Your doctor takes tissue samples (biopsies) from your bladder lining. These samples are looked at in the laboratory.
What it is
Cystoscopy is a test to look at the inside of your bladder. Your doctor uses a thin, flexible tube called a cystoscope to do this.
Your doctor passes small instruments through the tube to take tissue samples (biopsies) from your bladder lining. These samples are looked at under a microscope to see if the cells look abnormal.
You usually have a cystoscopy and biopsy if your specialist thinks there might be cancer in the lining of your bladder. This is the most important test to check whether there is cancer in the lining of your bladder. When the results come back your doctor can see whether you need further treatment.
How you have it
The doctor uses a thin, flexible tube called a cystoscope. The cystoscope has optic fibres inside it, and a light and eyepiece at one end. The doctor can see down the cystoscope to look at the pictures. These may also be shown on a TV monitor.
Your doctor also passes small instruments down the cystoscope to take samples of tissue (biopsies) from the lining of your bladder.
You usually have this test under a general anaesthetic.
A cystoscopy is a test to look at the inside of your bladder. The bladder stores urine and when we empty it the urine passes from the bladder down a tube called the urethra and out of the body.
The urethra in men passes through the prostate gland and down the penis.
In women the urethra is much shorter and passes from the bladder down to an opening just in front of the vagina.
You have the test lying on your back on a couch. The doctor cleans around the opening to the bladder.
Then they put anaesthetic jelly into the tube where urine comes out. This doesn’t hurt but can be uncomfortable.
Once the anaesthetic has worked they put a long flexible tube called a cystoscope into the opening and up into the bladder.
You may find this uncomfortable and feel like you need to pass urine. The doctor puts water in through the scope to make it easier to see the bladder wall
The tube has a light and a camera on the end. This sends pictures to a monitor.
Looking at the monitor they examine your bladder. If they see any abnormal areas they take a tissue sample. This is called a biopsy.
After the test you may have some soreness when you pass urine. Drink plenty of fluids to help prevent infection. You may need to take antibiotics.
Contact the hospital if you have pain or bleeding which becomes worse or lasts longer than two days or if you have signs of infection such as a fever or needing to pass urine more often.
At the hospital
You go to hospital for this test, usually on the day. You are asked not eat or drink anything for at least 6 hours before the cystoscopy.
You might need a blood test and a chest x-ray before the cystoscopy. This is normal for anyone having a general anaesthetic.
In some hospitals, you may have a spinal anaesthetic instead instead of a general anaesthetic. This is an injection into your spine (epidural) so you can’t feel anything from below your waist. You may also have some antibiotics before the test.
Your doctor may put a dye into your bladder an hour before your cystoscopy. The dye is sensitive to light. During the cystoscopy they shine a blue light on the bladder lining. This is called photodynamic diagnosis. It can help to show up any areas of cancer more clearly.
Your specialist thoroughly examines the inside of your bladder and urethra using the cystoscope while you’re under anaesthetic. They take samples of tissue (biopsies) from any areas that look abnormal. They also take biopsies from areas that look normal, to compare them with. This helps to make sure of the diagnosis.
The sampled areas are then sealed with a hot probe (cauterised) to help stop any bleeding.
Cystoscopy for a man
Cystoscopy for a woman
Transurethral resection of bladder tumour
Your surgeon will remove a bladder tumour that they can see during a cystoscopy. You may already have had tests that show a bladder tumour.
This operation is called a transurethral resection of bladder tumour (TURBT).
After the test
You can usually go home the same day. This depends on:
- how many biopsies were taken
- how you react to the anaesthetic
- the time of day you have the anaesthetic – if it’s very late in the day, it may be better to stay overnight
Most people do not have problems after having a cystoscopy but as with any medical procedure, there are possible risks. You might have mild burning or stinging when you pass urine. It may also look slightly blood stained for a day or two. Drinking plenty should help with this.
You should contact the hospital if you are still bleeding 48 hours after your test, the bleeding is getting worse or there are blood clots in your urine.
There is a small risk of infection. Symptoms can include:
- going to the toilet more often
- burning and stinging when passing urine
- high temperature
- feeling hot and cold or shivery
- cloudy or offensive smelling urine
- generally feeling unwell
If you think you have an infection, you should go to your GP. They can prescribe antibiotics to treat the infection.
Rarely, you may have difficulty passing urine after cystoscopy. If this happens, you may need a catheter for a short time. There is also a risk of delayed bleeding and damage to the bladder wall or urethra.
Getting your results
Waiting for test results can be a very worrying time. You can contact your specialist nurse if you are finding it hard to cope. You can also get in touch with them to ask for information if you need to. It can also help to talk to a close friend or relative about how you feel.
Sometimes, when the doctors examine the biopsies they do not include tissue from the muscle wall. If this happens the doctor will ask you to have another cystoscopy, to take samples from the muscle wall. You should have this within 6 weeks of your first operation.