Cystoscopy - How a cystoscopy is performed

Before your appointment to have a cystoscopy, you will be sent information and instructions to follow. 

If you're having a local anaesthetic you can eat and drink normally on the day of the appointment.

If you're having a spinal anaesthetic (epidural) or general anaesthetic, you won't be able to eat or drink for several hours before the procedure.

A cystoscopy is carried out using an instrument called a cystoscope (a thin, fibre-optic tube that has a light and a camera at one end). The anaesthetic needed will depend on whether a rigid (straight) or flexible cystoscope is used. Flexible cystoscopes are usually used under local anaesthetic, whereas general or epidural anaesthetic is used with a rigid cystoscope.

Most prescription medication can be taken as usual on the day of your appointment. However, you may not be able to take aspirin, warfarin or ibuprofen, because they could cause excessive bleeding during the procedure.

If you're taking one of these medications, contact the hospital for advice before your appointment. You may have to temporarily stop taking the medication.

Before the procedure, your doctor will explain what will happen and the risks involved. You will be asked to sign a consent form to show you have understood and give permission for the procedure to be carried out.

You'll be asked to go to the toilet, before changing into a surgery gown. You may also be asked to provide a urine sample, so it can be checked for signs of infection. The procedure may not go ahead if you have an infection.

The cystoscopy procedure

In most cases, a cystoscopy can be performed on an outpatient basis, which means you will be able to go home on the same day.

If you are having a local anaesthetic, an anaesthetic gel is applied to your urethra (the tube that carries urine out of the body) to numb it. If you're having an epidural or general anaesthetic, you will be given an injection of anaesthetic either in your spine (epidural) or the back of your hand (general anaesthetic).

Your genitals will be cleaned with an antiseptic and a sterile paper sheet will be placed over the surrounding area.

The cystoscope is lubricated with a special gel before being gently inserted into your urethra and passed into your bladder. Sterile water may be pumped through the cystoscope to expand your bladder. This enables the urologist (specialist in treating bladder conditions) to get a clearer view.

If local anaesthetic is used, you may be able to see the pictures being displayed by the cystoscope. A nurse will stay with you during the procedure and they can explain what is happening.

The cystoscope is usually kept in your bladder for between two and 10 minutes.

After a cystoscopy, you may need to go to the toilet so the sterile water can pass out of your system. You may also be prescribed antibiotics to reduce your risk of developing a bladder infection.

Is a cystoscopy painful?

People are often concerned that having a tube inserted into their urethra and up into their bladder will be painful. A cystoscopy isn't usually painful but it can sometimes be uncomfortable.

If you're having a cystoscopy under a local anaesthetic, you may feel a burning sensation and an urge to urinate when the cystoscope is inserted and removed from your urethra. You may also feel an uncomfortable sensation of fullness and a need to urinate when water is pumped into your bladder to expand it.

If you're having an epidural, you may feel a brief stinging sensation when the needle is inserted into your back, and you may experience some mild back pain after the procedure.

You may experience mild muscle pain and nausea after a general anaesthetic.

Results

In some cases, the urologist will be able to discuss the results of your cystoscopy and any associated implications with you as soon as you recover from the anaesthetic. However, it can sometimes take a few days for the results to become available. If a biopsy (tissue sample) was taken, it may take several weeks for the results to come back.

A follow-up appointment may be arranged to discuss the results of the procedure.

Read more about recovering from a cystoscopy.