A cystoscopy is a medical procedure used to examine the lining of the bladder and the urethra. A thin, lighted instrument called a cystoscope is inserted through the urethra into the bladder. This allows a doctor to look for the cause of symptoms like blood in the urine, frequent infections, or painful urination. Whether you can eat before this procedure depends entirely on the type of anesthesia planned, so it is important to confirm the specific instructions provided by your healthcare team.
Dietary Rules Based on Anesthesia Type
The most important factor determining whether you must fast is the level of sedation or anesthesia used during the cystoscopy. If the procedure uses only a local anesthetic gel, typically done in an outpatient clinic setting, you can generally eat and drink normally on the day of the exam. This is because the risk of aspiration, where stomach contents enter the lungs, is extremely low when you are fully awake.
When the cystoscopy is scheduled with general anesthesia or deep sedation, strict fasting guidelines apply. These guidelines, known as NPO (Nil Per Os, or nothing by mouth), are implemented to prevent pulmonary aspiration. Aspiration occurs if you vomit while unconscious or deeply sedated, posing a significant safety risk.
For solid foods, including chewing gum and candy, the standard instruction is to stop eating six to eight hours before the procedure. Clear liquids, such as water, apple juice, or black coffee, are often permitted until about two hours before the scheduled arrival time. Adhering to these timeframes is required for procedures involving general anesthesia, and failure to comply may result in cancellation. Always follow the exact instructions given by your anesthesiologist, as they may adjust these guidelines based on your health profile.
Essential Non-Dietary Preparations
Several preparations beyond managing food and fluid intake are necessary to ensure a smooth and safe procedure. Before the examination, you will likely need to provide a sterile urine sample to check for any active urinary tract infection (UTI). A cystoscopy is generally not performed if a UTI is present, as this could potentially spread the infection.
Medication management is a preparatory step, especially concerning blood thinners like aspirin or other anti-coagulation drugs. Your doctor will advise you on whether to stop these medications and for how long, typically to minimize the risk of bleeding during the procedure. Diabetes medications may also require adjustment. All regular prescription drugs should be discussed with the medical team in advance.
If any level of sedation is used, arranging for a responsible adult to drive you home afterward is mandatory. The effects of these medications can impair judgment and coordination for up to 24 hours. Taking a shower or bath before the procedure is recommended to reduce the risk of infection. You should avoid applying lotions, powders, or strong perfumes.
Understanding the Cystoscopy Process
The cystoscopy procedure itself is relatively brief, often taking less than 15 minutes for a flexible, diagnostic exam performed in a clinic. You will be positioned on an examination table. A numbing jelly containing local anesthetic will be applied to the opening of the urethra to reduce discomfort as the cystoscope is inserted.
The cystoscope, a thin tube with a light and camera, is gently guided through the urethra and into the bladder. Once the scope is in place, sterile liquid, such as saline solution, is slowly flushed into the bladder. This fluid fills the bladder, distending its walls to allow the physician a clearer view of the lining.
During the filling process, you may feel an increasing sense of pressure or a strong urge to urinate. This sensation is normal, resulting from the bladder stretching, and typically subsides once the procedure is complete. The doctor examines the bladder wall on a monitor, looking for abnormalities like stones, tumors, or inflammation. A tissue sample (biopsy) may be taken if necessary.
Managing Recovery and Expectations
Following a cystoscopy, a short period of recovery is expected, and most people can resume normal activities within a day or two. It is common to experience a mild burning sensation during urination for the first day or two, along with more frequent urges to use the restroom. You may also notice your urine is pink or lightly blood-tinged, especially if a biopsy was performed.
To help flush the bladder and alleviate discomfort, drinking plenty of fluids is encouraged, unless your doctor advises otherwise. Over-the-counter pain relievers can be used for soreness. A warm bath or a warm, damp washcloth applied to the urethral opening can also provide relief.
While minor discomfort is normal, you must contact your healthcare provider immediately if you experience certain warning signs. These symptoms could indicate a potential complication, such as infection or significant bleeding, and require prompt medical attention. Warning signs include:
- A fever of 100.4°F or higher.
- Severe pain that is not relieved by medication.
- The inability to urinate (urinary retention).
- The passage of bright red blood or large blood clots.