Why is a Cystoscopy done?

• Investigate causes of signs and symptoms, which could include overactive bladder, incontinence, painful urination and blood in the urine. Cystoscopy can also help find out the cause of frequent urinary tract infections. But, generally, cystoscopy is not performed while you experience an active urinary tract infection.
• Diagnose bladder diseases and conditions. Examples include bladder inflammation (cystitis), bladder stones and bladder cancer.
• Treat bladder diseases and conditions. In cystoscope, special tools can be passed to treat certain conditions. For instance, very small bladder tumors may be removed during a cystoscopy.
• Diagnose an enlarged prostate. Cystoscopy may show narrowing of the urethra where it passes through the prostate gland, demonstrating an enlarged prostate (benign prostatic hyperplasia).

How does the procedure work?

Before the Procedure

• Details of the medications and supplements currently being taken will be noted
• Tests can be done to check for the status of patient's general health condition
• Urine test has to be done to check for any urinary infection since that needs to be treated before doing cystoscopy.
• Food intake should be stopped the night before thw procedure, if general anaesthesia is to be administered.
• The patient will be asked to urinate immediately before the procedure

During the Procedure

• Anaesthesia will be administered to numb the patient to pain.
• A lubricated cystoscope will be slid into the urethra
• Your doctor may examine your urethra and bladder. A cystoscope has a lens on its end that works like a telescope to magnify inner surfaces of the urethra and bladder. The doctor may place a special video camera over its lens to project the images onto a video screen.
• Your bladder would be filled with a sterile solution, which inflates your bladder allowing your doctor to get a better look inside. As and when your bladder fills, you may feel the urge and need to urinate. You will be encouraged to do so as soon as your procedure is finished.
• Tissue samples may be taken by your doctor for lab testing, or to perform many other procedures during the cystoscopy.
• If the doctor wants to do a biopsy or remove some tumours, then the scope needs to be bigger and more rigid so that the surgical instruments can be inserted through it.
• After the procedure, the device will be taken out.
• The procedure normally gets over within five to six minutes. It would take a bit longer if the doctor decides to do other procedures at the same time.

After the Procedure

• The patient can leave the hospital the same day if there are no other complications found.
• The patient may have constant urges to urinate for the first two days which will fade gradually.
• Pain medications can be taken
• Drink plenty of water to flush out the bladder
• Antibiotic may be given to avoid infection
• Patients may apply warm water or keep a cloth dipped in warm water over the urethra to get relief from pain.

 

Contact the healthcare provider if,

1. The patient is unable to urinate even if they have a full bladder
2. Large amounts of blood  is found in the urine
3. The patient experiences a continuous burning sensation while urinating
4. The patient is unable to relieve pain with pain medications

 

Risks of the Procedure

Cystoscopy is generally a low risk procedure. But at times it can cause:

1. UTI
2. Bladder or urethral  infection
3. Cramps
4. Scars in the urethra
5. Injury caused by the devices inserted

 

Conclusion

A cystoscopy can help one find out medical issues pertaining to the urinary tract or bladder. It is normally a very safe procedure and the doctor can also conduct other procedures via a cystoscopy  to remove potentially risky growths or tumours.

Cystoscopy with DJ Stenting

DJ stenting is the abbreviated form of Double “J” stenting which is a procedure done to remove the blockage of the ureters (tubes which bring urine from kidney to the bladder).

As the name suggests, the ends of the stent is J shaped which allows it to stay in place and it will be removed after  about six weeks of placement when the ureter is dilated enough to pass the urine.

 

Who needs the procedure?

The procedure can be done on those whose ureters are blocked due to:

1. Kidney stone
2. Tumours
3. Clotting of blood
4. Infection

The stents can also be placed on those who are undergoing surgery in the ureters, to get a better view   

 

What are the procedures before stenting?

• Tests like, blood check, x-ray, electro-cardiogram etc have to be done before the surgery
• Cystoscopy or ureteroscopy has to be done to look for  obstructions in the tubes.
• Let the doctor know details of medications and supplements which are being consumed by you.
• Let the doctor know of any allergies
• Avoid food and water the day before the procedure, if suggested by the doctor

 

What happens during the procedure?

• The patient is administered either general or local anaesthesia as per the requirement.
• A cystoscope will be inserted into the urethra towards the bladder to see the opening of the ureter.
• A guidewire will be inserted through the cystoscope and passed into the ureter.
• The stent is then placed over the guidewire and pushed into the ureter.
• A device called fluoroscope is used to place the stent in the right position.
• Guidewire and cystoscope are then removed out of the body.

 

What can be expected after the procedure?

• One might feel pain in the pelvic region while in certain positions
• There may be minor quantities of blood in the urine But care has to be taken when excessive bleeding happens.
• Medications will be provided to relieve pain.

 

Risks

• Reaction to anaesthesia
• Curving of the stent inside the ureter causing pain and injury
• Excessive blood in the urine
• Injury to the adjacent organs
• Stones gets accumulated over the stent causing obstruction again