Flexible Cystoscopy

What does the procedure involve?

This procedure involves telescopic inspection of the bladder and

urethra with bladder biopsy (if indicated). We also use this technique for removal of a ureteric stent in patients.

What are the alternatives to this procedure?

General anaesthetic cystoscopy.

What should I expect before the procedure?

Please ensure that your bladder is comfortably full when you arrive because it is likely that we will need to obtain a urine specimen from you before the procedure. You will usually be admitted on the same day as your procedure. When you arrive, you will be asked to pass urine before the examination.

You may be given an antibiotic tablet (Ciprofloxacin 500mg), after checking for any allergies, to reduce the risk of urinary infection.

Please be sure to inform Professor Vale in advance of your surgery if you have any of the following:

  • an artificial heart valve
  • a coronary artery stent
  • a heart pacemaker or defibrillator
  • an artificial joint
  • an artificial blood vessel graft
  • a neurosurgical shunt
  • any other implanted foreign body
  • a regular prescription for Warfarin, Aspirin or Clopidogrel (Plavix®) (blood thinners)
  • a previous or current MRSA infection

What happens during the procedure?

In order to perform the procedure, it is necessary to insert the flexible telescope (cystoscope) into the bladder via the water pipe (urethra). A local anaesthetic jelly is used to numb and lubricate the urethra which makes passage of the instrument into the bladder as comfortable as possible. Men often find passage of the instrument through the area of the prostate gland uncomfortable but this is momentary.

Once the instrument is in place, the examination will only take a few minutes to complete. Attached to the instrument are a telescopic lens, a light source and some sterile water to fill the bladder so that all the lining can be inspected.

Are there any side-effects?

Most procedures can have side-effects. You should be reassured that although a number of potential complications are recognised, the majority of patients do not suffer any problems.

Common (greater than 1 in 10)

  • Mild burning or bleeding on passing urine for a short period after the operation
  • Biopsy of abnormal areas in bladder (this may require a further procedure under a general anaesthetic)

Occasional (between 1 in 10 and 1 in 50)

  • Infection of the bladder requiring antibiotics

Rare (less than 1 in 50)

  • Temporary insertion of a catheter
  • Delayed bleeding requiring removal of clots or further surgery
  • Injury to the urethra causing delayed scar formation

What should I expect when I get home?

By the time of your discharge from hospital, you should have been:

  • given advice about your recovery at home
  • told when to resume normal activities such as work, exercise, driving, housework and sexual intimacy
  • given a contact number if you have any concerns once you return home
  • given details about your follow-up and who will do this (Professor Vale or your GP)
  • informed when you will be told the results of any tests done on tissue removed (biopsies)

When you get home, you should drink twice as much fluid as you would normally for the next 24-48 hours to flush your system through. You may find that when you first pass urine, it stings or burns slightly and it may be lightly bloodstained. If you continue to drink plenty of fluid, this discomfort and bleeding will resolve rapidly.