Cystourethroscopy
Cystourethroscopy is a procedure that enables your health care provider to view the
inside of your bladder and urethra in great detail using a specialized endoscope (a tube
with a small camera used to perform tests and surgeries) called a cystoscope.
Why a Cystourethroscopy is performed
Categorized as an endoscopic procedure, Cystourethroscopy is used by urologists to
examine the entire bladder lining and take biopsies of any areas that look questionable.
This test is not used on a routine basis but may benefit the urologist who is needing
further information about a patient who displays the following symptoms or diagnosis:
- Blood in the urine (also known as hematuria).
- Incontinence or the inabililty to control urination.
- A urinary tract infection.
- A urinary tract which display signs of congenital abnormalities.
- Tumors located in the bladder.
- The presence of bladder or kidney stones.
- A stiffness or strained feeling of the urethra or ureters.
- Symptoms of an enlarged prostate.
Blood and urine studies, in addition to x rays of the kidneys, ureters and bladder may
all occur before a Cystourethroscopy. At the time of surgery, a retrograde pyelogram may
also be performed. Additional blood studies may be needed immediately following surgery.
General information about Cystourethroscopy
Depending on the type of information needed from a Cystourethroscopy, the procedure
typically takes 10-40 minutes to complete. The patient will be asked to urinate before
surgery which allows an accurate measurement of the remaining urine in the bladder. A well
lubricated cystoscope is inserted through the urethra into the bladder where a urine
sample is taken. Fluid is then pushed in to inflate the bladder and allow the urologist to
examine the entire bladder wall.
During an examination, the urologist may take the following steps: remove either
bladder or kidney stones; gather tissue samples; and treat any suspicious lesions. In
order to perform x-ray studies (retrograde pyelogram), a harmless dye is injected into the
ureters by way of a catheter which is passed through the previously placed cystoscope.
After completion of all needed tests, the cystoscope is removed.
How a Cystourethroscopy is performed
There are two types of cystoscopes, the standard rigid
cystoscope and the flexible cystoscope. The method for insertion of the cystoscope varies,
but the test is the same. The choice of which scope to use depends on the purpose of the
exam.
If the standard rigid cystoscope is used, you lie in the lithotomy position (on back
with your knees up and apart). The flexible cystoscope may be easier to insert than the
standard rigid model. It does not require the lithotomy position for insertion.
The procedure usually takes between 5 and 20 minutes. The urethra is cleansed and a
local anesthetic is applied. The scope is then inserted through the urethra into the
bladder.
Water or saline is inserted through the cystoscope and fills the bladder. As this
occurs, you are asked to describe the feeling to your health care provider, which provides
information about your condition.
As the fluid fills the bladder, it stretches the bladder wall, enabling the physician
to view the entire bladder wall. You will feel the sensation of a need to urinate when the
bladder is full; however, it needs to remain full until the examination is complete.
If any tissue appears abnormal, a small specimen can be taken (biopsy) through the
cystoscope to be analyzed. |