cystoscopy
Meaning of cystoscopy: Ultrasound and CT show the bladder wall from outside; only a look inside reveals flat patches of abnormal lining.
Definition of cystoscopy
Cystoscopy is the examination in which a thin lighted instrument is passed along the urethra so the inside of the urethra and bladder can be viewed directly. It is used to investigate blood in the urine, repeated urinary infections and bladder pain, and small instruments passed down the scope allow a sample to be taken during the same appointment.
Why can a scan not replace it?
Cross sectional imaging is good at shape, thickness and stones. It is poor at color and texture. Some of the most important changes in a bladder are flat rather than raised: a velvety red patch a few millimeters across can be an early cancer confined to the surface layer, and it casts no shadow a scanner can pick up. Direct inspection also covers the urethra along the way, which imaging largely skips. So a normal imaging procedure does not close the question when bleeding has no explanation, and a cystoscope is used to settle it.
What is being looked for?
| Reason for the examination | What the examiner is checking |
|---|---|
| Blood in the urine | A tumor, a stone, or an inflamed patch of lining |
| Repeated infections | A stone, a pouch in the wall, or poor emptying |
| Urgency, frequency or pain | Inflammation, a narrowed urethra, an enlarged prostate |
| Follow up after bladder cancer | New or returning growths, which are common enough to warrant a schedule |
What does the examination involve?
A numbing gel is placed in the urethra, and with a flexible instrument that is usually all the preparation needed, so the appointment runs in a clinic room and takes only minutes. Sterile fluid flows in to open out the bladder so the whole surface can be swept with the light. The examiner works around the wall in a set order, then looks back at the neck of the bladder where the scope entered. Anything suspicious can be sampled on the spot with a biopsy, and small growths can be removed. Burning on passing urine and a trace of blood are usual for a short while afterward, and the examination carries a modest risk of introducing infection because it enters a normally sterile space. Where a growth is already known and removal is planned, the same examination is arranged in an operating room with a rigid scope and anesthesia instead.
Used in a sentence
Cystoscopy was performed to evaluate the source of the patient's recurrent blood in the urine.
Good to know
Cystoscopy provides a direct visual examination of the bladder lining, which is distinct from imaging studies such as ultrasound or CT that assess the bladder's structure without directly visualizing its interior surface.
Word origin
Where “cystoscopy” comes from
Formed from Greek kystis, meaning bladder, skopein, meaning to look at or examine, and -y, denoting the act or process.