Cystoscopy
🔍 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.
