What does the procedure involve?
Telescopic inspection of the bladder, controlled distension of the bladder under anaesthetic and possible bladder biopsy or removal of abnormal areas using diathermy. Stretching of the bladder is usually done to diagnose painful bladder syndrome/interstitial cystitis. It can sometimes provide relieve bladder symptoms associated with painful bladder syndrome/interstitial cystitis although any relief is usually temporary.
What are the alternatives to this procedure?
Alternatives to this procedure include various medications taken orally or instilled into bladder, augmentation (enlargement) of the bladder with intestine and observation.
What should i expect before the procedure?
You will usually be admitted on the same day as your surgery.
You will be asked not to eat and drink for six hours before surgery. Immediately before the operation, the anaesthetist may give you a pre-medication, which will make you dry-mouthed and pleasantly sleepy.
Please tell your surgeon (before your surgery) if you have any of the following:
- An artificial heart valve.
- A coronary artery stent.
- A heart pacemaker or defibrillator.
- An artificial joint.
- An artificial blood-vessel graft.
- A neurosurgical shunt.
- Any other implanted foreign body.
- A regular prescription for a blood thinner e.g. Warfarin, Coumadin Xarelto®, Pradaxa®, Clopidogrel (Plavix®), Brilinta®, or Aspirin.
- Previous or current infection with an antibiotic resistant organism such as MRSA, VRE, etc.
What happens during the procedure?
Either a full general anaesthetic (where you will be asleep) or a spinal anaesthetic (where you are 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. The capacity of the bladder when full is measured and the bladder is then stretched gently with fluid, under slight pressure, to increase its capacity. Often a biopsy of the bladder may need to be performed at the same time.
What happens immediately after the procedure?
Sometimes there is some bleeding from the bladder after it has been stretched or a biopsy is taken, and a catheter needs to be inserted. If so, you will stay overnight. Otherwise, you should be able go home the same day, and you should be able to resume normal activities relatively quickly.
Are there any side-effects?
All procedures have the potential for side-effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.
Risks of the anaesthetic need to be discussed with the anaesthetist who will be looking after you during the operation, and who will visit you beforehand.
There are specific risks with this surgical procedure, and these will be discussed with you before your procedure. As a guide to complement that one-on-one discussion with your surgeon, these include:
Common (greater than 1 in 10)
- Mild burning or bleeding on passing urine for a short period after the operation.
- Temporary insertion of a catheter.
Occasional (between 1 in 10 and 1 in 50)
- Infection of the bladder requiring antibiotics.
- There is no guarantee of relief of bladder symptoms.
- Permission for telescopic removal / biopsy of bladder abnormality / stone if found.
Rare (less than 1 in 50)
- Delayed bleeding requiring removal of clots or further surgery.
- Injury to the urethra causing delayed scar formation.
- Perforation of the bladder requiring a temporary urinary catheter or return to theatre for open surgical repair.
What should I expect when I get home?
When you get home, you should drink twice as much fluid as you would normally for the first 24 - 48 hours to flush your system through. When you first pass urine, you may find that it burns and it may be lightly bloodstained.
What else should I look out for?
If you develop a fever, severe pain on passing urine, inability to pass urine or Worsening bleeding, you should contact your GP or Surgeon immediately.
Are there any other important points?
A follow-up appointment will be arranged before your discharge from hospital for 4-6 weeks after the operation. You may be asked to complete a frequency-volume chart when you arrive in the clinic, to assess the effects of the surgery.
This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional.
Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.