Female Cystoscopy Urethral Dilatation

Q 1. What does the procedure involve?

A. This procedure involves telescopic inspection of the bladder and urethra with gentle stretching of urethra and, occasionally, bladder biopsy or removal of abnormal areas with the use of heat/diathermy.

Q 2. What are the alternatives to this procedure?

A. The alternatives include:

  • Open surgery
  • Observation
  • Incision of the narrowing.

Q 3. What should I expect before the procedure?

A. If you are taking blood thinning medication on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits. Aspirin does not usually need to be stopped but will be the decision of your surgeon.

You will usually be admitted on the same day as your surgery, or a day before. You will normally undergo pre assessment on the day of your clinic. After admission, you will be seen by members of the medical team which may include the consultant, junior urology doctors and nurse.

You will be asked not to eat or drink for six hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

Please be sure to inform your urologist in advance of your surgery if you have any of the following:

  • Co-morbidities like Diabetes, Hypertension, Coronary artery disease or, stroke, epilepsy
  • Any transmissible disease like HIV/AIDS, Hepatitis B or C etc
  • Presence of implants, pacemakers, graft etc
  • You are taking prescription drugs like-
    • Blood thinners/ anti-platelets i.e. Warfarin, ecosprin, clopidogrel etc
    • Anti-epileptics like phenytoin, valproate etc

Q 4. What happens during the procedure?

A. Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you.
You will usually be given injectable antibiotics before the procedure, after checking for any allergies.
A telescope is inserted through the water pipe (urethra) to inspect both the urethra itself and the whole lining of the bladder. Dilators are then used to stretch the opening of the urethra gently.

Female Cystoscopy Urethral Dilatation

Q 5. What happens immediately after the procedure?

A. You will normally be allowed home once you have passed urine satisfactorily. If a catheter is left in place, this will normally be removed within 24 hours and you will be discharged once you have passed urine satisfactorily.
The average hospital stay is one day.

Q 6. What are the side effects?

A. Most procedures have a potential for side effects. You should be reassured that, although all these complications are well recognised, the majority of patients do not suffer any problems after a urological procedure.

Common (greater than one in 10)

  • Mild burning or bleeding on passing urine for short period after operation
  • Temporary insertion of a catheter
  • Need for self-catheterisation to keep the narrowing from closing down again

Occasional (between 1 in 10 and 1 in 50)

  • Infection of the bladder requiring antibiotics
  • Permission for telescopic removal/ biopsy of bladder abnormality/stone, if found
  • Recurrence of narrowing or symptoms necessitating further procedures

Rare (less than 1 in 50)

  • Perforation of bladder requiring a temporary urinary catheter or open surgical repair
  • Delayed bleeding requiring removal of clots or further surgery
  • Urinary incontinence due to damage to the urethra

Q 7. What should I expect when I get home?

A. When you leave hospital, you will be given a discharge summary of your admission. This holds important information about your inpatient stay and your operation.

When you get home, you should drink twice as much fluid as you would normally for the next 24 to 48 hours to flush your system through. You may find that, when you first pass urine, it stings or burns slightly and it may be lightly bloodstained.

If you continue to drink plenty of fluid, this discomfort and bleeding will resolve rapidly.

Q 8. What else should I look out for?

A. If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your urologist immediately.