A cystoscopy is a medical procedure used to look inside the bladder and the urethra, the tube that carries urine out of the body. A thin tube with a light and camera, called a cystoscope, is gently inserted through the urethra to allow a health professional to view the urinary tract lining. Many people feel anxious about having a cystoscopy because they are concerned about the potential for pain. While the procedure involves sensations of discomfort and pressure, it is rarely described as severely painful, and the experience is often manageable. This article will explore the sensations you can expect and the measures taken to ensure your comfort during the examination.
Understanding the Sensation During the Procedure
The sensation during a cystoscopy is generally characterized more by pressure and urgency rather than sharp, acute pain. The initial discomfort occurs when the lubricated cystoscope is first passed through the urethra into the bladder. This feeling is typically described as a brief, intense sensation or a burning feeling, which quickly subsides as the scope advances.
Once the scope is inside the bladder, a sterile fluid, often saline solution, is injected to gently inflate the bladder. This inflation stretches the bladder walls, allowing the doctor to see the lining clearly. This causes a strong feeling of fullness and a compelling urge to urinate, similar to having an extremely full bladder.
The entire diagnostic procedure is usually brief, often lasting only five to twenty minutes, which limits the duration of any discomfort. Any feelings of pressure or urgency are temporary and resolve almost immediately after the fluid is drained and the cystoscope is removed.
Factors Influencing Discomfort Level
The level of discomfort experienced during a cystoscopy can vary significantly among patients due to anatomical and procedural factors. Patient anatomy, specifically the length of the urethra, is a major influence. Male patients generally report slightly more discomfort during the insertion phase compared to female patients because the male urethra is substantially longer and has natural curves the scope must navigate.
The type of cystoscope used is another significant factor. The flexible cystoscope, the most common instrument used for diagnostic procedures, is better tolerated than the rigid scope. The rigid scope is often reserved for complex procedures that require general anesthesia or sedation, such as a biopsy or surgical treatment.
The reason for the procedure also impacts the discomfort level. A simple diagnostic examination is quicker and less uncomfortable than a therapeutic procedure. Procedures that involve passing instruments through the scope to remove tumors or take tissue samples require a higher degree of intervention, often needing more substantial anesthesia.
Steps Taken to Minimize Discomfort
Medical professionals have established protocols to actively reduce discomfort, ensuring the procedure is manageable. The most common step is applying a lubricating jelly directly into the urethra before the cystoscope is inserted, which reduces friction as the instrument passes through.
A local anesthetic gel, typically containing lidocaine, is often mixed with the lubricant and instilled into the urethra. This topical anesthetic numbs the lining, reducing the intensity of sensation during the scope’s passage. Allowing the lidocaine gel to dwell for about 10 to 15 minutes before starting the procedure maximizes its numbing effect.
During the procedure, the healthcare team may provide specific instructions to help manage anxiety and muscle tension. Simple relaxation techniques, such as taking slow, deep breaths, can help the muscles around the pelvis and urethra relax. This relaxation makes the insertion and passage of the scope smoother and less irritating.
Recovery and Expected Post-Procedure Feelings
After the cystoscopy, the focus shifts to the short recovery period and managing temporary side effects. It is common to experience a burning or stinging sensation when urinating for the first 24 to 48 hours. This results from the urethral lining being temporarily irritated by the scope.
You may also notice that you need to urinate more frequently or urgently than usual during this time. Additionally, it is not uncommon to see small amounts of blood in the urine, which may appear as a pink or light red tinge. These symptoms are expected and should gradually resolve completely within one to two days.
It is important to contact your healthcare provider immediately if you experience certain warning signs, as these may indicate a complication. These signs include:
- A fever of 100.4°F (38°C) or higher.
- The inability to urinate.
- Severe, escalating pain that is not relieved by over-the-counter medication.
- Passing large blood clots.
- Bright red bleeding that persists for more than a couple of days.