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CYSTOSCOPY

A cystoscopy is a procedure to look in to the bladder by passing a small telescope through the urethra (the tube you pass urine through).

The procedure can be performed with a flexible or rigid cystoscope. Flexible cystoscopy can be performed in our offices in Brisbane City. 

WHY IS CYSTOSCOPY REQUIRED?

Cystoscopy is performed to investigate and treat a range of problems with the bladder and the urethra. Common reasons for a cystoscopy include:

  • Blood in the urine.
  • Recurrent urinary tract infections.
  • Urinary symptoms such as frequency, urgency, incontinence, and difficulty voiding.
  • Abnormalities of the wall of the bladder requiring a biopsy. 
  • If you have had a cancer of the bladder, regular cystoscopy is required to make sure the cancer hasn’t returned.
  • If you have a ureteric stent, a cystoscopy is performed to remove the stent.
WHAT DOES FLEXIBLE CYSTOSCOPY INVOLVE?

A flexible cystoscopy can be performed in our offices in Brisbane City, or in a hospital. It is usually performed while you are awake. The procedure usually only takes a few minutes.

The genital area is cleaned. We instil a lubricating jelly into the urethra. We pass a thin flexible telescope through the urethra into the bladder. Sometimes there is mild discomfort as the telescope is passed into the bladder.

Once the telescope is in the bladder, we fill the bladder with sterile water and inspect the bladder.

If required we can remove a ureteric stent, or inject the bladder with botox while the telescope is in the bladder.

When the examination of the bladder is completed we remove the telescope. You are then able to get dressed and empty your bladder.

If you have a flexible cystoscopy done at a hospital, it is usually performed as day surgery – you can go home on the same day as the procedure.

WHAT DOES RIGID CYSTOSCOPY INVOLVE?

A rigid cystoscopy is usually performed under general or spinal anaesthetic.

We pass a telescope through the urethra into the bladder. Once the telescope is in the bladder, we fill the bladder with sterile water and inspect the bladder.

If required, during the cystoscopy we can:

  • Dilate a urethral stricture.
  • Take biopsies.
  • Cauterise bleeding.
  • Remove a ureteric stent.
  • Inject the bladder with botox.
  • Remove foreign bodies. 
  • Hydrodistend (stretch out) the bladder. 

The bladder is emptied at the end of the procedure. Occasionally a catheter (tube through the urethra into the bladder to drain urine) is placed at the end of the procedure. 

The procedure is usually performed as day surgery – you can go home on the same day as the procedure as long as you are accompanied by a responsible adult. If you have a catheter at the end of the procedure you may need to stay in hospital overnight.

WHAT IS THE RECOVERY AFTER CYSTOSCOPY?
  • You may notice blood in the urine for a day or two after cystoscopy.
  • Mild burning and stinging when passing urine is common for a day or two after cystoscopy.
  • Pain relief usually isn’t required after cystoscopy. If you do need pain relief, over the counter pain relief (eg. Paracetamol, Ibuprofen) should be enough. A urinary alkaliniser (eg. Ural) may help relieve burning and stinging when passing urine.
  • If you have the procedure while awake you can usually return to work the same day.
  • If you have a general or spinal anaesthetic you can usually return to work one to two days after the procedure.
  • If you have sedation or a general or spinal anaesthetic you will not be able to drive for 24 hours after the procedure.
WHAT ARE THE RISKS OF CYSTOSCOPY?

Occasional risks (1/10 – 1/50)

  • Urinary tract infection requiring antibiotics.

Rare risks (1/50 – 1/250)

  • Significant bleeding in the urine requiring another procedure to correct.
  • Damage to the urethra causing scaring.

Very rare risks (< 1/250)

  • Damage to the bladder requiring another procedure to correct.
WHAT ARE THE ALTERNATIVE TREATMENT OPTIONS?

Scans and urine tests are an alternative way to investigate problems with the bladder and urethra. Often they aren’t as reliable as directly inspecting the bladder with cystoscopy.

WHERE CAN I FIND MORE INFORMATION ABOUT CYSTOSCOPY?

British Association of Urological Surgeons (BAUS): Flexible cystoscopy leaflet

British Association of Urological Surgeons (BAUS): Rigid cystoscopy leaflet

International Urogynaecology Association (IUGA): Cystoscopy leaflet

REFERENCES

This is general information only. Please consult your doctor for more information and treatment options.

Approved March 2019. For Review March 2021. W-02-01.