Cystoscopy

 

What cystoscopy is

Cystoscopy is a test to look at the inside of your bladder using a thin, flexible tube called a cystoscope. A cystoscope has optic fibres inside it and a light and eyepiece attached to it. Through the eyepiece, your doctor can see down the optic fibres and into the inside of your bladder. You can have a cystoscopy under local or general anaesthetic, depending on what the doctor needs to do.

Cystoscopy for a man

Cystoscopy for a woman

Why you may have a cystoscopy

This is the most important test for diagnosing cancer of the bladder. You may also have a cystoscopy if you are having investigations for other types of cancer, to see if there is any spread to the bladder. You may have a cystoscopy to investigate

Cystoscopy under local anaesthetic

You usually have this during an outpatient appointment. You will need to undress your lower half and may have a gown to put on. You will have to lie on your back on the bed or couch. The doctor will squeeze some anaesthetic jelly into the tube where your urine comes out (your urethra). In men, this means squeezing the jelly down the penis. But don't worry - it doesn't hurt.

After waiting a few moments for the local anaesthetic to work, the doctor puts the cystoscope into your bladder. Your doctor will move the tube around so that they can examine the whole of the inside of your bladder.

The whole test only takes a few minutes and there are usually no after effects apart from some discomfort passing urine for the first time. If anything looks abnormal, your doctor will arrange for you to go into hospital for a cystoscopy under general anaesthetic so that they can take biopsies. The doctor or nurse will give you antibiotics to take to prevent infection. It is important to take these as prescribed.

Cystoscopy under general anaesthetic

For this test, you have to go into hospital. You will probably not have to go in until the day of the test. You will be asked not to eat or drink anything for at least 6 hours before you go in.

You may have a blood test and a chest X-ray first. This is routine for anyone having an anaesthetic. Then you will put on a hospital gown and lie down on the theatre trolley. The trolley is wheeled down to the operating theatre, where you have the anaesthetic.

While you are under anaesthetic, your specialist will thoroughly examine the inside of your bladder and urethra. They will take samples of tissue (biopsies) from any areas that look abnormal. Your doctor may also take random biopsies from areas of bladder lining that look normal. This helps to make sure of the diagnosis. The biopsied areas are sealed with a hot probe afterwards (cauterised) to help stop any bleeding.

You can usually go home the same day if the procedure has been minor. This will depend on

• How many biopsies were taken
• How you react to the anaesthetic
• The time of day you have the anaesthetic - if it is very late in the day, it may be better for you to stay overnight

If there are large tumours which need treatment, you will need to stay longer and you may need a catheter (a tube into the bladder) for a few days after the operation.

Your results

It can take time for test results to come through. How long will depend on why you are having the test. You may get the results within a couple of days. But if you have had biopsies taken, you won't get your results until these specimens have been fully examined and tested. This takes at least a week. The biopsy report will be sent to your specialist, who will then give the results to you. If your GP has sent you for the test, the results will be sent directly to their surgery.

Understandably, waiting for results can make you anxious. If your doctor needs the results urgently, it can be noted on the test request form, and the results will be ready sooner. Try to remember to ask your doctor how long you should expect to wait for the results when you are first asked to go for the test. If it is not an emergency, and you have not heard a couple of weeks after your test, ring your doctor's secretary to check if the results are back.