In urology, many patients are seen for hematuria and the doctor will make a decision whether or not to perform a cystoscopy based on the situation. Some patients are scared and consider cystoscopy to be a scary test and are reluctant to undergo it. The following is a brief introduction to cystoscopy, which will hopefully help some patients who are nervous about visiting the clinic. 1. Why do cystoscopy Cystoscopy, also known as urethrocystoscopy, is an invasive examination device commonly used by urologists. Cystoscopy requires the introduction of a cystoscope from the patient’s external urethra against the direction of urination, and the urologist uses the optical or electronic equipment inside the cystoscope to observe the bladder and diagnose and treat a number of genitourinary disorders under direct vision. Although it can be intimidating to insert a cystoscope that is the thickness of a small finger, similar to the length of a chopstick, from the urethra, a skilled urologist can generally complete the examination with a little mucosal surface anesthetic, and because the female urethra is both wide and short and straight, female patients can be examined without anesthetic. 2. What is involved in cystoscopy Cystoscopy provides insight into the bladder mucosa, such as ulcers, defects, and neoplasia of the bladder mucosa, and of course the site, size, and shape of the neoplasia, which can reveal lesions as small as 2 mm, while modern noninvasive imaging techniques indicate lesions often exceeding 5 mm. It is also possible to observe the morphology of the ureteral opening, the presence of stones in the bladder, the effect of the prostate on the urethra, the presence of lesions in the area where the bladder joins the urethra (medically known as the bladder neck), and it is also useful to determine the source of hematuria and to detect lesions in the urethra and their location. The cystoscope can also be used to perform simple operations under surface anesthesia, including the removal of blood clots from the bladder, biopsy of new organisms and mucous membranes from suspected lesions in the bladder, the removal of small foreign bodies from the bladder and the placement of an internal drainage catheter in the ureter after surgery, and the placement of a ureteral catheter through the cystoscope to collect urine from one side of the kidney for analysis or to perform imaging of the kidney and ureter on the side of the cannula The cystoscopy may be done to remove the foreign body. The cystoscopy may cause adverse reactions The cystoscope is a rigid cystoscope made of stainless steel that is routinely used in China, so cystoscopy may cause some pain to the patient, such as hematuria, infection, stinging pain, urinary frequency and urgency after the examination, and occasionally some patients may have difficulty urinating or even cardiovascular accidents. However, the good thing is that most of these adverse reactions are relatively mild and usually resolve 3-5 days after the examination, and only in rare cases do serious complications occur. In our department, fiberoptic cystoscopes (soft cystoscopes) have been used for many years. These cystoscopes are slim and soft, and have a larger viewing area and clearer images than ordinary cystoscopes, with almost no adverse reactions. Who is not suitable for cystoscopy Not all urinary tract disorders require cystoscopy. In some patients with acute cystourethritis, cystoscopy may lead to the spread of inflammation. And in those with a bladder capacity of less than 50 ml, such as those with bladder tuberculosis, cystoscopy runs the risk of stabbing the bladder through. Patients with urethral strictures and stones embedded in the urethra may suffer from the inability to insert the cystoscope. Cystoscopy should also be avoided in women who are menstruating or more than 3 months pregnant. Cystoscopy should also be done with considerable caution in patients with combined cardiovascular and cerebrovascular disease and other serious chronic diseases. Preparation for cystoscopy (1) Usually, cystoscopy does not require hospitalization, but requires a family member to accompany you to the hospital at the designated time. (2) Cystoscopy is performed in the cystoscopy room, change shoes, the doctor will first position you, and then the doctor will clean the urethral opening with disinfectant, inject local anesthetic and then put the cystoscope into the urethra for examination 6. If you have any doubts, you should consult a qualified doctor in time and never listen to some untrue information. It is best to empty the bladder a moment before the examination to help the examining doctor understand the residual urine in the bladder. The cystoscopy, especially in male patients due to the long urethra, can cause pain during the process of placing the cystoscope, the feeling of urination may occur when the cystoscope passes through the urethra of the prostate or observing the bladder wall near the bladder neck, when you should pay attention to relax as much as possible, you may want to do deep breathing, do not move your body and cause unnecessary damage. The patient should pay attention to the urination and urine properties for a few days after the examination. Minor hematuria or urinary frequency and urgency should be transient.