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Flexible cystoscopy uses a thin, flexible, lighted tube called a cystoscope to view the bladder and urethra. There is also a rigid cystoscope available. In the United States, the flexible cystoscope is more frequently used on men, while the rigid cystoscope is used for women.
The urinary bladder is a small, hollow organ that collects urine. When the bladder is full, the urine is emptied from the body through a tube called the urethra. This tube is very short in women, but longer in men. Occasionally, a flexible cystoscopy may include the ureters, which are tubes that carry urine from the kidneys to the bladder. The kidneys cannot be viewed with a cystoscope.
A flexible cystoscopy is used to diagnose and treat diseases and conditions affecting the bladder. It is possible for a biopsy to be performed using the cystoscope if a polyp or other growth is found, and some small tumors can be removed completely. Other procedures can be performed during flexible cystoscopy, using small tools passed through the tube.
Intravenous sedation may be given during the flexible cystoscopy procedure. In other cases a numbing jelly is used on the urethra, or rarely, general anesthesia is used. The procedure can be performed either in a clinic or as an outpatient procedure at a hospital. Flexible cystoscopy can last from five to 30 minutes, depending on the reason for the visit and instruments being used. Complications include bleeding, pain, and infection.
Enlargement of the prostate is one condition that can be diagnosed through flexible cystoscopy. Since the urethra passes through the prostate, there is a narrowing of that area when the prostate is enlarged. Symptoms of an enlarged prostate include difficult urination and the frequent need to urinate. Cystoscopy cannot determine the cause of enlargement, so further tests will be needed if this is found.
Flexible cystoscopy may also be done to evaluate the cause of painful urination. In this case, the doctor may discover that the urethra is narrowed. Another cause of painful urination is urinary stones which can develop in either the kidneys or the bladder. Stones may be removed via the cystoscope or broken up by instruments passed through the cystoscope.
Occasionally polyps or tumors are found in the bladder wall. The most common symptom of these is blood in the urine. Tumors and polyps can be biopsied by placing an instrument through the cystoscope. This instrument grabs onto a piece of the polyp or tumor and the sample is then sent to a lab and analyzed for the presence of cancerous cells.