Cystoscopy is an office or outpatient procedure performed by your physician to look inside the bladder and urethra with a thin, lighted instrument called a cystoscope. As the cystoscope is slowly advanced into the urethra and bladder, sterile water is used to slowly distend their lumens. Minimal anesthesia is required for diagnostic procedures. If you are expected to have your bladder hydro distended (i.e. interstitial cystitis patients) general anesthesia is recommended. The goal of diagnostic cystoscopy is to look for foreign objects, stones, bladder masses or tumors, diverticulum, fistulas, damage to the lining of the bladder or urethra. During operative cystoscopy your physician may need to place ureteral stents, perform biopsies, remove stones, excise scar tissue or foreign bodies, or perform periurethral injections for stress incontinence. If a local anesthetic is used, you may be able to get up immediately after the test. If a general anesthetic is used, you will stay in the recovery room until you are awake and able to walk (usually an hour or less). Most people report that this test is not nearly as uncomfortable as they had expected.

Cystoscopy generally is a very safe test. The most common side effect is a temporary swelling of the urethra, which may make it difficult to urinate. If needed, a catheter can be inserted in your bladder to help drain the urine until the swelling goes away. Bleeding sometimes occurs after biopsies, stent placement, hydro distension, or other operative procedures. It is also possible to acquire a mild infection in the urinary tract after cystoscopy. This is usually prevented or treated by taking antibiotics before and sometimes after the procedure. Another rare complication is a puncture of the urethra or bladder by one of the instruments, which requires surgical repair. Prior to your cystoscopy you will be given informed consent with review of possible risks, benefits and alternatives.

After the test, you may need to urinate frequently, with some burning during and after urination for a day or two. It is important to drink lots of fluids to help minimize the burning and to flush the urinary tract. A pinkish tinge to the urine is also common for several days after cystoscopy, particularly if a biopsy was performed. However, call your doctor immediately if:

1.      Your urine remains red or you see blood clots after you have urinated several times.

2.      You have not been able to urinate 8 hours after the test.

3.      You have a fever, chills, or severe pain in your flank or abdomen. These may be signs of a kidney infection.