This leaflet answers common questions about having a flexible cystoscopy. If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

In all cases, a doctor will explain the procedure to you and answer any questions you may have. In most cases it will be possible for a friend or relative to accompany you for all or part of the procedure. Please ask your nurse or doctor.

What is a flexible cystoscopy?

A flexible cystoscopy is an internal examination of your bladder. When you have a urinary problem, your doctor may use a cystoscope to see the inside of your bladder and urinary tract (urethra).

The cystoscope is a thin tube with a light at the tip. It has lenses like a telescope or microscope, which let the doctor look closely at the inside of the urinary tract up to the bladder.

Before the cystoscopy

No special preparation is needed at all. On the day of the investigation, you can eat and drink as normal. Please take your regular medication as normal. Please come to the appointment with a full bladder (if possible) as we need to test your pee prior to this procedure.

Where do I go for my cystoscopy?

Flexible cystoscopies take place in the urology outpatient department on level one, clinic 9 at the Royal Free Hospital, and level 0, Woodlands Unit at Barnet Hospital. Please arrive at the time indicated on your appointment letter, which you should bring with you. This is not the time of your procedure as some preparation is necessary once you have arrived.

Your stay in hospital

You will be in the hospital for the morning or afternoon. Please be aware that you may have to stay up to four hours for this appointment.

What happens when I arrive?

When you arrive at the urology outpatient department you will need to book in at reception where they will check your details.

The nurse will ask you a few simple questions about your health and explain the examination to you. You will then be asked to provide a pee sample into a container. You may be asked to carry out a urine flow test.

This involves peeing into a machine that measures its strength. After this procedure you will have a bladder ultrasound scan. This is when a small ultrasound probe is passed over your stomach and measures how much pee is left in your bladder. This is quick and painless. Please bring along any medicines or tablets that you are taking in their original containers/boxes.

If you have any worries or questions at this stage do not be afraid to ask. We want you to be as relaxed as possible and will not mind answering your questions.

Test procedure

Before the procedure you may be given antibiotic tablets or an injection as a precaution to help prevent infection. The test will only take a few minutes to complete. The doctor or nurse specialist will gently insert the tip of the cystoscope into your urethra and slowly glide it up into the bladder.

Relaxing your pelvic muscles will help make this part of the test easier. A sterile liquid (water or saline) will flow through the cystoscope to fill your bladder slowly and to stretch it so that the doctor has a better view of the bladder. You may feel some discomfort and the urge to pee. You will be able to pee as soon as the examination is over.

When will I know the results?

The findings and plans for any further treatment will be discussed with you after the test.

During the cystoscopy

We will take you into the examination room. The doctor or nurse specialist who is going to carry out the examination will meet you. He or she will ask if you have any questions and ask you to sign a form giving your consent. A nurse will stay with you throughout the test.

Although you do not need a general anaesthetic for flexible cystoscopy, the urethra will be prepared with anaesthetic jelly which numbs the area and lubricates it. It may also contain an antiseptic.

Will I need a further appointment?

Depending on the cystoscopy findings you may be asked to attend a follow-up appointment. The appointment date and time may be given to you before you go home, or an appointment letter will be sent to you in the post.

Could there be a problem after having this test?

A cystoscopy is usually performed with no problems whatsoever. However, possible side-effects are:

Discomfort

You may feel a stinging sensation when you pee, but this should only last a day or two. If the pain is severe and lasts for more than two days, please contact us or your GP.

Bleeding

You may have a little bleeding. This usually clears within two to three days if you drink plenty of water (two to three litres spaced out over 24 hours). If your pee remains pink after a few days, please contact us or your GP.

Infection

A infection of your pee can cause a fever and pain when going to the toilet. If you experience these symptoms, please contact your GP.

Rare occurrences

  • Temporary insertion of a catheter – this may be required if you are unable to pee normally following the procedure.
  • Delayed bleeding requiring further surgery.

Before you go home

You will be asked to stay in the department until you have had a pee. When you have done this, please tell one of the nurses. A discharge letter and post-cystoscopy information letter will be given to you before you go home.