What are the Symptoms?
- Flexible Cystoscopy is a diagnostic procedure to examine the inside of your bladder
- It is usually performed as an outpatient under local anesthetic
- Mild burning on passing urine is common after the procedure but side-effects are rare
What Does This Procedure Involve?
Telescopic inspection of your bladder and urethra (waterpipe) under local anesthetic. We can also take small bladder biopsies, remove a stent from your ureter (the tube between your kidney and bladder) and inject Botox into the wall of your bladder using this technique.
What are the Alternatives?
- Rigid cystoscopy under general anesthetic – your urologist will advise you if this is necessary
- No treatment – which may leave the cause of your symptoms unexplained
What Happens on the Day of the Procedure?
Your urologist (or a member of their team) will briefly review your history and medications and will discuss the surgery again with you to confirm your consent.
Details of the Procedure
- We normally carry out the procedure under local anesthetic
- We may give you some antibiotics before the procedure after you have been checked for any allergies
- We instill a jelly containing local anesthetic into your urethra (waterpipe) and leave it in place for a few minutes; this makes the introduction of the telescope as comfortable as possible
- We put the cystoscope (flexible telescope) into your urethra (waterpipe) and pass it into your bladder
- Men sometimes find that passing the telescope through the prostate is a little painful; this only lasts a few seconds
- Once the telescope is in place, we run sterile water slowly into your bladder so that we can inspect all the bladder lining. A nurse will remain with you throughout the procedure
- We remove the telescope once we have completed the examination
- The procedure usually takes no more than a few minutes to complete
- You will be able to pass urine, wash, and dress after the procedure
- The doctor or nurse will explain the findings to you
The procedure is normally performed on an outpatient basis, so you will be able to go home straight afterward
Are There Any After-Effects?
The possible after-effects and your risk of getting them are shown below. Some are self-limiting or reversible, but others are not. We have not listed rare after-effects (occurring in less than 1 in 250 patients) individually. The impact of these after-effects can vary a lot from patient to patient; you should ask your surgeon’s advice about the risks and their impact on you as an individual.
What is My Risk of a Hospital-Acquired Infection?
Your risk of getting an infection in the hospital is approximately 8 in 100 (8%); this includes getting MRSA or a Clostridium diffcile bowel infection. The risk is lower for “outpatient” procedures but higher if you are in a “high-risk” group of patients such as patients who have had:
- Long-term drainage tubes (e.g., catheters)
- Bladder removal
- Long hospital stays
- Multiple hospital admissions
What Can I Expect When I Get Home?
- You will get some burning and bleeding over the first few days when you pass urine
- Should drink twice as much fluid as you would normally for the first 24 to 48 hours to flush your system through
- If you develop a fever, severe pain on passing urine, inability to pass urine, or bleeding, you should contact your GP immediately
- Any antibiotics or other tablets you may need will be arranged and dispensed from the hospital pharmacy
- A follow-up appointment may be made for you to discuss any further treatment
General Information About Surgical Procedures
Before Your Procedure
Please tell a member of the medical team if you have:
- An implanted foreign body (stent, joint replacement, pacemaker, heart valve, blood vessel graft)
- A regular prescription for a blood-thinning agent (Warfarin, Aspirin, Clopidogrel, Rivaroxaban, or Dabigatran)
- A present or previous MRSA infection; or a high risk of variant-CJD (e.g., if you have had a corneal transplant, a neurosurgical dural transplant, or human growth hormone treatment)
Before You Go Home
We will tell you how the procedure went, and you should ask:
- Make sure you understand what has been done
- Ask the surgeon if everything went as planned
- Let the staff know if you have any discomfort
- Ask what you can (and cannot) do at home
- Make sure you know what happens next
- Ask when you can return to normal activities
We will give you advice about what to look out for when you get home. Your surgeon or nurse will also give you details of who to contact, and how to contact them, in the event of problems.