Cystoscopy

Cystoscopy is an endoscopic examination method of the urinary tract, which is commonly performed by urologists. It is essentially a urologic equivalent of more known endoscopic procedures such as upper GI endoscopy, colonoscopy or hysteroscopy.

Principle

Cystoscopy is performed by a cystoscope. It is a classic endoscopic device consisting of a flexible hose (flexible cystoscope) or solid tube (rigid cystoscope), which is equipped by a camera and a light source. This device is inserted into the urethra and guided through the urethra into the urinary bladder. As the device moves, the examiner sees the mucosa of the urethra and the inside of the bladder. For better visualization of the bladder's wall, the cystoscope may be used to fill the bladder with fluid to distend it.

 

Note: Simple cystoscopes have no camera and the doctor has to look directly into the device.

 

Cystoscopy

 

Scheme - Urinary catheter introduced into the urinary bladder (in male)

 

Preparation

The examination does not require any special preparation.

Indications

The cystoscopy is important for diagnostics of early stages of bladder cancer. These stages have form of polyps growing from the wall of the bladder into the bladder cavity. They are asymptomatic or cause occurrence of blood in urine. The suspicion may occur thanks to abdominal ultrasound, which may show thickening of the bladder wall or directly the polypous structure. The final confirmation is done by cystoscopy, which allows the doctor to see the bladder wall and identify any pathological structures. In addition, the cystoscopy allows removing such lesions by special tool inserted into the bladder through the endoscopic device. Obtained pieces of tissue can be sent for histological examination.

Disadvantages

The examination is not very pleasant, especially for men, because they have a longer urethra with an uneven course. Prior to the procedure, numbing gel is applied into the urethra to decrease any discomfort. Many people also complain about painful and burning sensations during urination that occur after the examination. These troubles are due to irritation of the urethral mucosa by the endoscopic device, but they usually disappear within one day.

Advantages

The main advantage is the relative availability of examination and the opportunity to directly see the lower part of the urinary tract. The possibility to obtain samples for histology or to remove early stages of bladder tumors is also great.