Urethrocistoscopy: what it is and how transurethral cystoscopy is performed

By Cristiano Antonino On Dec 20, 2022

Transurethral cystoscopy is an endoscopic diagnostic examination performed with an instrument called a cystoscope, which may be rigid or flexible

The flexible cystoscope is less invasive than the rigid one as it has an extremely thin gauge and the possibility of bending the end of the instrument also allows a more accurate and less uncomfortable endovesical view.

How transurethral cystoscopy is performed

Transurethral cystoscopy is performed under local anaesthesia by placing lubricating gel, containing anaesthetic, into the urethra through the external urethral meatus, while general anaesthesia is sometimes necessary for some operative procedures during cystoscopy.

The cystoscope is introduced into the urethra through the external urethral meatus and ascends to the bladder, which is distended with irrigating solution in order to inspect the entire bladder mucosa.

The duration of the examination varies from 5 to 20 minutes, depending on the ease with which the bladder lumen can be reached to study all parts of the bladder.

The day before the examination the patient who is to perform the endoscopic examination must begin an antibiotic prophylaxis that will continue for 4/5 days and at the time of the examination the patient must have sterile urine, therefore a week before the examination he must perform a urine test with urine culture and ABG.

The cystoscopic examination is more uncomfortable and in some cases painful, more so in males than in females due to the greater length and smaller diameter of the male urethra.

It allows the visual study of the entire urethra, the bladder neck and bladder mucosa in its entire width and the ureteral meatuses.

When it is necessary to perform transurethral cystoscopy

This examination is performed when patients present with

haematuria
recurrent bacterial and abacterial cystitis
interstitial cystitis
frequent urinary tract infections
irritative and obstructive urination disorders
bladder stones
the study of bladder neoformations indicated by diagnostic radiological or ultrasound examinations
on the basis of positive cytological examinations
bladder diverticulosis
suspected urethral stenosis or sclerosis of the bladder neck
chronic pelvic pain
bladder incontinence.