Cystoscopy & evacuation of blood clots from the bladder

What is this?

This procedure involves the inspection of the bladder and urethra with a telescope and removal of clots with suction; occasionally bladder biopsy or removal of abnormal areas with the use of a heat diathermy

What alternatives are there?

Washout of clots with a catheter, observation or irrigation.

What to expect before procedure

You will usually be admitted on the same day as your surgery although many patients requiring this procedure have already been admitted as an emergency. If you are to be admitted electively, a pre-clerking appointment will also be sent to you to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 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.

What happens during the procedure?

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. Blood clots are removed using suction through the telescope. Once the bladder is free of clots, it may then be possible to identify the cause of any bleeding and, If appropriate, this will be treated at the same time.

After the procedure

A catheter will normally be inserted into the bladder after this operation to allow irrigation of fluids and prevent further formation of blood clots. Once your urine is clear, the catheter will be removed. You will normally be allowed home once you have passed urine satisfactorily. The average hospital stay is 5 days.

Potential side effects