Article: Cystoscopy and Ureteroscopy

When you have a urinary problem, your doctor may use a cystoscope to see inside your bladder and urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers (flexible glass fibers) that carry an image from the tip of the instrument to a viewing piece at the other end. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems.

Your doctor may recommend cystoscopy for any of the following conditions:

  • frequent urinary tract infections

  • blood in your urine (hematuria)

  • loss of bladder control (incontinence) or overactive bladder

  • unusual cells found in urine sample

  • need for a bladder catheter

  • painful urination, chronic pelvic pain, or interstitial cystitis

  • urinary blockage such as prostate enlargement, stricture, or narrowing of the urinary tract

  • stone in the urinary tract

  • unusual growth, polyp, tumor, or cancer

Illustration of male and female urinary tracts, showing kidney, ureter, bladder, prostate(male), and urethera.
Male and female urinary tracts

If you have a stone lodged higher in your urinary tract, the doctor may extend the cystoscope through the bladder and up into the ureter. The ureter is the tube that carries urine from the kidney to the bladder. When used to view the ureters, the cystoscope is called a ureteroscope. The doctor can then see the stone and remove it with a small basket at the end of a wire inserted through an extra tube in the ureteroscope. The doctor may also use the extra tube in the cystoscope to extend a flexible fiber that carries a laser beam to break the stone into smaller pieces that can then pass out of the body in your urine.

Preparation

Ask your doctor about any special instructions. In most cases, you will be able to eat normally and return to normal activities after the test.

Since any medical procedure has a small risk of injury, you will need to sign a consent form before the test. Do not hesitate to ask your doctor about any concerns you might have.

picture of cystoscopes
Rigid and semirigid cystoscopes

You may be asked to give a urine sample before the test to check for infection. Avoid urinating for an hour before this part of the test.

You will wear a hospital gown for the examination, and the lower part of your body will be covered with a sterile drape. In most cases, you will lie on your back with your knees raised and apart. A nurse or technician will clean the area around your urethral opening and apply a local anesthetic.

If you are going to have a ureteroscopy, you may receive a spinal or general anesthetic. If you know this is the case, you will want to arrange a ride home after the test.

Test Procedures

The doctor will gently insert the tip of the cystoscope into your urethra and slowly glide it up into the bladder. Relaxing your pelvic muscles will help make this part of the test easier. A sterile liquid (water or saline) will flow through the cystoscope to slowly fill your bladder and stretch it so that the doctor has a better view of the bladder wall.

As your bladder reaches capacity, you will feel some discomfort and the urge to urinate. You will be able to empty your bladder as soon as the examination is over.

The time from insertion of the cystoscope to removal may be only a few minutes, or it may be longer if the doctor finds a stone and decides to remove it. Taking a biopsy (a small tissue sample for examination under a microscope) will also make the procedure last longer. In most cases, the entire examination, including preparation, will take about 15 to 20 minutes.

After the Test

You may have a mild burning feeling when you urinate, and you may see small amounts of blood in your urine. These problems should not last more than 24 hours. Tell your doctor if bleeding or pain is severe or if problems last more than a couple of days.

To relieve discomfort, drink two 8-ounce glasses of water each hour for 2 hours. Ask your doctor if you can take a warm bath to relieve the burning feeling. If not, you may be able to hold a warm, damp washcloth over the urethral opening.

Your doctor may give you an antibiotic to take for 1 or 2 days to prevent an infection. If you have signs of infection--including pain, chills, or fever--call your doctor.

For More Information

American Foundation for Urologic Disease
1000 Corporate Boulevard
Suite 410
Linthicum, MD 21090
Phone: 1-800-828-7866 or (410) 689-3990
Email: admin@afud.org
Internet: www.afud.org

Interstitial Cystitis Association of America, Inc. (ICA)
110 North Washington Street, Suite 340
Rockville, MD 20850
Phone: 1-800-HELP-ICA (435-7422) or (301) 610-5300
Email: icamail@ichelp.org
Internet: www.ichelp.org


National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way
Bethesda, MD 20892-3580
Email: nkudic@info.niddk.nih.gov

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This fact sheet was reviewed by Michael B. Chancellor, M.D., University of Pittsburgh Medical Center; and William D. Steers, M.D., University of Virginia.

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.


NIH Publication No. 04-4800
December 2003


Source: National Institute of Diabetes and Digestive and Kidney Diseases
Cache Date: December 10, 2004