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A cystoscopy procedure examines the inside of the bladder using a thin, flexible, tube-like telescope called a cystoscope, to determine the presence of abnormalities of the urinary tract.

The cystoscope instrument is carefully passed up the urethra (the tube that passes urine out of the body) and into the bladder. It enables Dr Swindle to inspect the bladder lining very closely for abnormalities.

During the cystoscopy procedure, Dr Swindle may also take a small sample of the lining of the bladder known as a biopsy, for examination by a pathologist. A cystoscopy is useful for determining the cause of symptoms such as blood in the urine or difficulties with urination. It is performed for the following reasons:

• Diagnosis and evaluation of urinary tract disorders
• Detecting growths, polyps, or cancer of the bladder or urethra
• Diagnosis of an enlarged prostate
• Cause of pain when urinating, chronic pelvic pain or interstitial cystitis
• Diagnosis of recurrent bladder infections
• Detection of urethral strictures
• Evaluation of blood in the urine
• Evaluation of the urinary tract prior to major surgery on the urethra, prostate or bladder

The cystoscope enables Dr Swindle to examine parts of the urethra, prostate and bladder that tend not to show up well on x-rays. Two types of cystoscopy are available - another form of cystoscopy, using a rigid rather than a flexible instrument, can be used to examine the urinary tract.

Rigid cystoscopy is where a straight rigid telescope is used alone with a high intensity light source. This instrument has a separate channel that allows other instruments to be used through the telescope. This is the conventional method of cystoscopy. A rigid cystoscopy is usually carried out as a day surgical procedure in the main operating theatres under a general anaesthetic.

Flexible cystoscopy is where a very small flexible telescope is used to examine the urinary tract. It is a fibre optic instrument that can bend easily and has a manoeuvrable tip, allowing it to pass along the curves of the urethra easily. A flexible cystoscopy is carried out in the endoscopy suite as a day surgical procedure under a light twilight anaesthetic.

Patient Preparation for a Cystoscopy

Once you have decided, in consultation with Dr Swindle, to undergo a cystoscopy, a date and time will be booked for the procedure. You will not be able to drink or eat for 6 hours prior to the procedure and you should allow the afternoon for the procedure. You will need to be accompanied to and from the procedure as you will not be able to drive after the anaesthetic and you should not be alone the night of the procedure.

The procedure itself will not take very long but there are several steps to the procedure:

• Medications:

  You can take all of your regular medications before the procedure. If you are taking anticoagulant medications you can continue to take them.

• Check in to Dr Swindle's rooms:

  Please attend Dr Swindle’s rooms and see Jan 1 hour before your scheduled procedure time to complete the appropriate paperwork.

• Check in to the endoscopy suite waiting room:

  From Dr Swindle’s rooms you will need to go to the Endoscopy Suite. The reception staff will then have you complete further paperwork relating to the Hospital and your procedure.

• Nursing Assessment:

  After completing the paperwork at the front reception desk, you will be taken by a nurse into the endoscopy suite where further questions will be asked by the nurse and you will be undressed and prepared for the procedure. You will be placed on a hospital bed in the holding area in preparation for the procedure.

• Anaesthetic Assessment:

  You will be assessed by the Anaesthetist prior to the procedure in the holding area. The anaesthetic used is known as a neurolept anaesthetic which is also referred to as a twilight anaesthetic. It is a light form of anaesthetic similar to what patients have when undergoing a colonoscopy. The anaesthetist will check your medical history and ensure you have not eaten or taken any fluids orally for the preceding 6 hours.

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