Do you have bladder problems? Let's talk about cystoscopy!

Do you sometimes have difficulty or pain when urinating? Or have you ever had blood in your urine? Cystoscopy is a special test that doctors perform to find the cause of these problems and sometimes to treat them. Today, we will talk about this in detail and very simply.

What is a cystoscopy? Simply put...

Simply put, a cystoscopy is a test to look inside your bladder (where urine collects) and urethra (the tube that carries urine out). This is done by a urologist. He or she uses a cystoscope, a small, lighted tube with a camera or lens attached.

Think of it like an endoscopy for a stomach bug, this is a procedure to look inside your urinary system. This allows the doctor to clearly see the inside walls of your bladder and urethra.

Why is a cystoscopy performed? What does it find?

If a doctor asks you to have this test, there may be several reasons. The main one is to diagnose problems in the urinary system and sometimes to treat them on the spot.

Cystoscopy can help with these things:

• Take a urine sample: You can take a urine sample directly from the ureters, the tubes that carry urine from your kidneys to your bladder.
• Inject a dye: This is used to inject a dye for procedures that track urine flow.
• Inject medication: Sometimes, you can inject medications into your bladder to stop leaking pee .
• Ureteral Stent Removal: Remove a small tube (stent) that was placed during a previous surgery to keep the urethra open.
• Remove stones, abnormal tissue, and tumors: This can also remove things like bladder stones, abnormal tissue, and small tumors (polyps or tumors).
• Take a biopsy: A small piece of tissue may be taken from a suspicious area of ​​the bladder or urethra and sent to a lab for testing. This can help determine if there is anything suspicious, such as cancer.
• Treat Urethral Strictures or Fistulas: This can also help treat urethral strictures or fistulas.

What types of conditions can be accurately diagnosed with cystoscopy?

This test can diagnose many urinary tract diseases. Here are a few examples:

• Bladder or urethral cancer.
• Bladder stones.
• Difficulty controlling urination, which means the inability to hold urine (Urinary incontinence) or the inability to feel the urge to urinate .
• Enlarged prostate (Benign Prostatic Hyperplasia - BPH) in men.
• Interstitial Cystitis/Bladder Pain Syndrome (ICS/BPS) is a painful condition that occurs in the bladder.
• Urethral strictures and urinary fistulas.
• Frequent urinary tract infections (UTIs).

In what cases do doctors recommend performing a cystoscopy?

Your doctor may suggest this test if you have any of the following symptoms:

• Urinary control problems: Feeling like you can't completely empty your bladder (Urinary retention) or losing urine without control (Incontinence).
• If you suspect you have bladder stones.
• Blood in the urine (Hematuria): This can sometimes be visible blood, or it can only be detected during a urine test.
• If you experience pain when urinating (Dysuria).

Important: If you have any of these symptoms, it is best to seek medical advice immediately without panicking.

How is this cystoscopy done?

The procedure is very simple. The urologist will slowly insert a device called a cystoscope into your urethra and into your bladder. He or she can then take a good look at the inside of your bladder. If necessary, they can insert small instruments through the device to take tissue samples or perform other treatments.

Are there different types of cystoscopes?

Yes, there are mainly two types of cystoscopes:

1. Flexible Cystoscope: This is a flexible tube that is a bit like a rubber tube. It can easily navigate the curves of the urinary tract and look inside the bladder and urethra. This is usually used for diagnosis.

2. Rigid Cystoscope: This is a straight, rigid tube. This is usually used to pass instruments for biopsies and cyst removal. When using this type of cystoscope, you will often be given sedation or general anesthesia.

Your doctor will choose the type that is most suitable for your test or treatment.

Do we get put to sleep during a cystoscopy?

This often depends on the reason for the test.

• For diagnosis: You are awake most of the time.But don't worry, a numbing gel is applied to the urethra to numb the pain.
• If you are having treatment or a biopsy: You may be given sedation or general anesthesia .

How should we prepare before this test?

Your doctor will give you specific instructions before a cystoscopy. It is very important to follow those instructions, as this can reduce the risk of unnecessary complications.

You mainly need to take care of these things:

• Tell your doctor about all medications you take (including vitamins and traditional medicines) and if you may be pregnant .
• On the day of the test, you will be asked to provide a urine sample . This will be used to check for a urinary tract infection (UTI). If an infection is present, the cystoscopy will usually be performed after the infection has been treated.
• If you are having a general anaesthetic, you will be asked not to eat or drink anything for eight hours before the test (fasting) .
• You may be asked to stop taking some medications before the test , or you may be asked to take them only with a sip of water. Do not stop taking any medication unless your doctor tells you to.
• If you are being sedated , arrange in advance for someone to take you home after the test.

What happens during a cystoscopy?

Here are some of the steps that usually happen:

1. You will be asked to urinate immediately before the test. It is best to have an empty bladder.

2. In some cases, you may be given general anesthesia or sedation .

3. A numbing gel is applied to your urethra.

4. The doctor then slowly inserts a lubricated cystoscope through your urethra and into your bladder.

5. To better see the inside walls of the bladder, a small amount of sterile salt water is injected into the bladder through the cystoscope. This will fill the bladder slightly, allowing you to see inside better. You may feel the urge to urinate at this time. This is normal.

6. Now the doctor will carefully examine the inside of the bladder and urethra.

7. If necessary, small instruments can be passed through the cystoscope to take tissue samples or remove things like tumors .

8. Finally, the water that was put into the bladder will be removed, or you will be asked to go to the bathroom and urinate .

How long does this test take?

A diagnostic cystoscopy usually takes about 5 to 10 minutes . However, if a biopsy is taken or a treatment is performed, it may take a little longer.

Is cystoscopy painful?

You may feel a little uncomfortable while doing this, or you may feel the need to urinate . However , you will not feel any pain because of the general anesthesia and the numbing gel.

What to expect after the test?

Depending on the reason for the cystoscopy, you may be able to go home the same day (outpatient procedure), or you may have to stay in the hospital overnight. When you go home, your doctor may prescribe antibiotics to prevent infection. It is important to take these medications as directed.

How long does it take to fully recover?

Most people feel better in a day or two . However, if you had something else done at the same time, such as a biopsy, it may take longer to heal. Ask your doctor about this.

The following may occur in the first day or two after the test:

• A slight pain in the lower abdomen.
• A little blood in the urine.
• Burning or pain when urinating .
• The need to urinate frequently and the need to urinate quickly.

You can do the following to reduce these symptoms:

• Place a cloth dampened with warm water over the urethra, or relax in a warm bath for a while.
• Drink several glasses of water a day. It will cleanse the bladder.
• Take an over-the-counter (OTC) pain reliever that your doctor recommends. For example, nonsteroidal anti-inflammatory drugs (NSAIDs).

What are the risks or complications of cystoscopy?

This is a relatively low-risk test . However, rare complications can occur, such as:

• An infection (Infection / UTI).
• Bladder spasms. This can cause severe pain and urine leakage.
• Bladder damage.
• Damage to the urinary tract, for example, scarring or narrowing of the passage.

What are the results after the test?

Your urologist will record everything they see during the exam. This includes any blockages, narrowings, stones, abnormal tissue, or tumors in your urethra. If everything is normal, they will also record that. They may tell you the results soon after the exam, or they may schedule a follow-up appointment to discuss the results.

If you have a biopsy, the tissue sample is sent to a lab and examined under a microscope to see if there are any cancerous cells.

How long does it take to know the results?

If you had a biopsy, it can take up to two weeks for the results to come back. If you only had other tests (and nothing else done at the time), the doctor will know the results at the same time as the test. Ask your doctor how long it will take to see the results in your records or to hear about them from him.

What time should I see the doctor again?

Symptoms such as pain when urinating and a little blood after the test usually improve within a day or two. However, if these problems persist or if you experience any of the following symptoms, see your doctor immediately:

• If you experience severe pain when urinating .
• If you have a large amount of blood or blood clots in your urine .
• The bladder is very full and painful, but you can't urinate .
• Signs of an infection (fever, lower abdominal pain, foul-smelling or dark-colored urine).

When you have symptoms like blood in your urine, pain, or urinary incontinence, it's normal to feel anxious about what's causing them. A cystoscopy is a great way for your doctor to start finding answers to those questions. It's a quick, low-risk, and quick-recovery procedure. Don't be afraid to talk to your doctor about any questions or concerns you may have before or after the procedure. He or she will explain everything to you.

The most important things to remember (Take-Home Message)

Okay, so from what we've discussed, I hope you've got a good idea about the cystoscopy test.

Simply put, this is a test that looks inside the bladder and urethra to find out if there are any problems, and sometimes even allows for minor treatment on the spot.

• If you have any difficulty urinating, pain, or unusual symptoms (such as bleeding), be sure to see a doctor.
• If your doctor suggests a cystoscopy, don't be afraid. It's often a simple, quick test.
• Follow the doctor's instructions carefully before and after the test.
• If you have any doubts or questions, ask your doctor.Never be shy.

Wishing you good health!

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