What to expect

What is a cystoscopy?

A cystoscopy views the inside of the bladder and urethra. The bladder stores urine until it flows out of the body through a tube called the urethra.

For the procedure, your doctor uses a cystoscope, a pencil-sized lighted tube with a camera, or a viewing lens. A cystoscopy helps specialists diagnose and sometimes treat urinary tract problems.

Who might need a cystoscopy?

Your healthcare provider may recommend a cystoscopy if you experience:

• Bladder control issues, such as urinary retention (being unable to empty the bladder all the way) or incontinence (not being able to control urine flow).

• Bladder stones.

• Blood in the urine (hematuria).

• Frequent urinary tract infections (UTIs).

• Painful urination (dysuria).

Your doctor may also use a cystoscope to:

• Get urine samples from ureters (the ducts that carry urine from the kidneys to the bladder).

• Inject dye for an X-ray procedure that tracks urine flow.

• Inject medication to stop urine leakage.

• Remove a ureteral stent (a tiny tube that holds open a ureter) placed during an earlier procedure.

• Remove bladder stones, abnormal tissue, polyps, or tumors.

• Take small pieces of bladder or urethral tissue to biopsy (examine in a lab).

• Treat urethral strictures (narrowing) or fistulas (holes that form between two areas).

How should I prepare for a cystoscopy?

For most diagnostic procedures, your doctor uses a numbing gel so you don’t feel pain in your urethra. However, for a more invasive cystoscopy, you may need sedation. If you get sedation, someone should drive you home after the procedure.

You may need to not eat or drink for several hours before getting anesthesia. Your preparation will depend on the anesthesia type and why you’re having the cystoscopy. Generally, you will:

• Give a urine sample on the day of the procedure to check for a UTI. You’ll need treatment before getting a cystoscopy if you have an infection.

• Urinate immediately before the procedure.

• Bring an updated list of medications and supplements.

• Stop taking blood-thinning medications, such as aspirin and warfarin (Coumadin®), but check with your provider before doing so.

• Tell your doctor if you might be pregnant. Regional and general anesthesia can harm an unborn baby.

What should I expect after a cystoscopy?

You may have belly pain, blood-tinged urine, or pain when peeing for the first day or two after the procedure. You may also feel like you need to pee often and urgently. These problems should fade within 48 hours.

Your doctor may prescribe an antibiotic to prevent infection.To ease side effects, you can:

• Apply a warm, damp washcloth over the urethral opening, or relax in a warm bath.

• Drink several glasses of water every day to flush out the bladder.

• Take an over-the-counter pain reliever, such as nonsteroidal anti-inflammatory drugs (NSAIDs).

What are the potential risks or complications of a cystoscopy?

A cystoscopy is a relatively low-risk procedure. Potential complications include:

• Bladder infection, perforation, or spasms (painful cramps and urine leakage).

• Urethral scarring, narrowing, or trauma.

• UTI.

When should I call the doctor?

Most post-procedure problems like painful urination and blood-tinged urine clear up within 48 hours. However, you should call your healthcare provider if problems last longer or you experience:

• Severely painful urination.

• A significant amount of blood or blood clots in urine.

• A painfully full bladder and inability to urinate.

• Signs of infection (fever, pelvic pain, strong-smelling or cloudy urine).