Cystoscopy: how does the examination work?

The cystoscopy is usually performed under  local anesthesia  of the urethra with a pain-relieving lubricant; general anesthesia is only necessary for 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 for 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 women are familiar with from their visits to the  gynecologist  : legs raised and spread, hips bent. The lower half of the body is covered with sterile towels.

This is how the bladder reflection works

The genital area is carefully cleaned and disinfected up to the thighs and the upper pubic hair line so that no germs are carried into the urinary tract through the endoscope. Then a lubricating gel, which also contains the anesthetic, is inserted into the urethra and waited a few minutes. Then the instrument is introduced and sterile rinsing water is constantly introduced through it. This stretches the urinary bladder for better assessment and flushes out any cloudiness that obstructs the view, for example due to blood or pus.

 As a result, the patient may feel the urge to urinate during the procedure  . In some cases, the doctor positions the patient slightly during the examination (e.g. head down, pelvis higher) or presses on his abdominal wall in order to be able to spy out “corners” that are difficult to access. The entire examination usually takes only five to ten minutes.

Can problems arise?

Many patients hardly feel anything from the examination and are quickly fit again afterwards. Others need a day or two to fully recover. Serious complications are rare, but the following cannot be ruled out:

Pain after a cystoscopy

In the first few hours (until the next day), urinating can hurt or burn. If the pain does not subside, increases or reappears some time later, inflammation may be behind it. A doctor’s visit is necessary!

inflammation of the bladder as a result

There are always cases where, despite the greatest caution, pathogens get into the urethra and bladder and cause an infection there. To minimize this risk, patients are given an antibiotic tablet after the procedure, which they should take as a precaution. If, despite all precautions, symptoms of inflammation such as pain or fever develop  , the doctor should be consulted.

injuries as complications

There may be small tears in the mucous membrane of the urethra and bladder. They usually heal without consequences, but can also lead to scars that narrow the urethra and can thus cause problems with urination. Slight traces of blood in the first few hours after the procedure are harmless, heavier or longer-lasting bleeding will require another visit to the doctor.

Urinary incontinence: rarely permanent

The irritation of the bladder sphincter can lead to an uncontrolled discharge of urine for a short time. Very rarely is this disorder permanent.

Important: drink a lot!

It is important to drink a lot right after the examination until the next day, even if urinating is still uncomfortable. In this way, pathogens are constantly flushed out and have little chance of settling in the urethra and bladder. Water and herbal tea are best suited   – they are the least irritating.

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