Medicine, Procedures, Therapies

Cystoscopy with Hydrodistention

 Hydrodistention is almost always done under general anesthesia since the stretching can be painful.

What is a Cystoscopy with Hydrodistention?

A hydrodistention is a surgical procedure in which the bladder is filled with water under pressure in order to inflate it beyond its usual capacity. This allows the walls of the bladder to stretch out, giving the doctor a better view of the bladder tissue through the cystoscope. Hydrodistention is almost always done under general anesthesia since the stretching can be very painful.

What is a Cystoscopy with no Hydrodistention?

A cystoscopy is a procedure in which a camera on a long, flexible tube is inserted into the bladder through the urethra so that the doctor can see inside the bladder. The instrument itself is called a cystoscope and is usually a little thicker than an adult standard catheter.

Cystoscopes do come in different sizes, including a pediatric size that is more comfortable for many ICers.

Cystoscopy is usually performed on awake patients without anesthesia, or with a local anesthetic such as lidocaine gel or a lidocaine instill prior to the procedure.

What does a Cystoscopy versus a Cystoscopy with Hydrodistention tell the doctor?

A cystoscopy can help the doctor see if there are any physical problems in the bladder, such as the presence of a tumor, stones or other foreign bodies, or structural abnormalities in the urinary tract, like urinary diverticula.

Hydrodistention allows the doctor to clearly see all the surfaces of the bladder and identify ulcerations/lesions and glomerations on the bladder wall that may be contributing to IC symptoms. If ulcers are particularly large they can sometimes be seen with a regular cystoscopy, but many ulcerations and glomerations can be concealed by folds in the bladder tissue.

Do I need a Cystoscopy or Cystoscopy with Hydrodistention to be diagnosed with IC? Is this the best way to tell if I have IC?

Short answer: no, you do not need either procedure to be diagnosed with IC in the US and Canada, and this is not the most reliable means of IC diagnosis for most patients.

The diagnostic benefit of cystoscopy is in ruling out other possible causes for IC symptoms. If there’s evidence to suggest that you may have other bladder illnesses, cystoscopy can help rule some of them out.

The diagnostic benefit of cystoscopy with hydrodistention hinges on identifying ulcerations or glomerations in the bladder wall. If those defects are present, this is often interpreted as evidence of IC. However, most IC patients do not have visible bladder wall defects, and some healthy people with no urinary symptoms do have ulcers and/or glomerations. So the exact relationship between IC and bladder wall defects isn’t entirely clear.

 In the UK and much of Europe, a positive finding on hydrodistention is still necessary to be diagnosed with Interstitial Cystitis.

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