Introduction
A cystoscopy is a diagnostic and sometimes therapeutic medical procedure that allows a doctor to examine the lining of the bladder and the urethra (the tube that carries urine out of the body). It is performed using a cystoscope, a thin, tube-like instrument with a light and a lens or small camera at the end. Doctors often recommend a cystoscopy to investigate causes of urinary problems, such as blood in the urine, frequent urinary tract infections, overactive bladder, or pelvic pain. It is also used to diagnose bladder cancer, urinary blockages, or an enlarged prostate. In addition to diagnosis, a cystoscopy can be used to perform small surgical procedures, such as removing tiny bladder tumors, crushing and removing small stones, or taking a tissue sample (biopsy).

Surgical Procedure
The procedure can be performed in a doctor’s office, clinic, or hospital. Depending on the purpose of the cystoscopy and patient preference, it may be done using a local anesthetic jelly applied to the urethra, conscious sedation, or general anesthesia.
There are two types of cystoscopes: flexible and rigid. A flexible cystoscope is often used for basic diagnostic examinations, while a rigid cystoscope is typically used when a biopsy or surgical intervention is required.
During the procedure, the doctor gently inserts the lubricated cystoscope through the urethra and into the bladder. Sterile water or saline is then pumped through the cystoscope to inflate the bladder, providing a clear view of the bladder walls. The doctor examines the lining and may pass tiny instruments through the cystoscope to take a biopsy or remove small stones. The entire procedure usually takes only 15 to 30 minutes.

Surgical Risks
Cystoscopy is generally a very safe procedure. The primary risks involve temporary irritation of the urinary tract, a small risk of introducing an infection, and minor bleeding. If a biopsy or tumor removal is performed, the risks of bleeding and infection slightly increase.

General Complications
Common, mild complications following a cystoscopy include:
– A burning sensation during urination for the first few days after the procedure.
– A frequent and urgent need to urinate, caused by irritation of the bladder lining.
– Mild hematuria (blood in the urine), causing the urine to appear pink or slightly red. This is normal and should clear up within a few days.
– Mild pelvic discomfort or lower abdominal cramping.

Rare but Serious Complications
Severe complications are rare but require prompt medical attention:
– A severe urinary tract infection (UTI) that may spread to the kidneys.
– Excessive bleeding, characterized by bright red blood or large blood clots in the urine.
– Urinary retention (inability to urinate), which may occur due to swelling of the urethra or an enlarged prostate reacting to the scope.
– Injury or perforation of the urethra or bladder, which may require surgical repair.

Pre-operative Preparation
– Medical History: Discuss any allergies, current medications (especially blood thinners), and history of UTIs with the doctor.
– Urinalysis: A urine test is usually performed before the procedure to ensure there is no active infection. If an infection is present, the cystoscopy may be delayed, and antibiotics will be prescribed.
– Fasting: If general anesthesia or sedation is used, fasting for a specified period is required. If only local anesthesia is used, no fasting is necessary.
– Hydration: You may be asked to drink water before the procedure so you can provide a urine sample.

Post-operative Care
If local anesthesia was used, you can usually go home immediately. If sedation or general anesthesia was used, you will stay in a recovery area until the effects wear off. It is normal to feel some discomfort, and applying a warm, damp washcloth over the urethral opening can help relieve pain.

Wound Care
There are no external incisions or wounds to care for.

Diet
You can resume your normal diet immediately. It is highly recommended to drink plenty of water (at least 8-10 glasses a day) for the first few days. This helps flush the bladder, dilutes the urine to reduce burning, and minimizes the risk of infection.

Post-discharge Notes
Recovery is very quick, and most people can return to their normal activities the next day.
– Avoid strenuous exercise and heavy lifting for a few days, especially if a biopsy was taken.
– Take any prescribed antibiotics exactly as directed to prevent infection.
– Contact your doctor immediately if you develop a high fever, severe abdominal or lower back pain, inability to urinate, or if your urine contains bright red blood or thick clots that do not resolve after a few days.