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Flexible Cystoscopy

What does the procedure involve?

The Flexible Cystoscopy is performed under local anaesthetic. Telescopic inspection of the bladder and urethra with bladder biopsy (if indicated); a stent can also be removed during this procedure.

What are the alternatives to this procedure?

Alternatives to this procedure include cystoscopy under general anaesthetic or sedation (with you asleep).

What should I expect before the procedure?

Please ensure that your bladder is comfortably full when you arrive. 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 will be asked to remove the garments on the lower half of your body and to put on a hospital gown. You may be given an antibiotic, after checking for any allergies. This is to reduce the risk of urinary infection.

Please tell your surgeon (before 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®).
  • A previous or current MRSA infection.

What happens during the procedure?

In order to perform the procedure, it is necessary to insert a flexible cystoscope (pictured) into the bladder via the waterpipe (urethra). We use local anaesthetic jelly to numb and lubricate the urethra. This makes introduction of the instrument into the bladder as comfortable as possible. Men sometimes find passage of the instrument through the area of the prostate uncomfortable. Any such discomfort tends to be momentary. Once the instrument is in place, the examination takes only 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.

A nurse will remain with you during the examination and will explain anything you do not understand.

What happens immediately after the procedure?

The surgeon has completed the examination; he / she will remove the instrument and explain the findings. You will also be advised whether any further treatment is needed. You will then be able to walk to the toilet to pass out the fluid that has been used to fill your bladder. Finally, you will be taken back to a cubicle where you can wash and dress yourself.

The average hospital stay is less than one day.

Are there any side-effects?

Most procedures have possible side-effects. Although the complications listed below are well recognised, most patients do not suffer any problems.


  • Mild burning or bleeding on passing urine for a short period after the operation.


  • Infection of the bladder requiring antibiotics.


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

You should drink twice as much fluid as you would normally for the first 24 to 48 hours to flush your system through. Any stinging or blood in the urine usually settles rapidly if you continue to drink plenty of fluid.

What else should I look out for?

If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your Surgeon or GP immediately. In case of emergency dial “000” or attend your nearest emergency department.


This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional.

Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.