Cystoscopy

Cystoscopy is a procedure that allows a urologic specialist to visualize the entire inside lining of the urethra and bladder in a great amount of detail.

Cystoscopy is often performed to further investigate urologic signs or symptoms. It is an anatomic visualization of the inside of the bladder, the urethra, and the ureteral openings into the bladder. X-ray, ultrasound, and CT or MRI imaging may miss findings in the bladder that can only be seen by looking directly, using a scope. Cystoscopy can diagnose a great variety of anatomic issues in the bladder or urethra.

• Microscopic hematuria (blood in your urine that is only seen by microscopic analysis)
• Gross hematuria (blood in your urine that you see with your own eyes)
• Bladder cancer
• Urethral cancer
• Enlarged prostate
• Bladder pain/interstitial cystitis
• Urethral abnormalities—ones you were born with or ones that developed
• Urethral strictures or blockages
• Congenital anomalies
• Foreign bodies, including prior surgical material or stone
• Chronic urinary infections
• Voiding symptoms or incontinence
• Urinary fistulas
• Radiation damage
• Structural changes related to neurogenic bladder or long-term blockage

Cystoscopy is commonly performed in the clinic, in a procedure room. A thin telescope is carefully passed through the urethra tube and into the bladder where live images are viewed on a monitor. The cystoscopy procedure itself takes less than five minutes, and is performed by a physician. The physician is able to see the entire bladder and urethra in great detail.

• Before the procedure—No preparation is needed. You may eat and drink normally. You may be asked to give a urine sample to ensure there is no infection. You will be brought to a procedure room where a team member will prepare the genital area with a cleansing liquid. You will lay on a procedure room exam table. The entire process includes time for preparation and time for the application of lidocaine gel, to help ease the procedure. You may be given antibiotics prior to the procedure if you have had a recent heart infection, a heart-valve replacement, or recent joint replacement surgery.
• During the procedure—Cystoscopy should not be painful, but it can be uncomfortable at times. It is important to breathe, relax your muscles, and not be tense during the procedure.
• After the procedure—You may have mild discomfort or burning when you urinate, but this should go away within 24 hours. You may have some bleeding, but this should resolve on its own over time. If you have symptoms that last longer than 24 hours, contact your doctor’s office. Cystoscopy is generally a safe procedure with a low risk of infection or bleeding.

Cystoscopy is performed by all urologists in the Section of Urology. Cystoscopy procedures are performed daily and can be scheduled in advance or performed the same day as your urology clinic visit. State-of-the-art cystoscopy equipment with high-definition capability is available in seven procedure rooms at the Virgnia Mason Medical Center. We also perform narrow band imaging (NBI) cystoscopy to enhance detection of bladder cancer. Flexible and rigid cystoscopy are performed based on the patient’s needs. All of our cystoscopes go through a rigorous sterilization process with a high level of sterilization with multiple checks and balances. Cystoscopy is also performed in the Lynnwood, Bellevue, Issaquah, and Federal Way medical centers. Every effort is made to make your experience as comfortable as possible.

Diagnostic cystoscopy (looking inside the bladder for the purposes of a diagnosis) is generally performed in the office.

Patients with a history of bladder cancer need “surveillance cystoscopy” in which cystoscopy is performed regularly to see if the cancer has come back.

The following cystoscopy procedures are also regularly performed in the urology office:

• Cystoscopy with removal of ureteral stent
• Cystoscopy with injection of Botox
• Cystoscopy with urethral bulking injection

Simple cystoscopy is performed in the office with the patient awake. More complex cystoscopy procedures are also performed in the operating room. For example, if a bladder tumor is detected, then the cystoscopy with bladder biopsy would be performed in the operating room using an anesthetic.

Cystoscopy is performed in various locations at Virginia Mason Medical Center.

For more information or to schedule a cystoscopy, please call:

• Downtown Seattle, Section of Urology: 206-223-6772
• Lynnwood, Section of Urology: 206-223-6772
• Bellevue, Section of Urology: 206-223-6772
• Issaquah, Section of Urology: 206-223-6772
• Federal Way, Section of Urology: 206-223-6772