Cystoscopy for Females - Indications and Contraindications

What Is a Cystoscopy for Females?

Cystoscopy is the procedure performed by a urologic surgeon to visualize the bladder, urethra, urethral sphincter, and ureteral orifices. Cystoscopy helps specialists diagnose and treat urinary tract problems like early signs of cancer, bladder control issues, bleeding, or urinary tract infections. This procedure is done with the help of a cystoscope device (a long-lighted tube with a camera at its end).

The cystoscopes can be of the following types-

• Rigid - The rigid cystoscopes do not bend. It can be used to pass instruments through the tube for biopsies or to remove tumors.

• Flexible - The flexible or bendable cystoscope is used to examine the inside of the bladder and urethra for diagnostic purposes.

What Are the Indications for a Cystoscopy?

The following conditions require a cystoscopy-

• Bladder stones, tumors, or cancer.

• Polyps or any non-cancerous growths.

• Frequent urinary tract infections (UTIs).

• Hematuria (blood in urine).

• Urinary retention (unable to empty the bladder).

• Urinary incontinence (unable to control urine flow).

• Dysuria (pain during urination).

• Congenital defects.

• Injury of the urinary tract.

• Chronic pelvic pain syndrome.

• An overactive bladder.

What Are the Contraindications for a Cystoscopy?

A cystoscopy is not recommended in the following conditions-

• Acute urinary infection.

• Intolerance of pain or any discomfort with the procedure.

• Urethral stricture (too narrow urethral passage).

What Is the Aim of Performing a Cystoscopy?

A cystoscopy can be used as a diagnostic tool and for treating urinary tract problems.

The following objectives can be achieved by cystoscopy-

Diagnosis of Urinary Tract Problems -

• Bladder cancer.

• Urethral cancer.

• Bladder control disorders.

• Bladder stones.

• Urethral strictures.

• Urinary fistulas.

• Urinary tract infections.

Treatment of Urinary Tract Problems -

• Collection of urine samples from the ureters (ureteral ducts carry urine from the kidneys to the bladder).

• Dye injection for imaging procedures that track urine flow like an X-ray.

• To collect tissue samples from the bladder or urethra for biopsy.

• To inject medication to stop urine leakage.

• Treatment of urethral strictures (narrowing) or fistulas.

• Removal of a ureteral stent (a tiny tube that holds open a ureter), bladder stones, abnormal tissue growth, polyps, or tumors.

How to Get Prepared for a Cystoscopy?

• Before cystoscopy, the patient is advised to check for any urinary tract infection by getting a urine sample tested in the lab.

• If the woman undergoing cystoscopy is pregnant or has doubts regarding pregnancy, this must be informed to the doctor.

• Patients must inform the doctor about all the medications they are taking and any drug allergies.

• Any anticoagulant (blood-thinning) medicines that affect blood clotting must be stopped before the procedure with the doctor's consent.

• The woman undergoing cystoscopy must urinate immediately before the procedure to empty the bladder.

How Is a Cystoscopy Procedure Performed?

Cystoscopy might take less than five minutes or more time, depending on the procedure to be performed along with it.

The following steps are taken to perform the cystoscopy procedure-

• The patient is asked to wear a hospital gown and the bladder right before the procedure.

• An intravenous line is started on the arm or hand to administer anesthetics or sedatives, depending on the cystoscope used and the patient's health condition.

• Blood pressure, heart rate, breathing, and oxygen levels are monitored during the procedure.

• The patient is positioned on the operating table, lying on their back with their legs in stirrups.

• A lubricated cystoscope slides through the urethra up to the bladder. Then, a sterile saline solution is injected into the bladder for better visualization. While the bladder is being filled with saline solution, the patient might have the urge to urinate or feel mild discomfort.

• The doctor can look inside the bladder and the urethra to check for abnormalities. In addition, small instruments can be entered through the cystoscope to remove tissue samples for biopsy or tumors.

• The doctor will carefully remove the cystoscope after the procedure has been done.

What to Expect After a Cystoscopy?

• After the cystoscopy procedure, the woman might have slight abdominal pain, pain during urination for a few days, or blood-tinged urine. These problems usually subside within 48 hours of the procedure.

• The doctor can prescribe some antibiotics to prevent any sort of infection.

• Over-the-counter painkillers like NSAIDs can be taken to relieve pain.

• It is recommended to drink plenty of water to flush out the bladder.

• A damp and warm washcloth can be applied over the urethral opening for some relief.

What Are the Risks Associated With Cystoscopy?

Although cystoscopy is a low-risk procedure, the following complications can occur-

• Bladder infection.

• Bladder perforation or spasms.

• Urinary tract infections (UTIs).

• Urethral scarring, trauma, or narrowing.

• Urinary retention due to swelling (urethritis) or irritation from the procedure.

The patient must immediately seek help from doctors if they have symptoms like-

• Fever or chills.

• Inability to urinate.

• Urinary urgency.

• Persistent stomach and lower back pain.

• Continued blood or blood clots in the urine for more than two days after the procedure.

• Burning sensation while urinating for more than two days.

Conclusion

Cystoscopy is an important diagnostic tool used by urologists to diagnose and manage many urological disorders. It is a very simple and relatively low-risk procedure. A cystoscopy can be uncomfortable for some women, but it should not be painful. After the procedure, the patient usually recovers within two to three days.

Mild pain can be relieved with the help of over-the-counter painkillers. If tissue samples for biopsy or urine samples were collected during the cystoscopy procedure, the results are obtained from the laboratory in a week or two. These results can help the doctor and the patient to discuss and plan the future line of treatment for any underlying diagnosed conditions.