Cystoscopy for Men and Women at New York Urology Specialists: All You Need to Know
We also offer emergency care for men with urological problems.
What is Cystoscopy?
Cystoscopy is a minimally invasive procedure that is commonly performed by urologists for diagnosis and treatment of urinary and bladder problems. A cystoscope is a diagnostic device consisting of a long lens of about 1/4 inch in diameter (the size of a slender pen) which is used to visualize the urethra and the urinary bladder.
At New York Urology Specialists we used video-cystoscopy which projects the image of the urethra and the bladder to a high definition monitor. This allows the urologist to better visualize the fine details of the urethra and the bladder while at the same time allowing the patient to see the inside of the urinary tract as visualized by a urologist. This has been shown to decrease the discomfort of cystoscopy to the patient.
Cystoscopy provides a much better evaluation of the urinary tract including the urethra and the bladder than what can be obtained from ultrasound, CT scan or MRI.
Cystoscopies are often performed in men and women with significant urinary symptoms that did not respond to initial treatment.
Cystoscopy is also indicated when there are suspicious areas in the urethra and the bladder to suspect a urethral stricture. Men and women who have blood in urine need cystoscopy as part of a full evaluation for hematuria.
Cystoscopy is also performed as part of other procedures including TURP, TURBT, ureteral stent insertion and removal as well as other specific circumstances.
Cystoscopy can be performed using flexible cystoscope or rigid cystoscope.
Cystoscopy using the flexible cystoscope can be usually performed in the office settings in men and women with local anesthesia with minimal discomfort. After cystoscopy one can expect some urinary frequency and burning which usually goes away within 2-3 days after the procedure. Bleeding is not common but one may experience a small amount of bloody urine after office cystoscopy. There is a small risk of infection after the procedure – a single dose of prophylactic antibiotics is typically given. Should one experience fevers, chills or malaise, one should promptly report these symptoms to a physician or go to the nearest emergency room.
Rigid cystoscopy is usually performed under spinal or general anesthesia. However, in women, it may be performed in the office settings with local anesthesia with minimal discomfort as the urethral anatomy is different in women. After the procedure, similar side effects can be expected as after flexible cystoscopy which includes frequent urination, urinary burning and small amounts of blood in urine. If one is unable to urinate after drinking an adequate amount of fluid, has more than a few drops of blood in their urine or has symptoms of infection such as fevers chills or malaise, please promptly report these to the treating physician or go to the nearest emergency room.
What is the Preparation for Cystoscopy?
It is important to inform your urologist of all the regular medications you are on. Certain medications like blood thinners can lead to excessive bleeding during cystoscopy, and these may need to be stopped a few days before the procedure. People with weak immune systems may need to be prescribed antibiotics as a preventive measure before they undergo a cystoscopy.
If your cystoscopy is being done under local anesthesia, you can eat and drink normally on the day of your procedure. You may be given a sedative medication to help you relax, but still remain aware during the cystoscopy. If you are undergoing cystoscopy under general anesthesia, you will receive more detailed instructions for preparation.
How Painful is Cystoscopy?
Cystoscopy is uncomfortable, but not usually painful. Most people experience a pain score of 1-3 out of 10 on the visual analog scale (VAS). The VAS is a method of pain self-assessment where 0 denotes no pain, 1-3 denotes mild pain, 4-6 denotes moderate pain, 7-9 denotes severe pain, and 10 denotes the worst possible pain.
When cystoscopy is performed under local anesthesia, you may feel a slight burning sensation. It is also common to experience the urge to urinate when the cystoscope is inserted and removed from the urethra. When the saline solution is pumped into the bladder, a cool sensation, a mildly uncomfortable feeling of fullness, or an urgent need to urinate can be expected. You will be encouraged to empty your bladder once the procedure has been completed.
What is the Recovery after Cystoscopy?
You will be able to go home the same day and resume your daily routine after outpatient cystoscopy. If you receive sedation or general anesthesia, you will be observed for a few hours in the recovery room until the effects of the medications wear off. You might experience some mild side effects for 1-3 days after cystoscopy, including:
- Increased frequency of urination
- Feeling of urgency
- Dysuria (painful urination) or burning with urination
- Bleeding from the urethra (pink urine or blood on the toilet tissue)
These symptoms are usually short-lived and can be relieved by drinking plenty of water to flush out the bladder. You could also try holding a warm, moist washcloth over the urethra to relieve mild pain.
We offer affordable, highest-quality urology care. We offer weekday, weekend and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating some of the most complex urology problems. He is an experienced surgeon and has performed over 1,000 cystoscopies in men and women of all ages.
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