1. Looking In From the Outside
Cystoscopy is a urologic procedure where a doctor inspects the inside of the bladder with a scope. The cystoscopic procedure can evaluate recurrent infections, check the prostate, look for bladder polyps and investigate urinary bleeding. It is also crucial for surgical techniques, such as the removal of kidney stones that are lodged in the ureter (the tube that leads from the kidney to the bladder). It is urology's most common procedure and can be performed in a doctor's office. Simple cystoscopy done by an experienced urologist takes but a matter of minutes.
2. The Procedure
The cystoscopy procedure begins with the insertion of a thin scope through the urethra, the tube that goes from the bladder to the outside world. As the scope is passed through the urethra, the cystoscopy exam begins with an examination of the lining of the urethra for signs of infection or inflammation. The scope then enters the bladder. Once in the bladder, the doctor inspects the bladder's lining. He can take pictures of areas of interest. With the use of instruments inserted through the scope, the urologist can also take biopsies of tissue, snip off polyps, remove foreign bodies (like pencils, toothpicks and 3 foot pieces of string) and insert stents into ureters. The stents are used when a patient has passed a large stone and the ureter is swollen or injured. It is the equivalent of a cast on an injured limb. Once the urologist's work is completed, she removes the scope.
3. Sounds Like Medieval Torture
There is a common misconception that cystoscopy pain is incredible. The most painful part of the procedure is the dilation of the urethra as the scope is inserted. For obvious reasons, this is more painful for men than it is for women. But in men, a local anesthetic is usually used to numb the urethra, and patients very rarely complain at all.
4. A Minor Procedure for You, Maybe, but for Me ...
Cystoscopy truly is a minor procedure. Unless a urologist plans to remove a large number of polyps, patients taking coumadin will often not even stop their blood thinner. Almost all patients go home right from the doctor's office. The exception to this rule is if something major is being done through a scope, like the insertion of ureteral stents. Even then, very few patients need an overnight stay in the hospital.
5. No Other Way
Patients will often ask, "Ain't there some other way, Doc? The idea just makes me a little queasy." The answer to that question is no, there is no magic scan that is as accurate as a urologist's skilled eyes.
