With the urethral endoscopy, the attending doctor, usually the urologist, has the opportunity to find pathological changes in the urethra. The technical term for the reflection of the urethra is urethroscopy .

A urethroscopy is performed, for example, if there is blood in the urine (hematuria), urinary incontinence , pain in the lower abdomen or recurring urinary tract infections . If necessary, minor interventions can be performed under local anesthesia as part of the examination. The urethral endoscopy as an examination method is similar to the cystoscopy method . However, the focus of the examination is on the urethra and not on the bladder. Often, however, both examination methods are carried out one after the other. Basically, the urethral examination is an uncomplicated diagnostic method that can be carried out within a few minutes.

Function, effect & goals

During urethral endoscopy, an endoscope is inserted into the urethra. Access is through the glans in men and through the vagina in women . A cytoscope is used for the examination. The patient is examined lying down.

In principle, two different types of cystoscopes can be used. The rigid cystoscope is a multi-part instrument made of metal. It is divided into an outer shaft, a so-called obturator, a working device and an optic. The flexible cystoscope consists of only one part. The shaft is flexible and equipped with a controllable and also very flexible tip. There is a lens at the tip of the flexible cystoscope. This is connected to the eyepiece via glass fibers. Inside the cystoscope is a combination of working channel and flushing channel. A local anesthetic is almost always given before the urethral endoscopy .

If expressly requested, the examination can also be carried out under general anesthesia . For local anesthesia, the doctor treating you applies a lubricating gel with anesthetic to the beginning of the urethra. The entrance to the urethra is then thoroughly cleaned. Once the numbing gel has taken effect, the doctor gently inserts the cystoscope into the urethra while irrigating with water. Here he looks closely at the structure of the urethra. He pays attention to constrictions (strictures), epithelial changes or tumors . Inflammation can also be diagnosed based on redness or swelling on the wall of the urethra.

Urethroscopy is indicated for blood in the urine. Hematuria can indicate inflammation of the kidneys , bladder , or urethra. A tumor in the urethra can also cause blood in the urine. Urinary incontinence is also an indication for urethral endoscopy. The same applies to recurring urinary tract infections. Constantly recurring bladder infections or kidney infections can be caused by a chronic focus of inflammation in the urethra. Chronic inflammation or injury to the urethra can cause scarring in the urethra.

Scarring can narrow the urethra. These narrowings are also known as strictures. Strictures can cause painful urination . They can be easily diagnosed with the help of urethral endoscopy. In addition, short constrictions can be treated immediately during the reflection under local anesthesia. The procedure of endoscopic slitting is used for this. However, longer or significant cicatricial strictures must be performed in the hospital under general anesthesia.

The urethra can not only be narrowed by scarring changes, an enlarged prostate can also narrow the urethra in men. The prostate encloses the urethra, so when it enlarges it presses on the urethra. This leads to problems with urination.

The urethral endoscopy is also used therapeutically in urethral diverticula. Urethral diverticula are also known as paraurethral cysts. Most often, women are affected by this condition. A urethral diverticulum is a bulging of the urethra. Urine can accumulate in this sack, so that inflammation can quickly develop there. During urethroscopy, urethral diverticula can be identified and flushed out. With the help of the urethral endoscopy, foreign bodies and tumors in the urethra can also be reliably detected.

Risks, side effects & dangers

A urethral endoscopy should not be performed if the prostate , bladder or urethra are acutely inflamed. Therefore, before each urethroscopy, a urine test must be carried out so that a urinary tract infection can be ruled out.

Urethroscopy is actually a straightforward procedure. However, in some cases complications can arise. After the examination, a urinary tract infection can develop due to pathogens that have been brought in. In addition to inflammation of the urethra, inflammation of the kidneys or prostate can also occur. The endoscope can injure the urethra. This causes pain and discomfort when urinating. A combined examination of the urethra and bladder can also injure the sphincter muscle of the bladder or the bladder itself. A lesion of the sphincter can lead to temporary incontinence .

Occasionally, symptoms such as burning when urinating or blood in the urine occur after the urethral endoscopy. Usually, these symptoms can be attributed to mechanical irritation of the tissue within the urethra. These complaints are therefore considered harmless and disappear by themselves within a short time. If the symptoms persist, the doctor treating you must be informed.

The risk of infection is increased in immunocompromised patients. People with metabolic diseases such as diabetes mellitus also suffer more infections after a urethral endoscopy. In order to prevent an infection, risk groups are therefore often given antibiotics as a precaution .

Typical & common urethral diseases

• Incontinence (urinary incontinence)
• Inflammation of the urethra (urethritis)
• urethral cancer (less common)
• urethral stricture
• Frequent urination