Cystoscopy

Cystoscopy is the internal telescopic examination of the bladder and urethra. It affords the best assessment of disease affecting the urethra or bladder lining and may be vital before a urological diagnosis can be reached (diagnostic cystoscopy). If performed under general anaesthetic it may be combined with biopsy, x-ray examination of the ureters and kidneys or simultaneous treatment of strictures, stones, tumours or prostate enlargement.

Pre-operatively:

• nil by mouth 4 hours prior to procedure

Post-operatively:

• stay 1 – 4 hours post-procedure (sedation – general anaesthetic)
• if other treatment has been performed, overnight stay may be required
• driving and normal activities are permitted from the day following the procedure

Although most cases proceed without particular difficulty, bleeding or infection occur in 2% of patients overall. Other complications are considered rare and extraordinary.

• Bleeding usually settles spontaneously, but rarely causes clots and urinary retention and requires catheterisation and bladder wash out.
• Bleeding and bladder washout are more common following treatment procedures.
• Infection may present as burning – frequency – urgency, requiring oral antibiotic treatment, or fevers, sweats and shivers for which admission to hospital for IV antibiotic is needed.
• Patients with underlying bladder obstruction may develop urinary retention requiring catheterisation
• There is a potential risk of allergic reaction to the lubricating jelly or agents used for cystoscope disinfection, which is estimated to be less than 1:40 000.