cystoscope

A cystoscope is a medical instrument used to visualize the interior of the bladder and the urethra. It combines an optical system with a light source to provide direct visualization of the bladder mucosa.

There are two main types: rigid and flexible cystoscopes. Rigid cystoscopes are straight tubes used mainly for diagnostic examination and certain procedures; flexible cystoscopes have a bendable shaft allowing navigation through the urethra with greater patient comfort, often used in outpatient settings. Modern devices may include a video camera and monitor and a working channel for instruments.

The cystoscopy procedure is performed by a urologist and may be done under local anesthesia and sedation or general anesthesia, depending on the purpose and patient factors. The urethra is cleaned and the cystoscope is inserted; sterile saline is used to fill the bladder to improve visualization. The physician inspects the bladder lining and ureteral openings and may pass instruments through the cystoscope’s working channel to obtain biopsies, remove stones, or perform treatments such as fulguration of lesions, dilation, or stent placement.

Indications include evaluation of hematuria, recurrent urinary tract infection, lower urinary tract symptoms, bladder pain syndrome, bladder stones, tumors or polyps, urethral strictures, and surveillance after bladder cancer treatment.

Risks include urinary tract infection, temporary blood in the urine, urethral trauma or false passages, and, rarely, bladder perforation or prolonged urinary retention.

History notes that early cystoscopes were rigid and used without video; modern developments introduced flexible endoscopes and video systems in the latter half of the 20th century, significantly improving comfort and diagnostic capability.