Cystoscopy is the use of a very small scope (with lots of lubricant) to look through the urethra into the bladder to evaluate the lining to document if there is disease. It can also be used to remove tissue that is abnormal. Cystoscopy can be used to distend or stretch the bladder in women who have a condition where the bladder capacity has contracted. Cystoscopy is frequently done by a gynecologist in an outpatient Surgery Center. Urologist perform Cystoscopies, many of which are done in the office.
Cystoscopy in women can be done in an office setting, also in an outpatient surgery setting or in the operating room of a hospital. It is important to remember that if you have what your doctor thinks is interstitial cystitis, or has urgency, frequency, or pain, then you should have cystoscopy done in an outpatient setting with anesthesia. The bladder in these women can be extremely tender, inflamed and just putting the scope in may irritate the delicate lining and cause a tremendous amount of pain, and spasms.
In my practice cystoscopy is performed in a surgery center setting to evaluate if a patient has inflammation consistent with interstitial cystitis and to rule out any type of cancer or lesions in the bladder. Cystoscopy can also be used to stretch the bladder and achieve a larger capacity. This will lead to a decrease in the need to void so frequently.
In the surgery center setting my cystoscopies take about twelve minutes. We ask that patients not void afterwards for 4 hours, if possible. There is usually very minimal discomfort related to Cystoscopy as I use a significant amount of lidocaine to prevent any discomfort afterwards.
The risk of bladder infection is quite small because I use irrigation in the bladder that has an antibiotic in it. This has been very successful in preventing infections. Perforations of the bladder are rare with the types of scopes I use today. Photographs can be taken while inside the bladder. This can be useful to explain to patients and for documentation of treatment and diagnosis.
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