Telescopic inspection of the bladder and urethra with bladder biopsy (if indicated); a stent can also be removed during this procedure

A cystoscopy is a procedure that looks at the bladder and other parts of the urinary system. It involves inserting a special tube, called a cystoscope, into the urethra and then passing it through to the bladder. There are two types of cystoscope: rigid and flexible.

Why do I need a cystoscopy? Some urinary symptoms – such as those outlined below – are due to problems in the bladder or urethra. Sometimes the cause of your symptoms will be clear from X-rays or tests of your blood or urine, but often the only way your doctor can be sure what is going on is to look inside your bladder. A cystoscopy can help to diagnose the causes of symptoms such as: 

• blood in your urine (haematuria) 
• frequent urinary tract infections
• difficulty or pain when urinating (passing urine) 
• incontinence (inability to control when you urinate).

What to expect

You will be asked to lie down on your back and the opening of the urethra and surrounding area will be cleaned. Some ‘jelly’ containing anaesthetic will be put in the urethra. This reduces the discomfort when the cystoscope is inserted into the urethra. When the cystoscope has been gently passed into the bladder, the doctor will insert sterile water into your bladder. This is to help your doctor see the lining of your bladder. It will make your bladder feel full, so you will feel like you need to urinate. This may be uncomfortable. The procedure will take about five minutes. When your doctor has finished the examination, he/she will gently remove the cystoscope.

What are the risks?

There are risks associated with most procedures. Your doctor will explain the potential complications of a cystoscopy before asking for your verbal consent to go ahead with the procedure. Please ask questions if you are uncertain. You should have received the leaflet, Helping you decide: our consent policy, which gives you more information. If you have not, please ask us for one. A cystoscopy is usually performed with no problems whatsoever.

Possible side-effects are:

• Discomfort – you may feel a stinging sensation when you urinate, but this should only last a day or two. Taking your usual pain-relieving medicine as prescribed on the packet may help. If the pain is severe and lasts for more than two days, please contact us or your GP.
• Bleeding – you may have a small amount of bleeding from the cystoscope being passed up the urethra. Some patients do not have any bleeding at all, but some find their urine is slightly pink for a few days after this procedure. Drinking plenty of water (two to three litres spaced out over 24 hours) can help to clear the urine. If your urine remains pink after a few days, please contact us or your GP.
• Infection – a urine infection can cause a fever and pain when you pass urine. The risk of this can be reduced by drinking plenty of water after the procedure. 3 of 4 Rare occurrences
• Temporary insertion of a catheter – this may be required if you are unable to pass urine normally following the procedure. • Delayed bleeding requiring further surgery.
• Injury to urethra causing delayed scar formation – this may require additional surgery in the future to widen the urethra.

Are there any alternatives?

A cystoscopy is the only way to have a close enough look at your urinary system to diagnose certain bladder conditions. If there are any alternatives, your doctor will discuss them with you. If a patient comes to MU with this condition, what can they expect? (no one is going to read more than 500 words on this one)

What if there are problems at home following the procedure?

Please contact your GP if you:

• are in extreme pain
• have difficulty passing urine.
• have continuous or excessive bleeding
• pass blood clots
• have a raised temperature - 38ºC (100.4F) or above