Cystoscopy

WHAT YOU SHOULD KNOW:

• A cystoscopy is a procedure to look inside your urinary bladder using a cystoscope. A cystoscope is a long metal tube with a lens and light on its end. The scope may be attached to a camera or monitor, and pictures may be taken. The scope may be flexible (bendable) or rigid (hard), and may have a fluorescent (special blue color) light. The fluorescent light helps abnormal areas show up better when a special dye is put into your bladder. The kind of scope that is used for your cystoscopy may depend on why you need the procedure. You may need a cystoscopy if you have pain or trouble passing urine, or blood in your urine. You may also need a cystoscopy if you have pain in your lower abdomen (stomach).
  
  
• A cystoscopy may be done to check for problems in your urinary tract (where urine passes). Urine normally flows from your kidneys into your bladder through your ureters. From your bladder, urine flows out of your body through your urethra. With a cystoscopy, your caregiver can check for bladder damage or narrowing of your urine tubes or bladder. Your caregiver may look for bladder stones, cancer, or for an enlarged prostate (male gland). Your caregiver may monitor your bladder after treatment for bladder cancer by doing a cystoscopy during your follow-up visits. Having a cystoscopy may help find the reason for your bladder problems and pain. Cystoscopy can also show if your treatment for bladder cancer is working.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Medicines used during your procedure may cause an allergic response. You may feel pain or discomfort when a rigid scope is used during your procedure. Small or flat tumors may not be seen with a rigid or flexible scope. Inflamed (swollen) cells may be mistaken for tumors when using a fluorescent cystoscope. Dye used for fluorescence cystoscopy may cause damage to your skin. The lining of your urinary tract may be damaged, causing it to swell. The swelling may block the passage of urine causing your urine to flow back into your ureters and kidneys.
  
  
• After your cystoscopy, you may have headaches, dizziness, and you may feel tired. You may lose your appetite, have an upset stomach, or throw up. You may have trouble having a bowel movement (BM) for a few days. You may have pain or trouble urinating, or you may feel the need to urinate right away. You may have bladder pain, get an infection, or have blood in your urine. If you do not have the cystoscopy, the cause of your bladder problems may not be found or treated. Your signs and symptoms may not resolve, and may get worse. Call your caregiver if you have questions or concerns about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Dye: If you will have a fluorescent cystoscopy, your caregiver will put a special dye into your bladder. The dye will need to be in your bladder for a short period of time before starting your procedure. Tell your caregiver if you are allergic to shellfish (shrimp, lobster, or crab). You may also be allergic to some dyes if you are allergic to shellfish.
  
  
• Pre-op care: You may be asked to empty your bladder. You may be given medicine right before your procedure to make you feel relaxed and sleepy. You are taken to the room where your procedure will be done, and moved to a special table. You may be asked to lie on your back. Your feet and legs may be placed in stirrups or leg holders.
  
  
  • Anesthesia: Anesthesia medicine is given to make you comfortable during your procedure. Your caregiver may insert numbing medicine into your urethra before your procedure. You may still feel pressure or pushing during your procedure, but you should not feel pain. You may also receive any of the following:
    
    
    • General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery. General anesthesia is commonly used if your caregiver needs to use a rigid scope.
      
      
    • Spinal or epidural anesthesia: This is medicine put into your back to numb you below the waist. With spinal anesthesia, the medicine is given through a shot. Feeling returns in about two hours. Epidural anesthesia is put into your back through a tiny tube. After epidural anesthesia, feeling returns to your legs when the medicine wears off.
    
    
  • Monitoring: Your heart rate and blood pressure will be checked during your procedure. Your heart rate and blood pressure will be taken so caregivers can see how you are doing.

During your procedure:

• Your groin (area between your legs) will be cleaned with a special soap. Sheets are then put over the cleaned area leaving your urethral opening uncovered. The cystoscope is put into your urethra and moved into your bladder. Liquid may be put into your urethra and bladder to wash the area out. Dye may be put into your urethra so your caregiver can take samples of your bladder cells. The dye will make the bladder cells show up better under a microscope. Your caregiver will carefully check your bladder for problems or abnormal growths.
  
  
• Another dye may be put into your IV if your caregiver needs to take pictures. The dye will help your bladder show up clearer in the pictures. Your caregiver may take a tissue sample from your bladder and send it to a lab for tests. He may also remove stones or abnormal growths in your bladder. He may place or remove a stent, which is a bendable tube put into your urethra. You may have or need a urethral stent if your urine passageway is narrow or you have stones. When the procedure is finished, your caregiver will carefully remove the scope.

After your procedure:

You will be taken to a room where you can rest. You will stay there until you are fully awake, and feeling returns in your numbed hips and legs. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you may be able to go home. If you are staying in the hospital, you will be taken back to your room.

• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.