Makindo Medical Notes

🔍 Cystoscopy is a common urological procedure that allows direct visualisation of the bladder and urethra using a cystoscope — a thin tube with a light and camera. It is an essential tool for diagnosing and managing lower urinary tract disorders, often providing information beyond what imaging can show.

🧾 What is Cystoscopy?

• A cystoscope is inserted via the urethra into the bladder to check for abnormalities.
• Two main types are used:
  • Rigid Cystoscopy: Straight and firm, used for biopsies, tumour resections, or stone removal.
  • Flexible Cystoscopy: Bendable and more comfortable, mainly for diagnostic assessment in the outpatient setting.
• Usually performed under local anaesthetic gel, though sedation or GA may be used in complex cases.

🎯 Indications (Why is it Done?)

• Recurrent or persistent urinary tract infections (UTIs).
• Unexplained haematuria (visible or microscopic).
• Evaluation of bladder tumours, polyps, or stones.
• Assessment of chronic pelvic pain or bladder outflow problems.
• Follow-up in bladder cancer surveillance.

🛠️ What Happens During the Procedure?

• 💧 Local anaesthetic gel is applied to the urethra.
• The cystoscope is gently advanced into the bladder.
• Saline is used to fill the bladder for clearer visualisation.
• Duration: typically 10–20 minutes.
• Rigid cystoscopy: Better for operative procedures but less comfortable.
• Flexible cystoscopy: Preferred in clinic, generally well tolerated.

🌡️ Common After-Effects

• Burning or stinging on passing urine (resolves within 24–48h).
• Slight haematuria (pink-tinged urine).
• Increased urinary frequency/urgency for a short period.

⚠️ Safety and Risks

• Overall safe, with very low complication rates.
• Rare risks: urinary tract infection (UTI), bleeding, urethral trauma, or bladder perforation.
• Seek medical advice if fever, persistent pain, heavy bleeding, or inability to pass urine develops.

📋 Preparation & Recovery

• Patients can usually eat and drink normally beforehand.
• Antibiotic prophylaxis is not routinely required unless risk factors for infection exist (per UK/NICE guidance).
• Most patients go home the same day and can resume normal activities.
• Hydration after the procedure helps flush the bladder.

✅ Benefits

• Direct inspection of the lower urinary tract for accurate diagnosis.
• Allows for biopsy, stone retrieval, and minor surgical procedures.
• Essential for bladder cancer follow-up and surveillance.

🔍 Types of Cystoscopy (Summary)

• Rigid Cystoscopy: Best for operative interventions, slightly more discomfort.
• Flexible Cystoscopy: Best for outpatient diagnostic use, more comfortable.

📌 Conclusion

• Cystoscopy is a vital, safe, and informative procedure in modern urology.
• Choice of rigid vs flexible depends on indication — diagnostic vs therapeutic.
• With minimal risks and high diagnostic yield, it remains a cornerstone of lower urinary tract assessment.