What is Cystoscopy with Hydrodistension?

Cystoscopy with hydrodistension is a minimally invasive procedure that serves both diagnostic and therapeutic purposes for patients with interstitial cystitis (IC). During this procedure, your urologist uses a thin, flexible camera (cystoscope) to examine the inside of your bladder while simultaneously stretching it with sterile water or saline solution.

This procedure allows your doctor to:

Visualize the bladder wall for signs of IC, including Hunner's lesions or glomerulations
Assess bladder capacity and identify areas of inflammation
Provide therapeutic benefit through controlled bladder stretching
Rule out other bladder conditions such as cancer or stones

The Procedure Process

Before the Procedure

Pre-operative consultation and medical clearance
Stop certain medications as directed
Arrange transportation (you cannot drive after anesthesia)
Follow fasting instructions (typically 8-12 hours)
Complete pre-operative paperwork

During the Procedure

General or regional anesthesia is administered
Cystoscope is inserted through the urethra
Bladder is gradually filled with sterile solution
Doctor examines bladder walls for abnormalities
Procedure typically takes 15-30 minutes

What We Look For

During the cystoscopy with hydrodistension, your urologist will carefully examine your bladder for specific signs of interstitial cystitis:

Hunner's Lesions: Reddish, bleeding areas on the bladder wall that are characteristic of IC
Glomerulations: Small pinpoint bleeding spots that appear when the bladder is stretched
Reduced Bladder Capacity: The amount of fluid your bladder can hold under anesthesia
Bladder Wall Thickness: Areas of scarring or thickening that may indicate chronic inflammation
Other Abnormalities: Ruling out tumors, stones, or other bladder conditions

The presence of these findings, combined with your symptoms, helps confirm an IC diagnosis and guides treatment planning.

Therapeutic Benefits

How It Helps

Stretches bladder muscle fibers
May disrupt pain nerve pathways
Increases bladder capacity temporarily
Can break down scar tissue
Reduces inflammation in some patients

Expected Relief

Symptom improvement in 60-80% of patients
Relief typically lasts 2-6 months
Some patients experience longer-lasting benefits
Procedure can be repeated if beneficial
Best results when combined with other treatments

Recovery and Aftercare

Immediate Recovery (First 24-48 Hours)

Rest: Take it easy and avoid strenuous activities
Hydration: Drink plenty of water to flush the bladder
Pain Management: Over-the-counter pain relievers as directed
Monitor: Watch for signs of infection (fever, increased pain)

What to Expect

Mild burning or discomfort when urinating (normal for 1-2 days)
Light pink-tinged urine from minor bleeding (normal)
Temporary increase in urinary frequency
Some patients may feel worse before improvement begins

When to Call Your Doctor

Fever over 101°F (38.3°C)
Severe or worsening pain
Heavy bleeding or blood clots in urine
Inability to urinate
Signs of infection

Risks and Considerations

Potential Risks

Temporary worsening of IC symptoms
Urinary tract infection (rare)
Bladder perforation (very rare)
Anesthesia-related complications
Temporary blood in urine

Who May Benefit

Patients with confirmed or suspected IC
Those not responding to conservative treatments
Patients needing definitive diagnosis
Those considering other IC treatments
Patients with recurring symptoms

Follow-Up Care

Your recovery and treatment plan will be carefully monitored:

Follow-up Appointment: Typically scheduled 1-2 weeks after the procedure
Symptom Tracking: Keep a diary of your symptoms and improvements
Additional Treatments: May be recommended based on findings and your response
Long-term Management: Ongoing care plan tailored to your specific needs

Many patients find that hydrodistension provides valuable information about their condition and can offer significant, though temporary, relief from IC symptoms. Your urologist will work with you to determine if this procedure is appropriate for your situation.