Flexible cystoscopy

Some urinary symptoms are because of problems in the bladder or the urethra. These symptoms may include blood in the urine (haematuria), recurrent infections, difficulty urinating (peeing), or pain. To investigate further your doctor may recommend a flexible cystoscopy.

If your doctor has previously inserted a ureteric stent, this can be removed using a flexible cystoscope.

We also sometimes use the flexible cystoscope to assess a prostate before considering a prostate operation.

No special preparation is required. You can eat and drink normally, and you can drive before and after the test. There is no need to rest afterwards. You may need to provide a urine sample before your cystoscopy so we recommend coming to the appointment with a full bladder, ready to give a urine sample. Please arrive 15 minutes before your appointment time.

• You may need to provide a urine sample to test for a urinary tract infection (UTI). Please tell the nurse if you have symptoms of a UTI such as a fever, rigors (shivering), pain when urinating (dysuria), or frequent urination (going often).
• We will ask you to sign a consent form, confirming you understand the reasons for the test, the benefit, the alternatives, and the risks (explained on page 5).
• You will lie on an examination couch, and we will ask you to partially undress - usually from the waist down.
• Your genital area will be cleaned with a mild antiseptic liquid.
• Sterile drapes will be used to keep the procedure as clean as possible.
• A lubricating jelly will be inserted into your urethra.

• The doctor will pass the cystoscope through the urethra into your bladder.
• The scope may be connected to a screen, allowing you to see inside your bladder if you wish.
• There should not be much discomfort, but there can be feelings you are aware of.
• Sterile water is run through the scope to fill the bladder which allows us to see things better. This may make you feel like you need to pass urine or are passing urine backwards.
• If you cannot tolerate this test you can request to have a general anaesthetic (you will be asleep). This is unusual but is sometimes necessary.
• The test takes about 5 minutes.
• You may be given some antibiotics either before or following the test, which you should take as prescribed.
• After the cystoscopy, you will be able to discuss the results with the clinician, and any further management that may be required. Therefore it can be useful for you to bring someone with you to this appointment.

• Having burning or bleeding on passing urine is very common following the test. We advise you to increase your fluid intake to flush your bladder through. Drink 2-3 litres a day for 1-2 days (unless you have been told to restrict your fluid intake for medical reasons).
• There is a risk of a urinary tract infection (UTI) following this test, which can be experienced by 1-2% of patients. Symptoms of a UTI may include abdominal pain, pain or difficulty passing urine, and fevers/shivers/shakes. If you develop these symptoms, seek urgent medical advice (for example from your GP).

If you need any further information about the procedure before your appointment, please contact the team.

Please do not bring in valuables, jewellery, or large sums of money. If this is unavoidable, please ask a relative to take them home for you. The hospital cannot accept liability for the loss of personal items.