(Cystourethroscopy)

Procedure overview

What is cystoscopy?

Cystoscopy is a diagnostic procedure that allows the doctor to directly examine the urinary tract, particularly the bladder, the urethra, and the openings to the ureters. Cystoscopy can assist in identifying problems with the urinary tract, such as early signs of cancer, infection, strictures (narrowing), obstruction, and bleeding.

A long, flexible, lighted tube, called a cystoscope, is inserted into the urethra (the tube that allows urine to pass outside the body) and advanced into the bladder. In addition to allowing visualization of the internal urethra and bladder, the cystoscope enables the doctor to irrigate, suction, and access these structures with surgical instruments. The urologist can also instill substances into the bladder using the cystoscope. During a cystoscopy, the doctor may remove tissue for further examination (biopsy) and possibly treat any problems that may be detected. The cytoscope can also be used to instill saline or water into the bladder.

Internally, a healthy urinary tract appears pink and smooth, with a moist mucosal lining. Some medical conditions may change the appearance of the lower urinary tract or cause bleeding. Other conditions may cause narrowing of the urethra, making it difficult for urine to empty from the bladder. Additionally, some diseases of the bladder may cause changes in its size, shape, position, and stability. Cystoscopy allows the physician to examine these structures in great detail, take pictures, and obtain a biopsy. It may be used to perform therapeutic procedures if necessary, such as removal of stones.

Other related procedures that may be used to diagnose problems of the urinary tract include kidney, ureters, and bladder (KUB) X-ray, computed tomography (CT scan) of the kidneys, cystometry, cystography, retrograde cystography, and pyelogram (antegrade, intravenous, or retrograde). Please see these procedures for additional information.

How does the urinary system work?

The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.

The urinary system keeps the chemicals, such as potassium and sodium, and water in balance by removing a type of waste, called urea, from the blood. Urea is produced when food containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.

Urinary system parts and their functions:

  • Two kidneys. A pair of purplish-brown organs located below the ribs toward the middle of the back. Their function is to remove liquid waste from the blood in the form of urine, keep a stable balance of salts and other substances in the blood, and produce erythropoietin, a hormone that aids the formation of red blood cells.

    The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.

  • Two ureters. Ureters are narrow tubes that carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.

  • Bladder. The bladder is a triangle-shaped, hollow organ located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.

  • Two sphincter muscles. These circular muscles help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder.

  • Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder.

  • Urethra. This is the tube that allows urine to pass outside the body.



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