Cystoscopy is a procedure that allows specially trained veterinarians to look inside the urinary bladder and the urethra (tube connecting bladder to outside body). It is endoscopy of the bladder and urethra. This is performed in a sterile manner under anesthesia in dogs and cats. It is performed with a thin lighted tube called a cystoscope. This allows veterinarians to see areas of the bladder and urethra that do not show up well on X-rays or ultrasound imaging. Typically you would be referred for this procedure from your primary care veterinarian after full blood work, X-rays, urinalysis and urine cultures have been performed.
Treatment & Aftercare
Cystoscopy is used to visualize the urethra and bladder inside the body in a minimally invasive way. This does not require an incision as the camera, scope and instruments are passed through the penis in males or the vulva in females.
Cystoscopy is used when patients exhibit signs of blood in the urine, urine leakage (urinary incontinence), urinary blockages, complicated urinary tract infections and/or when abnormalities in the bladder have been noted on radiographs (X-ray) or ultrasound.
When needed, the veterinarian can insert tiny surgical tools for biopsy through the cystoscope. Anatomic abnormalities can not only be identified but also corrected if indicated with small laser fibers through the cystoscope. This procedure can avoid the need for more invasive surgery.
The cystoscopes can be either rigid (used in females animals) or flexible (used in male dogs). Cystoscopy is challenging in male cats (due to the very small urethra) but can be done with a very small scope or by accessing the bladder with a small surgical procedure and then the urethra is visualized through the bladder. Cystoscopy takes approximately 20 to 30 minutes depending on experience of the endoscopist, and the pet is typically sent home the same day.
Lithotripsy is the physical breaking of stones formed by the body within the urinary tract of cats and dogs. Lithotripsy is usually performed within the body using a laser fiber via surgery or cystoscopy with a shock wave applied to the stones. In animals, lithotripsy is typically used for the removal of bladder stones but more recently has been used to break up kidney stones. If the kidney stone is causing problems (infection, kidney damage, obstruction of urine flow), this procedure is recommended. Once the stones have been broken, a specialized wand is used to suction the large stone fragments. A stent (plastic tube) is then placed in the ureter to ensure flow of urine from kidney to bladder and avoid obstruction by small pieces of stone. In the bladder, the stones are broken and removed with a small basket.
Stones can also be removed from the urethra when they are stuck and causing issues with urination. This is typically done with cystoscopy and use of a laser fiber through the scope so the veterinarian can see the stone, break it up and remove it during the same procedure. The dog or cat is usually kept overnight for monitoring after the procedure but will not have incisions and often goes home the next morning.
Fact Sheet Author:
Erinne Branter, BVSc, Diplomate ACVIM (SAIM)