Cystoscopy is usually performed under local anesthesia of the urethra with a painkilling lubricant; general anesthesia is necessary only in children and in a few exceptional cases. Since the urethra is only three to four centimeters long and straight in women (25 to 30 centimeters in men), the procedure is easier in them.
The patient does not have to make any preparations himself. He lies down on a special examination table in the so-called lithotomy position, which is familiar to women from their visit to the gynecologist: legs elevated and spread, hips flexed. The lower half of the body is covered with sterile drapes.
Here’s how the cystoscopy proceeds
The genital area is carefully cleaned and disinfected up to the thighs and upper pubic hairline so that the endoscope does not carry germs into the urinary tract. Then a lubricating gel, which also contains the anesthetic, is inserted into the urethra and a few minutes are waited. Then the instrument is inserted and sterile rinsing water is also constantly introduced through it. This dilates the urinary bladder for better assessment and flushes out any obstructions to visibility, such as blood or pus.
As a result, the patient may feel an urge to urinate during the procedure. In some cases, the physician repositions the patient slightly during the examination (for example: head down, pelvis up) or presses on his abdominal wall to be able to spy out “corners” that are difficult to access. The entire examination usually takes only five to ten minutes.
Can there be any problems?
Many patients hardly feel anything from the examination and are also quickly fit again afterwards. Others need another day or two to fully recover. Serious complications are rare, but the following cannot be ruled out:
- Pain
- Cystitis
- Injury
- Urinary incontinence
Pain after a cystoscopy
In the first hours (until the next day), urination may hurt or burn. If the pain does not subside, increases or recurs some time later, inflammation may be behind it. A visit to the doctor is necessary!
Bladder inflammation as a result
There are always cases in which, despite the utmost caution, pathogens get into the urethra and bladder and cause an infection there. To minimize this risk, patients receive a tablet of an antibiotic after the procedure that they should take as a precaution. If, despite all precautions, symptoms of inflammation develop, such as pain or fever, the doctor should be consulted.
Injuries as complications
Small tears may occur on the mucosa of the urethra and bladder. Usually they heal without consequences, but they can also lead to scars that can narrow the urethra and thus cause disorders during urination. Minor bleeding in the first few hours after the procedure is harmless, but more severe or prolonged bleeding requires another visit to the doctor.
Urinary incontinence: rarely permanent
Irritation of the bladder sphincter may cause uncontrolled leakage of urine for a short time. Very rarely, this disorder is permanent.
Important: drink plenty of fluids!
It is important to drink a lot immediately after the examination until the next day, even if urination is still uncomfortable. This way, pathogens are constantly flushed to the outside and have little chance to settle in the urethra and bladder. Water and herbal tea are best – these are the least irritating.
