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Cystoscopy and biopsy

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.

What happens

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.

The test

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

Diagram showing a cystoscopy for a man

Cystoscopy for a woman

Diagram showing a 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

Possible risks

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 worrying time. You can contact your specialist nurse if you’re finding it hard to cope. It can also help to talk to a close friend or relative about how you feel.

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

Further tests

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.

Information and help

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