Cystoscopy in Men – Procedure, Risks & Diagnosis
Cystoscopy in men is a urological procedure used to examine the bladder and urethra with an endoscope. It helps diagnose and treat conditions affecting the lower urinary tract.
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Cystoscopy in men is a urological procedure used to examine the bladder and urethra with an endoscope. It helps diagnose and treat conditions affecting the lower urinary tract.
What is Cystoscopy in Men?
Cystoscopy is an endoscopic procedure in which a thin, flexible or rigid optical instrument called a cystoscope is inserted through the urethra into the bladder. This allows the urologist to directly inspect the inner walls of the bladder and urethra. In men, the urethra is considerably longer than in women (approximately 20–25 cm), which makes the procedure slightly more complex but still routinely performed.
When is Cystoscopy Performed in Men?
Cystoscopy is indicated in men for a variety of diagnostic and therapeutic reasons, including:
- Blood in the urine (hematuria) – to identify the underlying cause
- Suspected bladder cancer or bladder polyps
- Recurrent urinary tract infections
- Assessment of voiding difficulties or urinary symptoms
- Suspected urethral stricture (narrowing of the urethra)
- Follow-up after bladder tumor surgery
- Diagnosis and treatment of bladder stones
- Evaluation of an enlarged prostate (benign prostatic hyperplasia)
- Collection of tissue samples (biopsy)
Procedure
Preparation
In most cases, no special preparation is required. Before the procedure, a local anesthetic gel is applied to the urethra to minimize discomfort. For more complex interventions, sedation or spinal anesthesia may be used.
How It Is Performed
The patient lies on his back with legs slightly bent. The cystoscope is gently inserted through the urethral opening. Sterile irrigation fluid is used to fill the bladder and improve visibility. The procedure typically takes only a few minutes. In men, the entire urethra – including the prostatic urethra – is examined on the way to the bladder.
Flexible vs. Rigid Cystoscopy
- Flexible cystoscopy: Performed under local anesthesia on an outpatient basis. More comfortable for the patient and suitable for diagnostic purposes.
- Rigid cystoscopy: Allows the use of surgical instruments (e.g., stone removal, biopsy). Usually requires deeper anesthesia.
Risks and Side Effects
Cystoscopy is generally a safe procedure, but some side effects and complications may occur:
- Burning or discomfort when urinating after the procedure – usually temporary
- Mild blood in the urine (microhematuria) – typically resolves quickly
- Urinary tract infection – prophylactic antibiotics may be prescribed in some cases
- Urethral injury – very rare
- Temporary urinary retention – uncommon
Serious complications such as urethral scarring or severe infections are very rare.
Results and Diagnosis
In many cases, the urologist can share initial findings immediately after the procedure. If tissue samples were taken, histological results are typically available within a few days. Possible findings include:
- Normal bladder mucosa (no abnormalities)
- Bladder inflammation (cystitis)
- Tumors or polyps
- Urethral strictures
- Bladder stones
- Changes in the prostate region
Aftercare
After cystoscopy, patients are advised to drink plenty of fluids (at least 2 liters per day) to flush the urinary tract. Mild burning during urination is normal and usually resolves within 1–2 days. If the patient experiences severe pain, persistent blood in the urine, or fever, medical attention should be sought promptly.
References
- European Association of Urology (EAU): EAU Guidelines on Non-muscle-invasive Bladder Cancer, 2023. Available at: https://uroweb.org
- American Urological Association (AUA): Cystoscopy and Urethroscopy Clinical Guidelines, 2022. Available at: https://www.auanet.org
- Wein A.J. et al.: Campbell-Walsh Urology. 11th Edition, Elsevier, 2016.
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Related search terms: Cystoscopy in Men + Bladder Cystoscopy Men + Cystoscopy Male