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CYSTOSCOPY

ABOUT CYSTOSCOPY

Cystoscopy is a procedure to look in to the bladder with a small telescope through the urethra (the tube you pass urine through).

WHY IS CYSTOSCOPY REQUIRED?

Cystoscopy is performed to investigate problems with the bladder and the urethra. Common reasons for a cystoscopy include bleeding in the urine, recurrent urinary infections, and urinary symptoms such as frequency, urgency and difficulty voiding.

If you have had a cancer of the bladder, regular cystoscopy is required to make sure the cancer hasn’t returned.

If you have had a ureteric stent, a cystoscopy is performed to remove the stent.

WHAT DOES CYSTOSCOPY INVOLVE?

Flexible cystoscopy

A flexible cystoscopy is usually performed with a local anaesthetic. The procedure usually only takes a few minutes.

The genital area is cleaned with an antiseptic solution. We instil a jelly containing local anaesthetic into the urethra.

We pass a thin flexible telescope through the urethra into the bladder. For men, sometimes there is some mild discomfort as the telescope passes through the prostate.

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

If required we can take small biopsies, 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.

We can perform flexible cystoscopy in our offices on Wickham Terrace. 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.

Rigid cystoscopy

A rigid cystoscopy is usually performed under general anaesthetic (completely asleep), but spinal anaesthetic (numb from the waist down) can be used instead.
We pass a small rigid 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 we can take small biopsies, remove a ureteric stent, inject the bladder with botox, cauterise small areas of the bladder, or remove foreign bodies while the telescope is in 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. This is usually removed the following day.

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.

WHAT IS THE RECOVERY AFTER CYSTOSCOPY?

Some mild burning and stinging when passing urine is common for a day or two after cystoscopy. You may notice some bleeding in the urine for a day or two after the procedure.

Pain relief usually isn’t required after cystoscopy. If you do need any pain relief, paracetamol and/or ibuprofen on an as needed basis should be enough. A urinary alkaliniser such as Ural may help relieve burning and stinging when passing urine.

If you have had a general or spinal anaesthetic or sedation you will not be able to drive for 24 hours after the procedure.

If you have had a local anaesthetic you can usually return to work the same day. If you have had a general anaesthetic you can usually return to work one to two days 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?

Cystoscopy is the best way to investigate problems with the bladder and urethra. Scans and urine tests aren’t as reliable as directly inspecting the bladder.

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