What is a cystoscopy?
A cystoscopy is a telescopic examination of the bladder. It can be carried out under general anaesthetic (asleep), or under local anaesthetic (awake). If the test is being done to make a diagnosis it is usually done under local anaesthetic (LA), whereas if it is being done as treatment it is usually done under general anaesthetic (GA). If done under LA, there is no need to starve before the operation. A flexible instrument is passed through the urethra into the bladder, and after filling the bladder with salty water the bladder is inspected. The procedure usually takes a few minutes and the results discussed immediately. After the test is complete the patient is discharged and is free to go back to normal lifestyle, although it is adviseable to increase fluid intake for several days afterwards. The procedure may cause discomfort, bleeding in the urine, or urinary infection. If the procedure is done under GA it usually involves admission to hospital for a day, but not overnight. It is not adviseable for the patient to be alone or drive/operate machinery for 24 hours after a general anaesthetic. The same risks of discomfort, bleeding or infection apply as with a LA procedure, but as with all procedures carried out under general anaesthetic, there are risks of heart, lung or thrombosis problems.
What is a ureteric stent and what problems might it cause?
A ureteric stent is a long thin plastic tube that is inserted into the ureter (the tube that joins the kidney to the bladder). It is held in position by a curl at the top, which sits inside the kidney, and a curl at the bottom, which sits inside the bladder. It is used to drain the kidney if there is a blockage within the ureter. It may also be used after surgery (such as telescopic examination of the ureter) in which there has be some stretching or damage to the ureter; when it helps to prevent blockage of the tube during healing. A stent can cause problems, such as pain in the kidney on passing urine, a feeling of needing to pass urine more often than normal, discomfort, infection or bleeding in the urine. Stents are usually only used for short periods of time and should not be left for more than 6-12 months without removing or changing. Removing a stent usually requires a cystosopcy under local anaesthetic, at which point the stent can be grasped and pulled out, without too much discomfort.