Urethrocystoscopy / Cystoscopy

Urethrocystoscopy, commonly referred to as cystoscopy, is a diagnostic procedure used by urologists to examine the lining of the bladder and the urethra. This procedure is instrumental in diagnosing, monitoring, and treating conditions affecting the lower urinary tract.

Procedure Overview

• Instrument Used: A cystoscope, a thin, tube-like instrument equipped with a camera and light, is used. There are two types of cystoscopes: rigid and flexible. Flexible cystoscopes are generally more comfortable and are often used for diagnostic purposes, while rigid cystoscopes are used for removing small bladder tumors or stones.

• How It's Performed: The procedure is usually done under local anesthesia, though sedation or general anesthesia may be used in more complex cases. The cystoscope is gently inserted through the urethra into the bladder. Water or saline is often infused through the cystoscope to inflate the bladder and allow the doctor a better view of the bladder wall.

Indications for Urethrocystoscopy

• Diagnosis: It helps in diagnosing causes of urinary tract symptoms such as blood in the urine (hematuria), painful urination (dysuria), frequent urination, or urgent need to urinate.

• Evaluation: It can evaluate problems like bladder stones, tumors, polyps, and chronic infections.

• Surveillance: Regular cystoscopies are often recommended for patients who have a history of bladder cancer to monitor for recurrence.

What It Can Detect

• Bladder Tumors: Both cancerous and non-cancerous growths can be identified.

• Inflammation: Signs of cystitis or other inflammatory conditions.

• Structural Abnormalities: Such as strictures (narrowing) of the urethra or bladder neck and congenital abnormalities.

Therapeutic Uses

Beyond its diagnostic capability, the cystoscope can also be used therapeutically to:

• Remove Bladder Tumors: Small tumors can be removed during cystoscopy using special tools.

• Retrieve Bladder Stones: Stones can be broken up or removed if they are small enough.

• Inject Medications: Directly into the bladder wall for certain conditions like interstitial cystitis.

After the Procedure

Patients may experience mild burning during urination or see small amounts of blood in their urine immediately following the procedure. These symptoms typically resolve within a few days. Drinking plenty of fluids can help alleviate discomfort and clear any blood from the urine.

Urethrocystoscopy is a valuable tool in urology, providing critical insights that help in the accurate diagnosis and management of urinary tract conditions. As with any medical procedure, it's important for patients to discuss their specific medical conditions and concerns with their urologist to understand how cystoscopy might play a role in their treatment plan.