Cystoscopy for Women

Cystoscopy is a test that lets the
healthcare provider view the urinary tract. This area includes the bladder, the urethra,
and the openings to the ureters. Cystoscopy can help find problems with the urinary
tract. This may include early signs of cancer, infection, narrowing, blockage, or
bleeding.

For this test, a long, flexible,
lighted tube (cystoscope) is put into the urethra and moved up into the bladder. The
healthcare provider can look closely at the inside of the urethra and bladder. He or she
can also wash the bladder. And he or she can reach the structures with special tools
used through the scope.

During a cystoscopy, the healthcare
provider may remove tissue to look at under a microscope. This is called a biopsy. Some
problems can be treated during the test.

A cystoscopy may be advised if your
healthcare provider thinks you have a problem of the urinary tract. For example, a
structural problem may block the flow of urine. Or it might cause urine to flow back.
If untreated, this may lead to problems.

Cystoscopy may also be used after
surgery near the bladder. The provider can check for correct placement of sutures and
support devices.

Some health problems of the urinary
tract that may be found during cystoscopy. They include:

  • Bladder cancer or tumor
  • Polyps or overgrowths of normal tissue
  • Bladder stones. These are stones made
    of calcium or uric acid crystals. They can cause infection, inflammation, bleeding,
    and blockages in the urinary tract.
  • Scarring and damage caused by frequent urinary tract infections (UTIs)
  • Problems of the urinary tract that may
    be present at birth (congenital). These may lead to a backflow of urine or kidney
    problems.
  • Urinary tract injury

Your healthcare provider may have
other reasons to recommend a cystoscopy.

Complications of cystoscopy may include:

  • Infection
  • Bleeding
  • Urinary retention because of
    irritation and swelling from the test
  • Narrowing of the urethra because of scarring
  • Poking a hole in the bladder with the
    cystoscope (bladder perforation)

There may be other risks depending
on your specific health condition. Discuss any concerns with your healthcare provider
before the test.

Urinary tract infection may interfere with a cystoscopy.

  • Your healthcare provider will tell you
    about the test. Ask any questions you may have.
  • You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
  • The type of fasting (not eating or
    drinking anything) needed before the test will depend on the type of anesthesia used.
    Follow any directions you are given for not eating or drinking before the test. You
    may be given other instructions about a special diet to follow for a day or two
    before the test.
  • Tell your healthcare provider if you
    are pregnant or think you may be.
  • Tell your healthcare provider if you
    are sensitive to or are allergic to any medicines, latex, iodine, tape, or anesthesia
    medicines (local and general).
  • Tell your healthcare provider about
    all of the medicines you are taking. These include prescribed and over-the-counter
    medicines, herbs, vitamins, and supplements.
  • Tell your healthcare provider if you
    have a history of bleeding disorders. Also tell him or her if you are taking any
    blood-thinning medicines, aspirin, or other medicines that affect blood clotting. You
    may need to stop these medicines before the test.
  • If local anesthesia is used, you will
    be awake during the test. But you may be given medicine (sedative) to help you relax.
    You will need someone to drive you home afterward.
  • Tell your healthcare provider if you
    think you have a urinary tract infection (UTI). A cystoscopy should not be done if
    you have a UTI. Your provider may check your urine for infection before doing the
    test. Signs of infection include frequent urination, pain or burning when passing
    urine, fever, and urine that looks dark, cloudy, or reddish in color and smells
    bad.

Based on your health condition,
your healthcare provider may request other specific preparation.

You may have a cystoscopy as an
outpatient. This means you go home the same day. Or it may be done during a hospital
stay. Tests may vary, depending on your condition and your healthcare provider’s
practices.

Generally, a cystoscopy follows this process:

  1. You will need to remove any clothing,
    jewelry, or other objects that may interfere with the test.
  2. If you are asked to remove your clothing, you will be given a gown to wear.
  3. An IV (intravenous) line may be
    started in your arm or hand.
  4. Often an antibiotic is given before
    the test.
  5. You may be given an IV sedative or
    anesthesia, depending on your situation and the type of scope that will be used. This
    will make you sleepy and not feel pain during the cystoscopy. If a sedative or
    anesthesia is given, your heart rate, blood pressure, breathing, and blood oxygen
    level will be closely watched during the test.
  6. You will be positioned on an exam table on your back with your knees up and spread apart. Your feet will be placed in stirrups.
  7. A numbing medicine in the form of a gel will be put into your urethra. This may be mildly uncomfortable until the area is numb.
  8. Once the urethra is numb or the
    anesthesia has taken effect, the healthcare provider will put the cystoscope into the
    urethra. You may have some discomfort when this is done.
  9. As the cystoscope is passed through the urethra, the healthcare provider will check the lining. The cystoscope will be moved up until it reaches the bladder.
  10. Once the cystoscope is in the bladder, the healthcare provider may put sterile water or saline into the bladder to help expand it and make the lining of the bladder easier to see. While the bladder is being filled, you may have the urge to urinate or feel mild discomfort.
  11. The healthcare provider will check the
    bladder for any problems. He or she may put a long, thin tool through the cystoscope
    to take out a piece of bladder tissue for testing. A urine sample may be taken from
    the bladder, too.
  12. The cystoscope will be carefully
    removed after the test has been completed.

After the test, you may be taken to
a recovery room to be watched if sedation or anesthesia was used. Your recovery process
will vary depending on the type of sedation that was given. Once your blood pressure,
pulse, and breathing are stable and you are alert, you will be taken to your hospital
room. Or you will be discharged to your home. Cystoscopy is most often done on an
outpatient basis.

You may go back to your usual diet and activities unless your healthcare provider tells you otherwise.

You will be encouraged to drink
extra fluids. The fluids dilute the urine and eases urinary discomfort such as burning.
Some burning with urination is normal after the test,but it should lessen over time. A
warm sitz bath or tub bath may help ease urinary discomfort.

You may notice blood in your urine
after the test. This is normal and should clear up over the next day or two.

Take a pain reliever for soreness
or discomfort as advised by your healthcare provider. Aspirin or certain other pain
medicines may increase the chance of bleeding. Take only recommended medicines.

Take the antibiotic exactly as
told.

Tell your healthcare provider if you have any of the following:

  • Fever or chills
  • Urinary frequency or urgency
  • Inability to urinate
  • Lower back pain
  • Continued burning with urination or blood in the urine

Your healthcare provider may give
you other instructions after the test, depending on your situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure