About flexible cystoscopy

Cystoscopy is an inspection of the bladder and water pipe (urethra). It is done with a flexible telescope. It helps us to identify anything abnormal.

Occasionally we may take a small sample (called a 'biopsy') of your bladder at the same time.

The procedure can also be used to remove a ureteric stent (a tube which has previously been inserted up into the kidney).

If your urethra is narrow, we may need to gently stretch it to pass the telescope through.

You will usually have this procedure as an outpatient in Albany Unit in the Kingston Surgical Centre at Kingston Hospital.

Benefits of this procedure

The cystoscopy allows us to diagnose anything abnormal in the bladder or urethra. It can also be used to remove a previously inserted ureteric stent.

Alternatives to flexible cystoscopy

Alternatives to have an flexible cystoscopy are:

  • a rigid cystoscopy - this needs to be performed under a general anaesthetic
  • relying on observation of your symptoms to make a diagnosis.

Side effects of flexible cystoscopy

Common (greater than 1 in 10)

  • Mild burning or bleeding when you pass urine for a short period afterwards.

Occasional (between 1 in 10 and 1 in 50)

  • Urinary infection, requiring treatment with antibiotics.

Rare (less than 1 in 50)

  • Continued bleeding afterwards, or bleeding that starts after internal scabs fall off (if biopsies have been taken). This may require removal of clots from the bladder or a further procedure to stop the bleeding.
  • Injury to the urethra itself. This may lead to scar tissue which may need treatment in the future.
  • Temporary urinary catheter if bleeding is heavy or you cannot pass urine. A catheter is a tube passed up the urethra and into the bladder.
  • If we are planning to remove a stent and we find that there is excessive calcium build-up on it, we may need to remove it under a under general anaesthetic on a different day, instead of during the flexible cystoscopy.

What anaesthetic is used

Anaesthetic is not usually needed. However, we can insert a local anaesthetic gel into your urethra, if you need this.

What the procedure involves

During a cystoscopy, we pass a small flexible telescope into your urethra and up into your bladder to check for anything abnormal. If we take a sample or plan to remove a stent, we can also pass small instruments down the telescope.

On the day of the cystoscopy

Black arrow icon.png  You may eat and drink normally before the procedure.
Black arrow icon.png  Bring a sample of urine in the bottle provided. The instructions are in the grey box. If you forget to do this, or forget to bring it with you, ask the receptionist in the Albany Unit for a urine sample bottle when you arrive. Then produce a sample before emptying your bladder.
Black arrow icon.png  Bring with you a list of any medicines you are taking with you.

How to collect a mid-stream urine sample

  1. Your urine sample should be taken after washing, bathing or showering on the day of your appointment.
  2. The sample does not need to be the first urine of the day.
  3. Unscrew the cap from the bottle and place it onto a clean surface.
  4. Pass a small amount of urine directly into the toilet and then stop.
  5. Pass a further quantity of urine directly into the bottle and then stop.
  6. Pass any remaining urine into the toilet.
  7. Do not pass urine into a separate container then transfer it.
  8. Fit the cap back onto the bottle.
  9. Wash your hands.
  10. Write your name, date and time on the bottle (or the label, if it has one).

If the bottle is broken, get another from your GP surgery or local pharmacy.

What happens afterwards

Once the procedure is completed, you will be allowed home straight away.

At first, you may notice a little blood in your urine. This may sting a little.

Over the next 24 hours, drink plenty of non-alcoholic fluids. This is to flush your urinary system and reduce these after effects. We suggest that you try to drink 2 to 3 litres (or 4 to 6 pints) over the 24 hour period.

You may also be given a short course of antibiotics.

What to look out for

Blue arrow icon.png Contact your GP or dial 111 if you develop a fever, increased bleeding or pain when you pass urine.

Red arrow icon.png Go to the nearest Emergency Department (A&E) if you become unable to pass urine at all.

Further appointments or treatments

If we have taken biopsies during the flexible cystoscopy, we may ask you to return to our outpatient clinic approximately two weeks afterwards, or we may send you a letter explaining the results.

If you need other treatments or procedures, you will be given information about these before you leave hospital.

Who to contact

Contact details for our teams can be found below.

Blue arrow icon.png Contact the Albany Unit if you need general advice and your flexible cystoscopy was performed as an outpatient.

Blue arrow icon.png Contact our Specialist Urology Nurse if you have any concerns.

Blue arrow icon.png Speak to the Urodynamics team for issues relating to bladder function.

Blue arrow icon.png Contact the Clinical Nurse Specialist in Urology Oncology if you have cancer and would like further information about this.

Blue arrow icon.png Alternatively, you can contact your GP or speak to your Urology Consultant when you see them next.

More information

The NHS has more information about cystoscopy.

Contact information

Albany Unit
020 8934 3184

Specialist Urology Nurse
020 8934 3547

Urodynamics Team
020 8934 3038

Clinical Nurse Specialist for Urology Oncology
020 8934 2729