Cystoscopy - Investigations and procedures

Cystoscopy

A rigid or flexible fibreoptic cystoscope is introduced through the urethra in order to visualise the interior of the bladder. Flexible cystoscopy can be done under local anaesthetic, as a daycase procedure, but rigid cystoscopy is performed under an epidural or general anaesthetic. The bladder is distended with distilled water or saline, and forceps or diathermy loops can be inserted through the instrument to take biopsies, and treat superficial bladder cancer (transurethral removal of bladder tumour – TURBT). The ureteric orifices can be inspected, and fibreoptic ureteroscopes can be passed up, to look for ureteric lesions such as stones or carcinoma. In addition, the ureteric orifice can be cannulated using a fine-bore catheter, so that retrograde pyelography can be performed. Prophylactic antibiotics are needed, to reduce the risk of a urinary tract infection.