Rigid Cystoscopy, Biopsy and Diathermy
What is Rigid Cystoscopy, Biopsy and Diathermy?
Rigid cystoscopy, biopsy and diathermy is a minimally invasive procedure used to examine the inside of the bladder and urethra, obtain tissue samples, and treat certain abnormalities. A rigid cystoscope, which is a thin, straight telescope fitted with a camera and light source, is inserted through the urethra to provide a clear view of the urinary tract.
During the procedure, your urologist can take biopsies of suspicious areas and use diathermy, a controlled electrical current, to stop bleeding or destroy small abnormal tissue. The procedure plays an important role in diagnosing and managing conditions such as bladder cancer, inflammation, recurrent bleeding, and other bladder abnormalities.
What are the Benefits of Rigid Cystoscopy, Biopsy and Diathermy?
This procedure allows both diagnosis and treatment during a single operation.
Benefits include:
- Direct visual examination of the bladder and urethra
- Accurate biopsy of suspicious tissue
- Early detection of bladder cancer and other abnormalities
- Treatment of small bleeding areas using diathermy
- Minimally invasive with no external incisions
- Can diagnose the cause of blood in the urine
- Usually performed as a day-case procedure
- Helps guide further treatment planning
When is Rigid Cystoscopy, Biopsy and Diathermy Recommended?
Your urologist may recommend this procedure when bladder abnormalities require further investigation or treatment.
Common indications include:
- Blood in the urine (haematuria)
- Suspicious bladder lesions seen on imaging
- Investigation of possible bladder cancer
- Persistent urinary symptoms without a clear cause
- Recurrent urinary tract infections
- Abnormal urine cytology results
- Monitoring patients with a history of bladder cancer
- Treatment of small bleeding areas within the bladder
The procedure provides tissue samples that allow a definitive diagnosis to be made under microscopic examination.
What does Preparation for Rigid Cystoscopy, Biopsy and Diathermy Involve?
Before the procedure, your healthcare team will assess your general health and review your medical history.
Preparation may include:
- Medical history and physical examination
- Blood and urine tests
- Review of current medications, including blood-thinning medicines
- Urine culture to exclude infection
- Fasting before general or spinal anaesthetic
- Discussion of the procedure, expected recovery, and potential risks
- Signing a consent form before surgery
If a urinary tract infection is present, it will usually be treated before the procedure takes place.
How is Rigid Cystoscopy, Biopsy and Diathermy Performed?
The procedure is usually performed under general or spinal anaesthetic and typically takes between 20 and 45 minutes.
A rigid cystoscope is gently inserted through the urethra into the bladder using sterile lubricant. Sterile fluid is used to fill the bladder, allowing the lining to be examined in detail. The surgeon carefully inspects the urethra and bladder for inflammation, tumours, stones, ulcers, bleeding points, or other abnormalities.
If suspicious tissue is identified, specialised instruments are passed through the cystoscope to obtain one or more biopsies. These tissue samples are sent to a pathology laboratory for microscopic examination.
Diathermy may then be used to seal small blood vessels, control bleeding from biopsy sites, or destroy small abnormal areas of tissue. This uses carefully controlled electrical energy and helps minimise blood loss during the procedure.
At the end of the examination, the cystoscope is removed. Some patients may require a temporary urinary catheter for a short period, particularly if extensive biopsies have been performed or there is concern about postoperative bleeding.
What to Expect during Recovery after Rigid Cystoscopy, Biopsy and Diathermy?
Most patients return home on the same day after recovering from the anaesthetic.
During recovery, it is common to experience:
- Mild burning or discomfort when passing urine
- Small amounts of blood in the urine for several days
- Increased urinary frequency or urgency
- Mild lower abdominal discomfort
- Temporary fatigue following the anaesthetic
Drinking plenty of fluids can help flush the bladder and reduce irritation. Most patients resume normal daily activities within a day or two, although strenuous exercise should be avoided until advised by your surgeon.
Biopsy results are usually available within one to two weeks and will be discussed during a follow-up appointment.
What are the Risks and Complications of Rigid Cystoscopy, Biopsy and Diathermy?
Rigid cystoscopy with biopsy and diathermy is a safe and commonly performed procedure, but all interventions carry some potential risks.
Possible complications include:
- Urinary tract infection
- Temporary blood in the urine
- Burning or discomfort during urination
- Difficulty passing urine requiring temporary catheterisation
- Bleeding from biopsy sites
- Bladder irritation causing urgency or frequency
- Injury to the urethra or bladder, although uncommon
- Rare bladder perforation requiring further treatment
- Temporary urinary retention
- Anaesthetic-related complications
Your urologist will explain why rigid cystoscopy, biopsy and diathermy has been recommended, discuss the potential benefits and risks, and outline any further treatment that may be required once biopsy results are available.