Cystoscopy and bladder biopsy

What is a cystoscopy and bladder biopsy?

A cystoscope is a long, thin tube that can be passed into your bladder. The camera on the end means that your consultant is able to view the inside of your bladder. As well as this, a cystoscope can be used alongside surgical instruments to perform minor surgeries.

A flexible cystoscopy looks for problems or abnormalities, if anything is found you can then plan for treatment. A rigid cystoscopy can perform minor surgeries and look at abnormalities. 

A bladder biopsy can be performed at the same time as a cystoscopy. A bladder biopsy removes a small amount of tissue from the bladder and we send it off for testing in a laboratory. 

What symptoms may require a cystoscopy?

•    Difficulty passing urine.
•    Your urine is dark or cloudy.
•    You have blood in your urine.
•    You have bladder stones.
•    You are experiencing pain around the urinary area.

What does the procedure involve?

You will meet with your anaesthetist who will discuss the options of a general anaesthetic or a spinal anaesthetic with you. As well as this, your anaesthetist will talk through pain relief medication post-surgery.

A telescope is inserted into your bladder through your urethra where your consultant will be able to analyse the interior of your bladder.

Small biopsies may be taken from any abnormal interior areas noted.

Sometimes we may place a bladder catheter inside if you have had any biopsies taken. This will be removed the following morning.

There are two types of cystoscopies which differ slightly.

A flexible cystoscopy

•    A gel is placed near the urethra acting as a local anaesthetic. This makes the procedure less painful.
•    A cystoscope is passed through the urethra and the camera projects the images back to your consultant so they can view any abnormalities.
•    This procedure takes around 10 minutes to complete. 

A rigid cystoscopy

•    This is a thin metal tube that can be used to pass surgical instruments to.
•    This procedure involves a general anaesthetic so you will be asleep, and you won’t feel any pain.
•    Diagnoses such as small bladder stones are removed using a rigid cystoscope as it allows the surgical instruments to be passed to it.
•    After the procedure, you may have a catheter inserted to drain any fluid.
•    This procedure may require you to stay in the hospital for a few days. 

What symptoms may require a cystoscopy?

•    Difficulty passing urine.
•    Your urine is dark or cloudy.
•    You have blood in your urine.
•    You have bladder stones.
•    You are experiencing pain around the urinary area.

You will meet with your anaesthetist who will discuss the options of a general anaesthetic or a spinal anaesthetic with you. As well as this, your anaesthetist will talk through pain relief medication post-surgery.

A telescope is inserted into your bladder through your urethra where your consultant will be able to analyse the interior of your bladder.

Small biopsies may be taken from any abnormal interior areas noted.

Sometimes we may place a bladder catheter inside if you have had any biopsies taken. This will be removed the following morning.

A flexible cystoscopy
•    A gel is placed near the urethra acting as a local anaesthetic. This makes the procedure less painful.
•    A cystoscope is passed through the urethra and the camera projects the images back to your consultant so they can view any abnormalities.
•    This procedure takes around 10 minutes to complete. 

A rigid cystoscopy
•    This is a thin metal tube that can be used to pass surgical instruments to.
•    This procedure involves a general anaesthetic so you will be asleep, and you won’t feel any pain.
•    Diagnoses such as small bladder stones are removed using a rigid cystoscope as it allows the surgical instruments to be passed to it.
•    After the procedure, you may have a catheter inserted to drain any fluid.
•    This procedure may require you to stay in the hospital for a few days. 

A cystoscopy is usually a day-case procedure, so, you will leave the hospital the same day as your procedure.

Any antibiotics required will be dispensed to you from our hospital pharmacy.

For the initial 24-48 hours post-operation you should drink 1.5 litres of fluid to reduce the risk of infection.

You may experience blood in your urine for a couple of days after the procedure, this is normal so don’t worry about it.

However, if you do experience discomfort or have any worries, we will be there to help every step of the way.

A cystoscopy is a low-risk procedure and we very rarely experience problems. However, as with any procedure, there are risks involved. For a cystoscopy, these specifically include:

•    All patients experience mild burning while passing urine, but this will return to normal very shortly after the procedure.
•    A few patients experience bleeding for a few days post-operation, however, this will subside.
•    A urinary tract infection (UTI).
•    Not being able to urinate at home. This can be treated by having a catheter inserted for a few days after the operation.

A bladder biopsy can be performed during a cystoscopy. This is when tissue is removed from the bladder and sent off for testing.

You may need a bladder biopsy if you are experiencing:

•    Blood in your urine.
•    Lower back pain.
•    Pain while urinating.

After the procedure, you may experience blood clots. These will last 2-3 days and you should drink fluids to flush them out.

A bladder biopsy is often undergone if your consultant believes there is a large risk of cancerous cells. However, if the biopsy does not show cancer, it can also show us whether you have alternative medical conditions such as:

•    Cysts.
•    Ulcers.
•    An infection.
•    Bladder diverticula.