Bladder examination (cystoscopy)

Bronze or tin catheters were inserted into the urinary bladder as early as 3,000 BC in ancient Egypt, and Hippocrates used rigid tubes around 400 BC to look into the mouth or rectum. At the beginning of the 19th century, the German doctor Bozzoni came up with the idea of ​​using candlelight in addition to a two-part tube – its “light guide” was the original form of endoscopy, with which body cavities can be examined. The first “modern” cystoscope was presented by the Dresden urologist Nitze 70 years later.

Definition: What is an endoscopy?

Looking inside the body without injuring it: an age-old dream of doctors. Reflections of body cavities, technically known as endoscopies (endo = inside, skopie = looking around) have been offering this option for a good 100 years now, in addition to X-ray and ultrasound examinations.

They have the advantage that the organ can not only be viewed directly from the inside, but the examiner can also take tissue samples, carry out measurements and even carry out therapeutic interventions.

How does the cystoscopy work?

When examining the urinary bladder (cystis), the endoscope is inserted through the urethra (urethra) and this is usually examined at the same time – the procedure is therefore also known as  urethrocystoscopy  . If the examination is extended to the ureter and the renal pelvis, it is called  ureterorenoscopy .

The endoscope (cystoscope) is a tubular device that is rigid or flexible, depending on the problem, with a diameter of three to four millimeters and includes a light source and a light-conducting cable (with a small camera at the end), which is inserted through a canal. An additional channel is used for rinsing and suction, through another, for example, rinsing fluids, auxiliary instruments or ureteral splints (stents; to bridge narrowing) can be introduced and tissue samples or stones can be removed.

In addition, an X-ray contrast medium can also be filled into the ureters and thus they can be displayed together with the renal pelvis in the X-ray image (retrograde urography).

When is the cystoscopy performed?

There are a number of reasons for a cystoscopy:

  • blood in the urine ( hematuria )
  • Suspected tumor, stone, or foreign body
  • Suspected narrowing of the urethra
  • Follow-up care after  bladder cancer removal
  • recurring urinary tract infections
  • unclear pain when urinating
  • voiding disorders

However, for some of these indications, other tests are performed first, such as urine tests, blood tests, and kidney and urinary tract tests, X-rays. In any case, a  blood test is carried out beforehand  to rule out coagulation disorders.


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