This information will help you prepare for your cystoscopy and other related procedures at Memorial Sloan Kettering Cancer Center (MSK).
A cystoscopy is a procedure that allows your doctor to examine your urethra, bladder, and openings to your ureters (tubes that carry urine from your kidneys to your bladder; see Figures 1 and 2). The purpose of a cystoscopy is to look for problems in the urinary tract, such as a blockage in the urethra caused by kidney stones or tumors.
A cystoscopy is done using a thin, hollow, lighted instrument called a cystoscope. Your doctor will insert the cystoscope into your urethra and slowly move it into your bladder. Small surgical instruments can be inserted through the cystoscope to remove samples of tissue (biopsy), stones, or small growths.
During your cystoscopy, you may also have one or more of the following procedures:
- Transurethral resection of the bladder tumor (TURBT)
- This is a procedure in which a bladder tumor is removed with an instrument that goes through the cystoscope.
- This is a procedure in which your doctor inserts a thin instrument called a ureteroscope through your urethra, bladder, and then directly into your ureter. It is done to see if there is anything blocking or interfering with the flow of urine.
- Retrograde pyelogram
- This is a procedure that allows your doctor see your ureters and renal pelvis in your kidney (see Figure 3). It is done to see if there is anything blocking or interfering with the flow of urine.
- During the procedure, small, thin, flexible tubes called catheters are guided up to your kidney through your ureters. Contrast media is then injected through the catheters. Contrast media is a substance that makes these areas stand out so your doctor can see them better.
- X-rays are taken of your renal pelvis and ureters.
- Removal of stones or blood clots from your bladder through the cystoscope
- Placement of urethral catheters (stents)
- Stents are placed to help urine flow from the kidneys to the bladder.
Before Your Procedure
Tell your doctor or nurse if you are taking any:
Tell your doctor or nurse if you have had an allergic reaction to contrast media in the past.
Ask your doctor what to do if you are taking any medications or injections to thin your blood, such as:
10 days before your procedure
Stop taking vitamin E, aspirin, and products that contain aspirin 10 days before your procedure, or as instructed by your doctor. Your nurse will give you a resource called Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), which lists the names of medications that contain aspirin.
2 days before your procedure
Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®) or naproxen (Aleve®), 2 days before your procedure, or as instructed by your doctor. Please review the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), which lists the names of NSAIDs.
Arrange for someone to take you home
You must have a responsible adult take you home when you’re discharged from the recovery area. Your procedure will not be done if you do not have someone who can do this. If you don’t have someone who can do this, call one of the agencies below. They will help find someone to take you home.
Caring People: (877) 227-4649
Partners in Care: (888) 735-8913
Prime Care: (212) 944-0244
The Day Before Your Procedure
A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you where to go on the day of your procedure. This will be either the Surgical Day Hospital (SDH) or the Presurgical Center (PSC). If you do not receive a call by 7:00 pm the evening before your procedure, please call (212) 639-5014. If you need to cancel your procedure for any reason please call your doctor’s office.
Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.
The Day of Your Procedure
On the morning of your procedure:
Do not eat or drink anything, including water, gum, and hard candy. Take any medication as instructed with a sip of water.
Shower or bathe with soap and water.
Do not apply any lotions, powders, deodorant, or makeup to your skin.
You can brush your teeth and rinse your mouth. Do not swallow any water.
Remove all your jewelry before you come to the hospital. This includes wedding rings, earrings, and any body piercings.
Bring only a small amount of money to buy a newspaper or pay for parking.
You must have a responsible adult take you home the day of your procedure. Your procedure will not be done if you do not have someone who can do this.
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a tunnel that connects the garage to the hospital. There are also other garages nearby: four on East 69th Street between First and Second Avenues, one on East 67th Street between York and First Avenues, and three on East 65th Street between First and Second Avenues. If you have questions about prices, call (212) 639-2338.
What to expect
Your procedure will take up to 1 hour. Before it begins, an intravenous (IV) line will be started to give you anesthesia (mediation to make you sleep) directly into a vein. You will be asleep during the procedure.
Once you are asleep, a urinary catheter will be inserted into your urethra. The urinary catheter will drain your urine into a bag.
Your doctor will then perform the cystoscopy and any other procedures that are needed.
After Your Procedure
You will spend 3 to 4 hours in the Post Anesthesia Care Unit (PACU), which is the recovery room.
While you are in the PACU, your nurse will check your heart beat, breathing rate, temperature, and blood pressure. Your nurse will also check your urine output to make sure your flow of urine is not blocked. You will still have the urinary catheter in place. It may be removed before you are discharged or a few days after your procedure. When you are awake and alert, you will be discharged.
Do not drive for 24 hours after your procedure.
If you had a biopsy or tumor removal
If you had a biopsy or a tumor removal, you will have a scab inside your bladder. It will loosen within a month. If the scab loosens before your healing is complete, it may cause bleeding. If this happens, rest and increase your liquid intake. Most bleeding will stop in 3 to 4 hours, but it is best to rest that day to help stop the bleeding. Call your doctor if you continue to bleed, or if you are not able to urinate.
Hematuria and dysuria
You will most likely experience hematuria (blood in your urine) after your procedure. This should clear within 1 week.
You may also have frequent urination and dysuria (pain or burning when you urinate). This can last for 3 to 4 weeks.
To help relieve both of these symptoms, drink eight, 8-ounce glasses of liquids a day for the first 2 weeks after your procedure. Avoid drinking liquids after 8:00 pm so that you don’t have to go to the bathroom during the night. Be sure to get plenty of rest.
While the urinary catheter is in place, you may feel a strong urge to urinate. This happens because the small inflated balloon that keeps it in place may cause your bladder to feel full. Relaxing and allowing the urine to flow will decrease this urge.
If you go home with a catheter in place, your nurse will show you how to care for it. If you catheter is removed before you go home, you must urinate before you are discharged.
Your doctor may want you to take medication(s) at home. You may be told to take antibiotics to prevent an infection. You may also be given other prescription(s) to relieve discomfort. Your nurse will review them with you before you leave the hospital.
- Do not go on long car trips (i.e., over 1 hour) for 1 week after your procedure without telling your doctor.
- Do not lift heavy objects (10 to 15 pounds) for 2 weeks after your procedure.
- Do not engage in strenuous exercise, such as tennis, jogging, or exercise programs for 2 weeks after your procedure.
- You can walk and climb stairs right away after your procedure.
How soon you can return to work depends on how extensive your procedure was. Ask your nurse or doctor when you can go back to work.
If you had urethral catheters (stents) placed during your procedure, please contact your doctor or nurse for a follow-up appointment. The stents will need to be changed every 3 to 6 months, or as instructed by your doctor.
Call Your Doctor or Nurse if You Have:
- Continuous bright red blood or blood clots in your urine
- Persistent bleeding (pink urine) for more than 3 days that is not improving
- Persistent pain or burning during urination for more than 3 days that is not improving
- Persistent frequent urination for more than 3 days that is not improving
- A temperature of 101° F (38.3° C) or higher
- Shaking chills
- Low back pain
- An inability to urinate