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Urethrocystoscopy

doctor and patient

Almost every woman knows annual gynecological checkups and regular pap smears are important to maintaining good pelvic health. Sometimes, though, things go wrong down below and we begin to hear about tests and procedures that not only sound intimidating, but are hard to pronounce. One of those procedures may be urethrocystoscopy, a multisyllabic word that sounds as complicated as it is to spell. Based on symptoms you’ve mentioned having to your doctor, he or she may have recommended urethrocystoscopy to further investigate and diagnose your problem.

What is Urethrocystoscopy?

Simply put, urethrocystoscopy or cystoscopy is an examination of the bladder and urinary tract. An instrument is inserted into the urethra, the tube or duct that empties urine from your bladder and out of your body. This instrument is called a cystoscope and assesses any damage, disorder, disease or irregularity.

What is a Cystoscope and How Does it Work?

A cystoscope is a long tube with a light and camera on one end. The other end is equipped with lenses just like a microscope or telescope. As the doctor slowly probes the area to be examined, the camera will project pictures onto a screen to study. Some cystoscopes also have flexible glass called optic fibers that can generate an image from the probe end to the examiner’s viewing lens.

Depending on your particular case, your doctor may opt to use a cystoscope that is either hard and rigid or soft and flexible. He may also use one equipped with an extra tube in order to perform surgical procedures or immediately correct other problematic urinary issues.

For biopsy purposes, or for surgical procedures, the rigid cystoscope is used, but if your doctor is simply investigating the area to look for whatever might be ailing you, the flexible tool is used.

Sometimes, a ureteroscope, which is similar to a cystoscope, but of a thinner caliber, is better suited for the procedure if it’s necessary to remove stones or other blockages high in the urinary tract. This apparatus allows the physician to push a wire equipped with a basket through the ureteroscope’s extra tube to remove the stone. It also enables him to insert a laser fiber to break up larger ones that will later pass harmlessly during normal urination.

That Sounds Terribly Painful. Is it?

No. At worst, urethrocystoscopy can be uncomfortable and you may experience a burning sensation, along with the urge to urinate while the tube is being inserted. For a flexible cystoscopy, a local, often topical anesthetic is given before the procedure with plenty of time to take effect. If a rigid cystoscope is used, local anesthetic can be equally effective, but a general one can be used as well.

Why Would I Need a Urethrocystoscopy?

This procedure may be warranted if you’re experiencing or complaining of the following:

• Repeated urinary tract infections
• Kidney stones in the kidney ducts (ureters)
• Blood in your urine (hematuria)
• Pain or discomfort when urinating
• Suspicious cells found in your urine sample
• Suspicious polyps, tumors, growths or cancer in the ureter
• A necessity for a bladder catheter
• Urinary tract stones
• Overactive bladder
• Chronic pelvic pain
• Incontinence
• Interstitial cystitis
• Any blockage that might be impeding your urinary flow, or causing a narrowing in your ureters.

What Preparations are Necessary for a Urethrocystoscopy?

Your doctor will discuss any preparations necessary. In some cases, with a weakened immune system, you may be prescribed an antibiotic prior to the examination. A urine sample may also be required. Make certain your physician is aware of any and all medications you may be taking. This includes vitamins and supplements. You may be asked to discontinue some of them to prevent excessive bleeding during the procedure. Unless you’ll be given a general anesthesia, you can probably eat and drink normally that day, but again, check with your doctor in case you may need to fast.

What Can I Expect During the Urethrocystoscopy?

First, you will be asked to change into a gown and empty your bladder. When you are finished, you will be led to a table, asked to lie down on your back, and possibly put your feet into stirrups. Depending on your case, you may be given an antibiotic to avoid getting a bladder infection.

At this time, the area will be cleaned and sterilized and you will be given anesthesia. If it is general anesthesia, you won’t remember much after this point until you wake up.

If your doctor has opted for a regional or local anesthetic, a sedative may be provided to calm you as you will feel some sensation during the examination.

The area of the urethra will be treated with a numbing agent and checked to make sure that you are properly desensitized.

The lubricated probe will now be gently inserted into your urethra. You may experience a burning sensation, coupled with a need to urinate.

As the scope moves through your bladder, your doctor will be watching through the lens. He will then flood your bladder with a sterile solution, enabling him to assess the situation. Again, you may feel the need to urinate.

The entire urethrocystoscopy with local anesthetic will take about 5 minutes, and perhaps 15 to 30 if using general anesthesia. Complete results may be immediate or they may take a few days.

What Happens After?

Urethrocystoscopy doesn’t usually have too many side effects, but you should take note of the following:

• If general anesthesia was required, you may be somewhat groggy and should avoid driving or operating machinery. It would be wise to have someone stay with you for a few hours or even the rest of the day if possible.
• You may need to urinate more often for a few days. Void as often as you need to and do not hold it in. Urinating whenever your body urges you to can prevent clots from forming in the bladder and creating possible blockages.
• It’s normal to see a little blood in your urine, especially if you had a biopsy.
• Drink lots of fluids to minimize bleeding and burning.
• If you have swelling or pain, holding a damp warm washcloth against your urethra. Taking a warm bath may also help.
• Avoid alcohol for a few days.
• Refrain from sexual activity for the time period your doctor has recommended.
• Biopsies require healing time. Don’t do any heavy lifting or strenuous exercise.
• If you are given antibiotics, take them for the entire duration of time prescribed.

Is There Anything Else I Should Worry About?

Some mild discomfort could be expected, but contact your doctor immediately if you experience any of the following symptoms:

• Severe stomach pain
• Inability to urinate for more than eight hours
• Fever over 100.4 ° F
• Foul smelling urine or discharge
• Lower back pain
• Nausea
• Vomiting
• Serious bleeding
• Bright red blood or clots when you urinate.

All urethrocystoscopy procedures are performed at Northside Hospital Cherokee, where we have generous use of their state-of-the-art cystoscopy equipment.

At Cherokee Women’s Health Specialists, our Female Pelvic Medicine Reconstructive Surgeons (FPMRS) are highly trained urogynecologists who are skilled in performing all diagnostic testing and women’s health surgeries.

If you are experiencing bladder issues, call us today at 770.720.7733.