About Your Cystoscopy

This information will help you prepare for your cystoscopy and other related procedures at Memorial Sloan Kettering (MSK).

Cystoscopy (sis-TOS-koh-pee)

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 your 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.

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Other Procedures

During your cystoscopy, you may also have 1 or more of the following procedures:

  • Transurethral resection of the bladder tumor (TURBT)
    • During a TURBT, your doctor can remove a bladder tumor by using an instrument that goes through the cystoscope.
  • Ureteroscopy (YER-eh-ter-OS-koh-pee)
    • During a ureteroscopy your doctor will insert 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
    • During a retrograde pyelogram your doctor can see your ureters and renal pelvis in your kidney (see Figure 3). This procedure is done to see if there is anything blocking or interfering with the flow of your urine.
    • During the procedure, small, thin, fcatheters (flexible tubes) are guided up to your kidney through your ureters. Contrast media is then injected through the catheters. The xontrast media 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 stents
    • The stents will help urine flow from your kidneys to the bladder.
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Before Your Procedure

  • Tell your doctor or nurse if you are taking any:

    • Medications that do and do not require a prescription

    • Herbal remedies

    • Vitamins

    • Dietary supplements

  • 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:

    • Aspirin

    • Clopidogrel (Plavix®)

    • Enoxaparin (Lovenox®)

    • Warfarin (Coumadin®)

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 someone 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is a charge for this service and you will need to provide the transportation.

In New York:

     Partners in Care: 888-735-8913

     Prime Care: 212-944-0244

In New York or New Jersey:

     Caring People 877-227-4649

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.

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

Parking at Memorial Sloan Kettering is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about ¼ block toward First Avenue, on the right (north) side of the street. A pedestrian tunnel connects the garage to the hospital. For questions about pricing, call 212-639-2338. The line for the parking garage can be long, especially in the middle of the day. You may wish to consider using one of the nearby commercial garages, which are located on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues.

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.

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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.

Changes when you urinate

You will most likely experience hematuria blood in your urine after your procedure. This should go away within 1 week.

You may also have frequent urination and pain or burning when you urinate. This can last for 3 to 4 weeks.

To help relieve both of these symptoms, drink 8 (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.

Urinary catheter

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.

Medications

Your doctor may want you to take medication(s) at home. You may be instructed 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.

Activity

  • Do not go on long car trips (over 1 hour) for 1 week after your procedure without talking with your doctor.
  • Do not lift heavy objects (10 to 15 pounds) for 2 weeks after your procedure.
  • Do not do 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.

Work

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.

Follow-up care

If you had urethral stents placed during your procedure, contact your doctor’s office to schedule a follow-up appointment. The stents will need to be changed every 3 to 6 months, or as instructed by your doctor.

  • Continuous bright red blood or blood clots in your urine
  • Bleeding (pink urine) for more than 3 days that is not getting better
  • Pain or burning when you urinate for more than 3 days that is not getting better
  • Fequent urination for more than 3 days that is not getting better
  • A temperature of 101° F (38.3° C) or higher
  • Shaking chills
  • Pain in your lower back
  • An inability to urinate
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If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.
About Your Cystoscopy
©2015 Memorial Sloan Kettering Cancer Center - Generated on September 1, 2015