What is a bladder inspection, what is a cystoscopy? Ackermann will explain it to you. Cystoscopy, i.e. the inspection of the urinary bladder (bladder inspection), is performed with the help of what is known as a bladder scope (cystoscope). This is a special, thin, and sterile camera instrument (endoscope), which is inserted naturally from the outside and without surgery through the urethra and sphincter system into the interior of the urinary bladder (cystis). In men, cystoscopy also allows the internal parts of the prostate gland to be examined.
The endoscope (cystoscope) is a tube-shaped device, flexible or rigid depending on the application, with a diameter of three to four millimeters, which includes a light source and a light-conducting cable (equipped with a small camera at its end). This optical system is inserted through a channel of the endoscope. An additional working channel is used for rinsing and suction. Rigid cystoscopes can also be used to insert other instruments via a channel. If necessary, for example, irrigation fluids, auxiliary instruments, or therapeutic ureteral splints (known as stents) can be inserted, and tissue samples can be taken.
By using the optical system, a color image of the structures is directly generated under illumination, which the attending physician can immediately view on an external screen.
Thus, with the help of cystoscopy, the physician is able to recognize all the details of the individual organs of the urogenital tract, in some cases even the functioning of the sphincter and the ureteral orifices in the bladder, as well as important pathological changes. As a standard urological method, cystoscopy is an irreplaceable complement to other techniques, such as ultrasound or computed tomography.
As a general rule, the use of flexible cystoscopes is more comfortable for patients during cystoscopy, as they are better able to follow the bends of the urethra. The flexible systems are mainly used for cystoscopy in men. However, since it is not possible to add additional accessories in this case, operations are not possible.
Cystoscopy preparation: When is cystoscopy advised?
A cystoscopy preparation and procedure (bladder inspection) is used for diseases or unexplained findings of the urinary bladder or urethra. They include, for example:
- Blood in the urine (hematuria)
- Tumors (e.g. bladder cancer)
- Stones and constrictions (strictures)
- Anatomical changes of the urinary bladder and urethra (urethral stenosis)
- Mucosal inflammation in the urethra
- Kidney inflammations
- Change in sphincter function
If tumors are suspected, tissue sampling (biopsy) can be planned during cystoscopy preparation. Superficial tumors can be ablated using an electric snare. Bladder and ureteral stones can also be removed with a snare or by fragmentation.
Cystoscopy is usually performed under local anesthesia of the urethra with a painkilling lubricant; general anesthesia is necessary only for children and in a few other exceptional cases. Patients themselves do not have to do anything to prepare for a cystoscopy.
Cystoscopy procedure: Information on the procedure and risks!
Since cystoscopy is a relatively straightforward procedure, only local anesthesia is required.
The patient lies down on a special examination table with the lower half of their body covered with sterile drapes. The entire genital area is carefully cleaned and disinfected so that no bacteria are introduced into the urinary tract during the cystoscopy procedure. A lubricant, which also contains the anesthetic, is then inserted into the urethra. The cystoscope is then slowly pushed into the urinary bladder via the urethra. Due to the irrigation solution also introduced, the urinary bladder unfolds and the assessment of the structures to be examined is performed. If tissue samples will be taken or tumors removed, the physician inserts additional instruments via the working channel of the cystoscope. The actual cystoscopy procedure takes only a few minutes. Because the female urethra is only three to four centimeters in length, a cystoscopy is usually less complicated in women than in men, whose urethra is 25 to 30 centimeters long and not straight. For this reason, flexible cystoscopes are preferred in men.
A purely diagnostic cystoscopy is an outpatient procedure, and the patient can go home after the examination.
Sometimes, despite the anesthetic, the bladder inspection can be experienced as painful. There may also be a burning sensation during urination in the first few hours after cystoscopy is performed.
Since bacteria can enter the urethra and the bladder despite the greatest amount of care, inflammations of the bladder occasionally occur after cystoscopy. These are usually treated with antibiotics. In rare cases, the inserted cystoscope may injure the mucosa of the urinary bladder and urethra. Irritation of the bladder sphincter may also occur, which can temporarily lead to uncontrolled urination (incontinence). Very rarely, inflammation of the kidneys or prostate may occur.
Urinary bladder inspection (cystoscopy) - Urologenportal.de (accessed: 2/23/2021)
Urocystitis – amboss.com (accessed: 2/23/2021) Cystoscopy - Urologielehrbuch.de (accessed: 2/23/2021)
Bladder inspection – netdoktor.de (accessed: 2/23/2021)