Cystoscopy and ureteroscopy

A cystoscopy is a procedure that lets the doctor look at the bladder and urethra for problems. The doctor may also take samples and treat problems. The doctor uses a type of endoscope (called a cystoscope) with a camera on the end. The cystoscope can be straight and stiff (called a rigid cystoscope) or it can bend (called a flexible cystoscope). Doctors most often use a flexible cystoscope.

A ureteroscopy uses a flexible endoscope (called a ureteroscope) to examine the ureters and renal pelvis in the kidney as well as the prostate in men. A ureteroscope is smaller and thinner than a cystoscope.

A cystoscopy may be done to:

• look for problems that cause blood in the urine (pee) (called hematuria), frequent urinary tract infections, pain when urinating or a frequent and urgent need to urinate
• follow up when abnormal cells are found in a urine sample
• find a blockage or a narrowing of the urethra or prostate in men
• follow up after being treated for bladder cancer

A ureteroscopy may be done to:

• put in special tubes (called stents) to help urine flow from the kidneys to the bladder
• look for and remove polyps, stones or tumours
• collect biopsy samples for diagnosis

A cystoscopy is usually done in a hospital and takes less than 5 minutes. You don’t stay overnight.

Your healthcare team may ask you to do certain things before having a cystoscopy. You may need to give a urine sample to make sure you don’t have a urinary tract infection. If you have an infection, the doctor will give you medicine to treat it before you can have the test.

You will be asked to remove your clothing and to put on a gown. The healthcare team may offer you medicine to help you relax. The doctor will put a numbing jelly into the opening of the urethra (at the end of the penis in men and just in front of the vagina in women). This will help the doctor put the scope into the urethra with as little discomfort as possible.

The doctor will clean the opening of the urethra with an antibacterial solution and will slowly push the scope up the urethra and into the bladder. To help the doctor see the bladder more clearly, it is filled with water through the cystoscope. You may feel you have to urinate, which may be uncomfortable.

The doctor will carefully look at the bladder to see any abnormal areas. If there are any abnormal areas, you may have to book another cystoscopy for the doctor to collect biopsy samples, to remove polyps or stones or to help open blockages. You will get a general anesthetic (a drug that puts you to sleep so you don’t feel pain) to do these procedures.

After the test, the cystoscope is removed and you can empty your bladder. You will also need to drink 4 to 6 glasses of water to help you flush out the bladder.

A ureteroscopy is done like a cystoscopy except the doctor will look directly at the ureters and renal pelvis. You will get a general anesthetic.

Arrange for someone to take you home after the test because you will not be able to drive.

A cystoscopy or ureteroscopy usually doesn’t cause any serious side effects. It is normal to see a small amount of blood in your urine after the test. Tell your doctor if you still have blood in your urine after you’ve urinated 3 times or if your urine starts to smell unpleasant or turns cloudy.

A cystoscopy or ureteroscopy may also cause:

• bladder cramping
• burning feeling when you urinate
• severe pain when you urinate
• frequent need to urinate
• problems urinating because of blood clots
• chills, fever and back pain (which are symptoms of an infection)

Your doctor will talk to you about the results of the cystoscopy or ureteroscopy and may recommend more tests, procedures, follow-up care or treatments.

Preparing children before a test or procedure can help lower their anxiety, increase their cooperation and develop their coping skills. This includes explaining to children what will happen during the test, such as what they will see, feel and hear.

Preparing a child for a cystoscopy or ureteroscopy depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.