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June 20, 2013
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Cystoscopy (cont.)

Medical Author:
Stuart M Gaynes, MD
Medical Editor:
Scott H Plantz, MD, FAAEM
Medical Editor:
Francisco Talavera, PharmD, PhD
Medical Editor:
Steven L Bernstein, MD

During the Procedure

  • Two different types of cystoscopes can be used to perform the procedure: flexible and rigid.

    • The flexible scope can be used with the person lying flat, but can only be used for very minor procedures.

    • More frequently, the rigid cystoscope is used. This requires the person to be placed in a position similar to the way a woman is situated during a pelvic examination.

  • A local anesthetic is used. Sedation can be given by an anesthesiologist when the procedure is performed in an operating room. For prolonged procedures, general or spinal anesthesia is given.

  • Cystoscopy begins with thorough washing of the perineum (genital region).

  • Sterile drapes are applied. Then the cystoscope is lubricated and inserted into the urethra.

  • The urethra is examined as the scope is passed into the bladder. The bladder is drained and then filled with sterile water or an alternative solution. The bladder is examined as it is being filled and is periodically drained. During some procedures, the bladder is continuously irrigated.

  • The bladder is viewed directly through the cystoscope. A video camera can also be attached to the cystoscope so the images can be viewed on a television monitor. Different angled lenses on the end of the cystoscope allow the urologist to view the entire bladder.

  • The cystoscope has channels in it that allow the passage of instruments. This enables the urologist to perform transurethral procedures such as stone removal, prostate or bladder tumor resection, and cauterization. Cauterization involves the use of a small electric charge to stop bleeding.

  • When cystoscopy has been completed, fluid is drained from the bladder. Depending on the nature of the procedure being performed, a catheter may be left in place to continuously drain the bladder.

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