected into the urinary tract to create images of the urinary tract system and to diagnose various abnormalities.

  The doctor may also recommend another diagnostic procedure called ureteroscopy. This method uses a smaller device to examine the tubes connecting the kidneys and the urinary bladder.

The side effects after Cystoscopy include:

• Blood in urine – usually a few drops only
• Frequent urination/burning sensation/discomfort for a couple of hours

Side effects subside maximally by 48 hours. Consult a doctor if the problems last longer and cause severe painful urination.

Cystoscopy is a low-risk procedure. Some complications include:

• Infections

  In a few cases, a cystoscope may cause the germs to travel to the urinary tract leading to an infection.

• Pain

  Before the procedure, journal anaesthesia or sedation is given to numb the area. After the procedure, the patient can experience abdominal pain, sensitivity, and a burning sensation while urinating. The symptoms are mild and get better with time.

• Bleeding

  A cystoscopy procedure may sometimes lead to blood in the urine.

A person can have serious complications if he experiences the following symptoms:

1. Inability to urinate after Cystoscopy
2. Experiencing extreme pain while urinating
3. Burning sensation while urinating
4. Nausea
5. Discomfort in the bladder or kidney area
6. Chills and fever
7. Frequent urination
8. Blood in the urine

When a patient is at home, he/she needs to take care and have enough rest to relieve the symptoms.

• Drink a good amount of water
• Take a bath to reduce the burning sensation
• Place a warm and damp lot over the urethra to relieve discomfort
• Take a pain reliever after consulting with the doctor

Reviewed by Dr. Ruchir Maheshwari, Associate Director, Urology on 23-Sep-2022.

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