A cystoscopy is a medical procedure used to examine the lining of the bladder and the urethra, the tube that carries urine out of the body. A physician uses a thin, lighted instrument called a cystoscope, equipped with a lens or camera, to look for abnormalities. This article provides a clear picture of what a woman can expect regarding sensations and pain management during and immediately following the procedure.
The Cystoscopy Process and Expected Sensations
The cystoscopy process begins with the patient lying on an examination table, typically on her back with knees bent and feet resting in stirrups. A healthcare professional first cleanses the area before gently applying a numbing medication to the urethra. For women, the procedure is generally faster and less involved than for men because the female urethra is shorter and straighter.
Once the area is prepared, the doctor inserts the lubricated cystoscope into the urethra and advances it slowly into the bladder. During this insertion, the primary sensation reported is often a feeling of strong pressure rather than sharp pain. A brief, mild discomfort may be felt as the scope passes through the urethral opening and into the bladder.
After the cystoscope is in place, the bladder is slowly filled with a sterile liquid, such as saline or water, which expands the bladder walls to improve visibility. This stretching of the bladder often creates a strong urge to urinate. The physician then examines the bladder lining before the fluid is drained and the scope is removed. The entire diagnostic process typically takes less than ten minutes.
Anesthesia and Pain Management During the Procedure
The standard approach to minimizing discomfort during a cystoscopy involves the use of a topical local anesthetic. A lubricating jelly mixed with a local anesthetic, such as lidocaine gel, is applied directly into the urethra before the insertion of the cystoscope. This gel numbs the urethral lining, which significantly reduces the intensity of the pressure and scraping sensations as the instrument is passed through the area.
While this local anesthetic gel is highly effective for most diagnostic cystoscopies, it minimizes pain rather than eliminating all sensation. Patients should still expect to feel the movement of the scope and the pressure from the fluid filling the bladder. The goal of this pain management is to ensure the patient is comfortable enough to remain still and cooperate during the quick procedure.
In cases where a more complex procedure is necessary, such as the removal of a bladder stone or a biopsy, the physician may recommend deeper sedation or general anesthesia. Sedation allows the patient to remain relaxed and less aware of the procedure while still breathing independently. General anesthesia is typically reserved for longer or more invasive procedures, ensuring the patient is completely unconscious and pain-free.
Immediate Post-Procedure Discomfort and Recovery
Following the cystoscopy, it is common to experience a set of temporary symptoms in the hours and days immediately after the procedure. The most frequently reported discomfort is a burning sensation during urination, known as dysuria, which results from irritation of the urethra. This symptom is usually mild and can persist for one to three days as the lining heals.
Patients may also notice trace amounts of blood in their urine, a condition called mild hematuria, which typically presents as a pink or light red tint. This minimal bleeding is expected and usually resolves within 24 to 48 hours. Accompanying these symptoms is often an increased frequency and urgency to urinate, which is related to the bladder’s temporary irritation from the procedure.
To manage discomfort, physicians recommend increasing fluid intake to flush the bladder, which can dilute the urine and reduce the burning sensation. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can effectively control mild pain or cramping. Applying a warm, damp washcloth over the urethral opening or taking a warm bath can also help soothe the irritated area.
While these symptoms are normal, patients must be aware of warning signs that indicate a potential complication. Immediate medical attention is needed if a patient develops a fever over 100.4°F, experiences a complete inability to urinate, or notices heavy bleeding with large clots. Severe or worsening pain that is not relieved by over-the-counter medication should also prompt a call to the healthcare provider.