What Is A Flexible Cystoscopy?
A flexible cystoscopy is a procedure to check for any problems in your bladder using a flexible telescope (cystoscope). The procedure is performed by an urologist. Dr Vasudevan has recommended a flexible cystoscopy. However, it is your decision to go ahead with the procedure or not.
This document will give you information about the benefits and risks to help you to make an informed decision. If you have any questions that this document does not answer, ask Dr Vasudevan.
What Are The Benefits Of A Flexible Cystoscopy?
Dr Vasudevan is concerned there may be a problem with your bladder. You may be getting pain, blood in your urine or repeated infections, or you may have an irritable bladder (a sudden and uncontrolled urge to pass urine).
If Dr Vasudevan does see a problem during the cystoscopy, they may perform a biopsy (removing small pieces of tissue).
If the cystoscopy is normal, Dr Vasudevan will be able to tell you straightaway and hence will reassuring to you.
Are There Any Alternatives To A Flexible Cystoscopy?
A scan may give some information about the cause of the problem but a flexible cystoscopy often leads to a diagnosis. Some problems with the lining of your bladder can be seen only with a cystoscope.
It is possible to have a rigid cystoscopy that allows Dr Vasudevan to treat certain problems with your bladder and urinary tubes. However, a rigid cystoscopy involves a general or spinal anaesthetic.
What Will Happen If I Decide Not To Have A Cystoscopy?
Dr Vasudevan may not be able to confirm what the problem is. If you decide not to have a cystoscopy, you should discuss this carefully with Dr Vasudevan.
What Does The Procedure Involve?
Before the procedure
If you take Warfarin, Clopidogrel or other blood-thinning medication, let Dr Vasudevan know. It is still possible to perform the cystoscopy while taking these medications.
The healthcare team will carry out a number of checks to make sure you have the procedure you came in for. You can help by confirming to Dr Vasudevan and the health care team your name and procedure you are having.
You may need to give a sample of your urine to check for any infection.
A flexible cystoscopy usually takes about five minutes.
Dr Vasudevan will use antiseptic to clean the area at the opening of your urethra (tube that carries urine from your bladder). They may squeeze some local anaesthetic jelly into your urethra to reduce discomfort.
Dr Vasudevan will pass the cystoscope into your urethra (see figure 1). Dr Vasudevan will examine the lining and diameter of your urethra, and the valve that controls the flow of urine from your bladder. You will feel as if you are passing urine. Try to relax your muscles, as you would do normally when you pass urine, as this will make it easier to move the cystoscope into your bladder.
Dr Vasudevan will pass fluid through the cystoscope and into your bladder to help assess the bladder. He will use the cystoscope to look for any problems in the lining of your bladder. Dr Vasudevan will tell you if he needs to perform a biopsy. You will feel an uncomfortable, tugging sensation when the tissue is removed. If Dr Vasudevan finds a small growth or stone, it may be possible to remove it through the cystoscope. Dr Vasudevan will remove the cystoscope on completion of the procedure.
What Complications Can Happen?
Dr Vasudevan will try to make the procedure as safe as possible but complications can happen. The possible complications of a flexible cystoscopy are listed below.
- Bleeding during or after the procedure. You may notice a small amount of blood the first few times you pass urine (risk: 1 in 5). Most women who have a biopsy will notice blood in their urine. Any bleeding is usually little.
- Infection (risk: 1 in 50). If you need to pass urine often and pass only small amounts with a great deal of discomfort, you may have an infection. If your symptoms continue to get worse, contact Dr Vasudevan . A formal test of your urine will be done (MSU test) and if this confirms an infection you will need treatment with antibiotics.
- Narrowing of your urethra (stricture) caused by scar tissue forming. This is unusual after a single cystoscopy. You may need further surgery (risk: less than 1 in 1,000). You should discuss these possible complications with Dr Vasudevan if there is anything you do not understand.
How Soon Will I Recover?
After the procedure you will be transferred to the recovery area where you can rest.
You should be able to go home the same day, after you have passed urine.
You may get a little stinging the first few times you pass urine. Drink plenty of water to help you to pass urine more easily.
A flexible cystoscopy is not usually painful. If you have any discomfort, take simple painkillers such as paracetamol.
You should be able to return to work the day after the cystoscopy unless you are told otherwise.
Do not drive until you are confident about controlling your vehicle and always check your insurance policy.
Results from biopsies will not be available for a few days so, you will need to ring Dr Vasudevan ’s office to make an appointment to discuss results.
If you smoke, stopping smoking will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.
Regular exercise should improve your long-term health.
A flexible cystoscopy is usually a safe and effective way of finding out if there is a problem with your bladder. However, complications can happen. You need to know about them to help you to make an informed decision about the procedure. Knowing about them will also help to detect and treat any problems early.