PATIENT & CAREGIVER EDUCATION About Your Cystoscopy This information will help you prepare for your cystoscopy and other related procedures at Memorial Sloan Kettering (MSK). Cystoscopy (sis-tos-koh-pee) A cystoscopy is a procedure that allows your doctor to examine your urethra, bladder, and opening s to your ureters. Your ureters are the tubes that carry urine from your kidneys to your bladder (see Fig ure 1). A cystoscopy is done to look for problems in the urinary tract, such as a blockag e in your urethra caused by kidney stones or tumors. Fig ure 1. Female urinary system (left) and male urinary system (rig ht) A cystoscopy is done using a thin, hollow, lig hted instrument called a cystoscope. Your doctor will insert the cystoscope into your urethra and slowly move it into your bladder. Small surg ical instruments can be inserted throug h the cystoscope to remove samples of tissue for a biopsy, stones, or small g rowths. About Your Cystoscopy 1/8
Other Procedures During your cystoscopy, you may also have 1 or more of the following procedures: Transurethral resection of the bladder tumor (TURBT) During a TURBT, your doctor will remove a bladder tumor by using an instrument that goes through the cystoscope. Ureteroscopy (YER-eh-ter-OS-koh-pee) During a ureteroscopy, your doctor will insert a thin instrument called a ureteroscope throug h your urethra, bladder, and ureter. This procedure is done to see if there is anything blocking or interfering with the flow of urine. Fig ure 2. Parts of the kidney Retrog rade pyelog ram A retrograde pyelogram is done to see if there is anything blocking or interfering with the flow of your urine. Your doctor does this by looking at your ureters and renal pelvis in your kidney (see Fig ure 2). During this procedure, small, thin, catheters (flexible tubes)are g uided up to your kidney throug h your ureters. Contrast media is then injected throug h the catheters. The contrast media makes these areas stand out so your doctor can see them better. X-rays are taken of your renal pelvis and ureters. Removal of stones or blood clots from your bladder Placement of ureteral stents The stents will keep your ureters open. That helps urine flow from your kidneys to your bladder. About Your Cystoscopy 2/8
Before Your Procedure Ask about your medications You may need to stop taking some of your medication before your procedure. We have included some common examples below. If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it. Some examples are aspirin, warfarin (Coumadin ), dalteparin (Frag min ), heparin, tinzaparin (Innohep ), enoxaparin (Lovenox ), clopidog rel (Plavix ), cilostazol (Pletal ), dabig atran (Pradaxa ), and apixaban (Eliquis ). Tell your doctor or nurse what medications you are taking, including prescription medications, patches, creams, herbal supplements, and over-the-counter medications. Tell your doctor or nurse if you have had an allerg ic reaction to contrast media in the past. Arrange for someone to take you home You must have someone 18 years or older take you home after your procedure. If you don t have someone to do this, call one of the agencies below. They will send someone to go home with you. There s usually a charge for this service, and you will need to provide transportation. Agencies in New York Agencies in New Jersey Partners in Care: 888-735-8913 Caring People: 877-227-4649 Caring People: 877-227-4649 10 days before your procedure If you take vitamin E, stop taking it 10 days before your procedure, because it can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). 7 days before your procedure If you take aspirin, ask your doctor if you should continue. Aspirin and medications that contain aspirin can cause bleeding. For more information, read About Your Cystoscopy 3/8
Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). 2 days before your procedure Stop taking nonsteroidal anti-inflammatory drug s (NSAIDs) such as ibuprofen (e.g., Advil, Motrin ) and naproxen (e.g., Aleve ). These medications can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). The Day Before Your Procedure Note the time of your appointment A clerk from the Admitting Office will call you after 2:00 PM the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 PM, please call 212-639-5014. On the day of your procedure, you will g o to the Presurg ical Center (PSC) on either the 2 nd or the 6 th floor. Both locations are at 1275 York Avenue between East 67 th and East 68 th streets. Presurg ical Center (PSC) on the 2 floor M elevator to the 2 nd Floor nd Presurg ical Center (PSC) on the 6 floor B elevator to the 6 th Floor th About Your Cystoscopy 4/8
Instructions for eating and drinking before your surgery Do not eat anything after midnight the night before your surg ery. This includes hard candy and gum. Between midnig ht and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see fig ure). Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water. The Day of Your Procedure Things to remember Take a shower with soap and water. You can brush your teeth and rinse your mouth. Do not put on any lotion, cream, deodorant, makeup, powder, or perfume. Do not wear any metal objects. Remove all jewelry, including body piercing s. Leave valuables, such as credit cards, jewelry, or your checkbook, at home. Bring only the money you may need for a newspaper, bus, taxi, or parking. Where to park Parking at MSK is available in the g arag e on East 66 th Street between York and First Avenues. To reach the g arag e, turn onto East 66 th Street from York Avenue. The g arag e is located about a quarter of a block in from York Avenue, on the rig ht-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338. There are also other g arag es located on East 69 th Street between First and Second Avenues, East 67 th Street between York and First Avenues, and East 65 Street between First and Second Avenues. th About Your Cystoscopy 5/8
What to expect Your nurse will start an intravenous (IV) line in your vein to g ive you anesthesia (medication to make you sleep). Once you are asleep, your doctor will perform the cystoscopy and any other procedures that you are having. He or she may insert a urinary catheter at the end of your cystoscopy to help drain your urine into a bag. Your procedure will take up to 1 hour. After Your Procedure In the hospital When you wake up, you will be in the Post Anesthesia Care Unit (PACU). While you are in the PACU, your nurse will check your heart beat, breathing rate, temperature, and blood pressure. Your nurse will also check your urine output to make sure your flow of urine is not blocked. You may still have the urinary catheter in place. It may be removed before you are discharged or a few days after your procedure. If you catheter is removed before you go home, you must urinate before you are discharged. If you go home with a catheter in place, your nurse will show you how to care for it before you go home. You may need to take medication(s) at home, such as antibiotics to prevent infection or medications to relieve discomfort. Ask your doctor or nurse when you can go back to work. Your nurse will explain your discharg e instructions to you and your careg iver before you go home. At home Do not drive for 24 hours after your procedure. Biopsy or tumor removal If you had a biopsy or a tumor removal, you will have a scab inside your bladder. It will loosen within a month. If the scab loosens before your healing is complete, it may cause bleeding. If this happens, rest and drink more liquids. Most bleeding will stop within 3 to 4 hours, but it is best to rest that day to help stop the bleeding. Call your doctor if you continue to bleed, or if you are not able to About Your Cystoscopy 6/8
urinate. Changes when you urinate You will most likely experience blood in your urine (hematuria) after your procedure. This should g o away within 1 week. You may also have frequent urination and pain or burning when you urinate. Althoug h these symptoms can last for 3 to 4 weeks, they should be improving as you heal. If they do not improve or if they worsen, call your doctor, because you may have a urinary tract infection (UTI). To help relieve both of these symptoms, drink 8 (8-ounce) g lasses of liquids a day for the first 2 weeks after your procedure. Avoid drinking liquids after 8:00 PM so that you don t have to go to the bathroom during the night. Be sure to get plenty of rest. Urinary catheter While the urinary catheter is in place, you may feel a strong urg e to urinate. This happens because the small inflated balloon that keeps it in place may cause your bladder to feel full. Relaxing and allowing the urine to flow will decrease this urge. Urinary stents You may feel the stents. They usually feel like pain in the kidney. The pain may be worse when you urinate or exercise. Your doctor may g ive you medication to help with the pain. Drink plenty of liquids while you have the stents. Activity If you need to go on car trips that are longer than 1 hour for 1 week after your procedure, talk with your doctor or nurse. Don t lift objects heavier than 10 pounds (4.5 kilog rams) for 2 weeks after your procedure. Don t do strenuous exercise, such as tennis, jogging, or exercise programs, for 2 weeks after your procedure. You can walk and climb stairs rig ht away after your procedure. About Your Cystoscopy 7/8
Follow-up care If you had ureteral stents placed during your procedure, call your doctor s office to schedule a follow-up appointment. The stents will need to be chang ed every 3 to 6 months, or as instructed by your doctor. Continuous brig ht red blood or blood clots in your urine Bleeding (pink urine) for more than 1 week that is not g etting better Pain or burning when you urinate for more than 3 days that is not g etting better Frequent urination for more than 3 days that is not g etting better A temperature of 101 F (38.3 C) or hig her Shaking chills Pain in your lower back An inability to urinate If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday throug h Friday from 9:00 AM to 5:00 PM at. After 5:00 PM, during the weekend, and on holidays, please call. If there s no number listed, or you re not sure, call 212-639-2000. About Your Cystoscopy 2018 Memorial Sloan Kettering Cancer Center - Generated on October 4, 2018 About Your Cystoscopy 8/8