you have a urinary problem, your doctor may use a cystoscope
to see inside your bladder and urethra. The urethra is the
tube that carries urine from the bladder to the outside
of the body. The cystoscope has lenses like a telescope
or microscope. These lenses let the doctor focus on the
inner surfaces of the urinary tract. Some cystoscopes use
optical fibers (flexible glass fibers) that carry an image
from the tip of the instrument to a viewing piece at the
other end. The cystoscope is as thin as a pencil and has
a light at the tip. Many cystoscopes have extra tubes to
guide other instruments for procedures to treat urinary
problems. Your doctor may recommend cystoscopy for any of
the following conditions:
urinary tract infections
in your urine (hematuria)
cells found in urine sample
urination, chronic pelvic pain, or interstitial cystitis
blockage such as prostate enlargement, stricture, or narrowing
of the urinary tract
and female, urinary tracts.
have a stone lodged in your ureter or have an area that
needs more study in your ureter, your doctor may recommend
a ureteroscopy, usually with general or regional anesthesia.
The ureter is the tube that carries urine from the kidney
to the bladder. The ureteroscope is a special, very thin
instrument used to look directly at and visualize the inside
of the ureter. Some ureteroscopes are flexible like a small,
very long straw. Others are more rigid and firm. Through
the ureteroscope, the doctor can see the stone. The doctor
can then move the stone, either by removing it with a small
basket at the end of a wire inserted through an extra tube
in the ureteroscope or by extending a flexible fiber that
carries a laser beam to break the stone into smaller pieces
that can then pass out of the body in your urine. How and
what the doctor will do is determined by the location, size,
and composition of the stone. The doctor may leave a stent,
a flexible tube that keeps the ureter open for drainage
after the procedure.
your doctor about any special instructions. In most
cases, you will be able to eat normally and return to normal
activities after the test.
any medical procedure has a small risk of injury, you will
need to sign a consent form before the test. Do not hesitate
to ask your doctor about any concerns you might have.
cystoscope and semirigid ureteroscope.
may be asked to give a urine sample before the test to check
for infection. Avoid urinating for an hour before this part
of the test.
will wear a hospital gown for the examination, and the lower
part of your body will be covered with a sterile drape.
In most cases, you will lie on your back with your knees
raised and apart. A nurse or technician will clean the area
around your urethral opening and apply a local anesthetic.
are going to have a ureteroscopy, you may receive a spinal
or general anesthetic. If you know this is the case, you
will want to arrange a ride home after the test.
doctor will gently insert the tip of the cystoscope into
your urethra and slowly glide it up into the bladder. Relaxing
your pelvic muscles will help make this part of the test
easier. A sterile liquid (water or saline) will flow through
the cystoscope to slowly fill your bladder and stretch it
so that the doctor has a better view of the bladder wall.
bladder reaches capacity, you will feel some discomfort
and the urge to urinate. You will be able to empty your
bladder as soon as the examination is over.
time from insertion of the cystoscope to removal may be
only a few minutes, or it may be longer if the doctor finds
a stone and decides to remove it. Taking a biopsy (a small
tissue sample for examination under a microscope) will also
make the procedure last longer. In most cases, the entire
examination, including preparation, will take about 15 to
may have a mild burning feeling when you urinate, and you
may see small amounts of blood in your urine. These problems
should not last more than 24 hours. Tell your doctor if
bleeding or pain is severe or if problems last more than
a couple of days.
discomfort, drink two 8-ounce glasses of water each hour
for 2 hours. Ask your doctor if you can take a warm bath
to relieve the burning feeling. If not, you may be able
to hold a warm, damp washcloth over the urethral opening.
doctor may give you an antibiotic to take for 1 or 2 days
to prevent an infection. If you have signs of infection
— including pain, chills, or fever — call your doctor.
on diet, drink at least 8-10 oz. Glasses of fluid every
day, unless restricted by your physician. Avoid caffeine.
Try water with lemon wedges, soup, 7-up.
may be some nausea after your anesthesia. If nausea is present,
rest in bed. After the nausea has stopped try fluids such
as listed above.
amount of discomfort is very unpredictable. You may have
some burning upon voiding, blood tinged urine and urinary
frequency. It is not uncommon to have spasms (colicy or
intermittent pain, pain that comes and goes) of the ureter
(flank area) or urethra (bladder) while stent is in place.
For pain relief and promotion of muscle relaxation, take
a warm bath or apply heat to the abdomen. Unless contraindicated
take Tyienol for the discomfort, according to package directions.
not uncommon to pass blood or small clots, especially the
first 72 hours. Keep drinking fluids.
fever is common even after a simple procedure. If your temperature
is elevated, drink plenty of fluids. If you have questions
about your temperature, do not hesitate to notify your doctor.
resting as much as possible the day of surgery, then you
may resume your normal activity as you feel like it. Do
not drive a car for 24 hours after a general anesthetic.
You may experience some blood in your urine with increased
activity, such as lifting, exercising, or sexual intercourse,
with a stent in place. This is normal, continue to drink
plenty of fluids.
have a problem of an emergency nature and are unable to
reach your doctor, come to your nearest hospital or emergency
facility. If unable to pass your urine, first try sitting
in a warm tub and void, if still unable to void go to the
nearest Emergency Outpatient Department.
your doctor (or doctor on call) if you have any problems:
over 100 oral
stent is coming out of the urethra and was not placed there
at the time of surgery.
amount of bright blood or clots in urine.
unrelieved by medication or warm bath.
burning upon urination, frequency and blood in urine continues
after 72 hours post-op.
it is necessary for you to contact your doctor before your
office visit, he can be reached at his office number.