The typical cystoscopy procedure is done to examine the urinary bladder in both men and women. It is done on an outpatient basis, and most people are able to return home within one to four hours after the exam is completed. Anesthetic is usually administered prior to the exam to eliminate any possible pain or discomfort.
Before the procedure, a person will be asked to arrive an hour before the appointment to give a urine sample. After being shown to the exam room, the patient will remove her clothing, put on a cloth or paper gown, and either lie flat on the exam table or with her feet in stirrups, depending on the instrument being used. The urologist will then drape a sheet over the lower half of the patient's body, cleanse the genital area, ask the patient to relax, and then administer either local, general, or spinal anesthesia to minimize pain and discomfort.
During the cystoscopy procedure, the urologist will insert a lighted cystoscope, which is a long, thin hand-held instrument with a camera lens embedded in it that may be flexible or rigid, into the urethra. As the instrument advances through the length of the urethra, a slight stinging or burning sensation may be felt. If the urethra is too narrow for the cystoscope to travel through, a series of small surgical tools can be inserted into a hollow space within the cystoscope to slowly widen the diameter of the urethra.
The urologist will continue to advance the cystoscope until the bladder is reached. A sterile fluid may be slowly added to the bladder through the hollow space in the cystoscope. Adding fluid to the bladder will cause the bladder walls to expand, enabling the urologist to get a clear view of the internal structure of the organ. The enlarging bladder usually causes a very uncomfortable urge to urinate that lasts for the remainder of the exam. If a biopsy or stent removal is scheduled, the urologist will perform it at this time.
Once the lower urinary tract has been examined, the urologist will gently withdraw the cystoscope from the urethra. There may be some discomfort as the instrument is removed. The genital area is then wiped clean of any remaining fluid or lubricant used during the exam.
Depending on the anesthetic used during the cystoscopy procedure, the amount of time a patient will need to stay for observation after the procedure varies. If a local anesthetic was used, the patient will be able to dress and leave shortly after dressing. When a general or spinal anesthetic is used during the cystoscopy procedure, she will need to stay for observation for one to four hours after the exam. Another person will need to be available to drive her home after general or spinal anesthesia.