A direct visual examination of the inside of the bladder and urethra using a thin telescope. The cornerstone of bladder cancer diagnosis, surveillance, and the investigation of urinary symptoms.
Cystoscopy involves passing a thin, flexible or rigid telescope (cystoscope) along the urethra — the tube through which you pass urine — into the bladder. The camera at the tip transmits a magnified live image, allowing Dr Tan to examine the lining of the bladder and urethra in detail.
Flexible cystoscopy is performed under local anaesthetic gel as an outpatient procedure. A narrow, soft telescope is used, and most patients tolerate it well with only mild discomfort. It can also be used to take small biopsies, remove ureteric stents, or administer botulinum toxin into the bladder wall.
Rigid cystoscopy requires a short general anaesthetic and is performed in theatre. It uses a firmer instrument and allows more complex procedures, such as biopsy or bladder tumour removal (TURBT), to be carried out during the same sitting.
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Before your procedure
For flexible cystoscopy (local anaesthetic): you can eat and drink normally. Arrive with a comfortably full bladder and provide a urine sample on arrival.
For rigid cystoscopy (general anaesthetic): fast for six hours before your procedure. Water is permitted up to two hours prior.
Take your regular medications as usual. If you take blood thinners, inform Dr Tan’s team — specific guidance will be given.
Please inform the team of any active urine infection — the procedure may need to be postponed until it is treated.
For flexible cystoscopy, you can drive yourself home. For rigid cystoscopy under general anaesthetic, arrange for someone to collect you.
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Risks and benefits
Direct visualisation
No imaging test can match the clarity and accuracy of looking directly inside the bladder.
Diagnosis and treatment together
Biopsies and minor treatments can often be completed in the same procedure, avoiding the need for a second visit.
Minimally invasive
Flexible cystoscopy requires no incisions, no general anaesthetic, and allows same-day return to normal activities.
Common
Burning on urination
A mild stinging sensation when passing urine is very common for 24–48 hours after the procedure. Drinking extra water helps significantly.
Common
Temporary urinary frequency
You may feel the urge to urinate more often than usual for a day or two. This settles quickly and does not require treatment.
Uncommon
Urinary tract infection
A small number of patients (around 1 in 10 to 1 in 50) develop a urine infection requiring a short course of antibiotics.
Rare
Bladder injury or perforation
Very rarely, the wall of the bladder may be damaged during the procedure. This occurs in fewer than 1 in 500 cases and usually heals with catheter drainage alone.
Rare
Urinary retention
Difficulty passing urine after the procedure occasionally occurs. A temporary catheter may be required.
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Aftercare and recovery
1
Drink plenty of fluids
Aim for 2 litres of water on the day of the procedure. Good hydration reduces burning and flushes the urinary tract.
2
Return to normal activity
After a flexible cystoscopy, you may resume normal activities — including driving and work — the same day, provided you feel well.
3
Mild discomfort
Over-the-counter pain relief such as paracetamol is sufficient for any discomfort. Symptoms should improve significantly within 24–48 hours.
4
Biopsy results
If a biopsy was taken, results are typically available within 2–3 weeks and will be discussed with you at a follow-up appointment.
When to seek urgent advice
Contact the clinic if you experience: a high temperature, inability to pass urine, heavy or persistent bleeding, or severe worsening pain.
Why am I having a cystoscopy — what are you looking for?
Will I need flexible or rigid cystoscopy, and why?
Will a biopsy be taken, and what would that mean?
How long will the results take?
Can I go back to work the same day?
How often will I need surveillance cystoscopies?
Disclaimer
This information is for general education and is not a substitute for personal medical advice.
Content adapted from the British Association of Urological Surgeons (BAUS) and the American Urological Association (AUA) patient information resources.