Cystourethroscopy is a procedure that allows your provider to visually examine the inside of your bladder and urethra. This is done using either a rigid or flexible tube (cystoscope), which is inserted through the urethra and into the bladder. Sterile water runs through the cystoscope to allow for a more comfortable and more complete examination.
Who needs a cystoscopic exam?
Some indications for cystourethroscopy are:
- Rule out bladder perforations during sling procedures
- Confirm ureteral patency after vaginal vault suspensions, hysterectomies, and complex pelvic surgical cases
- Undiagnosed hematuria (blood in the urine)
- Refractory urge urinary incontinence (especially if it develops after a previous surgery)
- Rule our a foreign body
- Recurrent Urinary Tract Infections
- Rule out Interstitial Cystitis
- Evaluation for vesicovaginal fistula
- Examination for stones or tumors inside the bladder
- Evaluation for bladder/urethral diverticulum
Do I need to prepare for a cystourethroscopy?
Generally, there is not much preparation needed for a routine, in-office cystoscopy. Simply follow instructions given to you before your procedure, which can be found here. Cystourethroscopy is generally well-tolerated. We ask our patients to take ibuprofen before arriving for their appointment, and we administer lidocaine gel into the urethra a few minutes before the procedure. This is usually enough to keep the majority of patients pain free until the procedure is completed. Afterwards, to avoid dysuria, or burning, we will give our patients a couple of tablets of a medicine called Uribel.
If your cystoscope is scheduled as an “operative cystoscope,” this will typically mean that the procedure will be performed in the operating room under general anesthesia. If that is the case, the preparation changes a bit, as you will not be allowed to eat or drink anything after midnight in the hours leading up to you exam. While most people can usually drive themselves home after an in-office exam, you will need someone to drive you home if you have an operative cystoscope or any cystoscopic exam that requires general anesthesia.
In-office cystourethroscopy usually takes no more than 5 minutes to complete, while times for operative cystoscopies vary depending on the reason for the exam.
Will I have problems after my cystourethroscopy?
Generally, people experience little to no problems following these exams. However, you should call your physician immediately if you experience any of the following:
- Hematuria (or blood in the urine)
- Inability to urinate
- Burning or pain during urination