A urologist, also called a urological surgeon, is defined by Medterms.com as “a physician who specializes in diseases of the urinary organs in females and the urinary tract and sex organs in males.” To look inside the bladder, they perform a procedure called cystoscopy, or cystourethroscopy, using an instrument called a cystoscope. Cystoscopy allows a urologist to see the inside of the lower urinary tract and is used to detect abnormalities of the lower urinary tract or to assist in surgery.
Cystoscopy is a diagnostic procedure used to examine the urinary tract to aid in identifying problems such as early signs of cancer, infection, narrowing, obstruction, and bleeding. The urinary tract includes the bladder, the urethra, and openings to the ureters, which are the tubes that carry urine from the kidney to the bladder.
A cystoscope is a long, thin, hollow, flexible, lighted, telescope-like tube with a tiny camera attached to the end. It is inserted into the bladder through the urethra, which is the tube where urine passes from the bladder out of the body and in men, acts as the passageway for semen. The cystoscope allows the doctor to see detailed images of the urethra and bladder, to take pictures, to check if the urinary tract looks healthy, and to obtain a biopsy. Additionally, it allows the urologist to perform certain procedures and access these body parts with surgical instruments.
A cystoscopy is usually performed to evaluate and diagnose problems that can lead to obstruction or backflow of urine. Some conditions or reasons for a urolgist to recommend a cystoscopy include an unusual growth, polyp, tumor, or cancer in the urinary tract or prostate gland, benign prostatic hypertrophy (BPH), chronic pelvic pain, frequent urinary tract infections (UTIs), blood in the urine, frequent and urgent need to urinate, stones, painful urination, abnormalities of the urinary tract, and traumatic injury of the urinary tract.
Generally, the prodecure for a cystoscopy involves giving the patient a sedative or anesthetic. The patient is positioned on their back on the examination table with both feet placed in stirrups. A topical anesthetic gel is inserted into the urethra to numb the area using a special catheter. Once the gel has taken effect, the urologist inserts the cystoscope into the urethra to look for abnormalities or obstructions then moved to the bladder to check for any abnormalities. The urologist may infuse the bladder with sterile water or saline to help get a clearer view. Sometimes, a small device is passed through the cystoscope to collect a tissue sample for a biopsy or a urine sample. Once the procedure is complete, the cystoscope is carefully removed.
Complications can occur due to a cystoscopy including infections, bleeding, urinary retention, and bladder perforation. Women who are pregnant or who think they are pregnant should notify the urologist before going through the procedure. Risks may vary depending on specific medical conditions and having a urinary tract infection may interfere with the procedure as well.