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Cystoscopy Without Biopsy

  • Posted on- Dec 20, 2017
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Cystoscopy is a procedure to examine inside of the bladder and urethra, using a fine telescope passed through the urethra.

Flexible Cystoscopy is carried out using a fine, flexible, fiber-optic telescope under local anesthetic. This is often performed in the office setting or as an outpatient.

Rigid cystoscopy is carried out under general anesthesia. This is often performed in the hospital or as an inpatient.

Cystoscopy is a minor procedure. It causes only minor discomfort.

A cyst scope is a thin tube with a camera and light on the end. During a cystoscopy, a doctor inserts this tube through your urethra and into your bladder, so that they can visualize the inside of your bladder. Magnified images from the camera are displayed on a screen where your doctor can see them.

Types of cystoscopy

Flexible cystoscopy

Generally, cystoscopy is performed under local anesthesia. Flexible cyst scope is a thin, flexible, fiber-optic telescope. It allows your doctor to examine the bladder wall very closely for unusual growths.

Rigid cystoscopy

Generally, rigid cyst scope is a thin, solid, straight telescope. Generally, it is performed under general anesthesia.


Normally, before testing, you are asked to avoid urinating for an hour before this part of the test and to take a urine sample to check for infection. In general, you are able to eat normally and return to normal activities after the test.

A doctor, nurse or technician will clean the area around the urethral opening and apply a local or general anesthetic. The doctor will insert the tip of the cyst scope into the urethra and slowly guide it up into the bladder. The procedure may be painful. You are also asked to relax the pelvic muscles to make the insertion easier, then a sterile liquid will flow through the cyst scope slowly to fill the bladder and stretch it so that the doctor has a better view of the bladder wall.

After the test, you may feel some burning sensation when you urinate and often see small amounts of blood in their urine.

The cystoscopy procedure

Before the cystoscopical procedure you are required to go to the bathroom. Just before the cystoscopy, you need go to the bathroom to empty your bladder. Then, you change into a surgical gown and lie down on your back on a treatment table. Your feet may be positioned in stirrups. The nurse may provide you with antibiotics to help prevent a bladder infection.

At this point, you'll be given anesthesia. If you get a local or regional anesthetic, you may also be given a sedative to relax. Your urethra will be numbed with an anesthetic spray or gel. The doctor will lubricate the scope with gel and carefully insert it into the urethra. This may burn slightly, and it may feel like urinating.

If the procedure is investigatory, your doctor will use a flexible scope. The bigger scope allows surgical instruments to pass through it.

It becomes easy for the doctor to keep a watch on what is going on. The fluid might give you an uncomfortable feeling of needing to urinate.

With local anesthesia, your cystoscopy may take less than five minutes. If you're sedated or given general anesthesia, the entire procedure may take 15 to 30 minutes.


What should you do to prepare for cystoscopy?

No preparation is required for flexible cystoscopy. You can eat, drink as normal and attend the appointment. However if you are having a rigid cystoscopy, you will need to fast for 6 hours. You should be able to go home by yourself after flexible cystoscopy, but you cannot drive for 6 hours. After rigid cystoscopy, under general anesthesia, you need escort home if you are leaving on the same day and you must not drive within 24 hours of the general anesthesia. If a bladder biopsy is likely, you should check with your doctor whether you need to stop aspirin or other blood thinners a few days prior to the biopsy.

Reasons for having a cystoscopy

These test could be prescribed by the doctors if you are suffering with urinary problems, such as a constant need to urinate or painful urination. Your doctor might also order the procedure to investigate reasons for:

  • blood in your urine
  • frequent urinary tract infections
  • an overactive bladder
  • pelvic pain

A cystoscopy can reveal several conditions, including bladder tumors, stones, or cancer. The procedure is:

  • blockages
  • enlarged prostate gland
  • noncancerous growths
  • problems with the ureters (tubes connecting your bladder to your kidneys)

A cystoscopy can also be used to treat underlying bladder conditions. Doctor will pass tiny surgical tools through the scope to remove small bladder tumors and stones or to take a sample of bladder tissue.

Other uses include:

  • taking a urine sample to check for tumors or infection
  • inserting a small tube to assist with urine flow
  • injecting dye so kidney problems can be identified on an X-ray

What is involved in the actual process of flexible cystoscopy?

As you are awake throughout the procedure, your doctor may give you a running commentary while he gets you prepared. The genital area is cleaned with a mild antiseptic and the area covered with a sterile sheet. Then a local anesthetic gel is put into the urethra.

The gel comes in a tube and is squeezed into the urethra. There may be slight stinging as it starts to work. When the instrument reaches the sphincter inside the urethra, you will be asked to do the action of voiding or cough, to relax the sphincter. There may be a brief moment of discomfort as the telescope passes through.

When your doctor examines the bladder, he fills your bladder with saline and you may feel that you want to pass urine. By the end of the procedure which only takes a few minutes, you may feel the fullness and need to pass water again.

Anesthesia during a cystoscopy

A small amount of anesthesia will be needed, so before inhaling it take a suggestion from your doctor before the procedure. These include:

Local anesthesia: Outpatient procedures generally involve local anesthesia. This means you'll be awake. You can drink and eat normally on your appointment day and go home immediately after the procedure.

General anesthesia: General anesthesia means you'll be unconscious during the cystoscopy. With general anesthesia, you may need to fast for several hours ahead of time.

Regional anesthesia: Regional anesthesia involves an injection in your back. This will numb you below the waist. You might feel a sting from the shot.

With either regional or general anesthesia, you will probably need to stay in the hospital for a few hours after the procedure.

Will I feel any discomfort after the procedure?

You may feel minor pain in your urethra on passing urine. You may also see traces of blood in the urine. These symptoms should not last longer than 24 hours. Drinking more water helps a lot. Occasionally, infection may occur and give you more pain, frequency and urgency than expected. Fever may also occur, rarely. Should you suspect that infection is present, contact your doctor. He will need to prescribe antibiotics to fix this.

Cystoscopy without biopsy will cost minimum to Rs.21,000 to maximum Rs.42,000.


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