Cystoscopy 

Introduction 

Cystoscopy

A cystoscopy is a procedure that examines the inside of the bladder. In this video, surgeon Gurminder Mann explains how it is performed.

Media last reviewed: 14/11/2013

Next review due: 14/11/2015

Screening and testing

Information about the various screening and testing health checks you may undergo throughout your life

A cystoscopy is a medical procedure used to examine the inside of the bladder using an instrument called a cystoscope.

A cystoscope is a thin, fibre-optic tube that has a light and a camera at one end. It is inserted into the urethra (the tube that carries urine out of the body) and moved up into the bladder.

The camera relays images to a screen where they can be seen by the urologist (specialist in treating bladder conditions).

There are two types of cystoscope:

  • flexible cystoscope – a thin, flexible tube used when the only purpose of a cystoscopy is to look inside your bladder
  • rigid cystoscope – a thin, straight metal tube used for passing small surgical instruments down through the cystoscope to remove a tissue sample or carry out treatment

Most cystoscopies are performed as outpatient procedures, so you'll be able to go home on the same day.

Read more about what happens during a cystoscopy

Why it is used

A cystoscopy can be used to investigate and treat symptoms and conditions that affect the bladder and urinary system. For example, it can be used to:

  • check for abnormalities in the bladder
  • remove a sample of bladder tissue for further testing (a biopsy) in cases of suspected cancer
  • treat certain bladder conditions, such as removing small bladder stones

Read more about why a cystoscopy might be used.

Is a cystoscopy painful?

You shouldn't feel any serious pain as a flexible cystoscopy is usually carried out using a local anaesthetic gel or spray to numb the urethra. A rigid cystoscopy is usually done under general anaesthetic (where you are asleep), or a spinal anaesthetic (epidural) that numbs all feeling below your spine.

However, for some people the procedure may feel uncomfortable and you may have mild side effects afterwards, such as muscle pain and nausea.

For a few days after the procedure, you may feel a burning sensation when passing urine and you may pass blood in your urine. This is normal and not something to worry about unless it is severe and lasts longer than a few days.

Read more about recovering from a cystoscopy.

Risks

It's rare to experience serious complications after a cystoscopy, but some people experience persistent bleeding or problems passing urine.

There's also a small risk of developing a urinary tract infection (UTI) that affects your urethra, bladder or kidneys. You should see your GP if you experience symptoms of infection such as a high temperature (fever) of 38ºC (100.4ºF) or above.

Read more about the possible complications of a cystoscopy.

Page last reviewed: 11/06/2013

Next review due: 11/06/2015

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Comments

The 23 comments posted are personal views. Any information they give has not been checked and may not be accurate.

MrsA1975 said on 24 July 2014

I had flexible cystoscopy done a week ago. I really wish I hadn't. The pain I felt urinating after the anesthetic wore off made me scream. The only slight relief I got was from urinating in a bath of warm water.

The pain did subside after 24 hours, but after two days of feeling okay, I now have a really strange, sharp feeling when I urinate. I have suffered from many UTI's but this feels different. Hopefully, it's just a bruised urethra. I dread needing to wee!

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SusJ said on 17 July 2014

Just had a flexible cystoscopy. Posting here to reassure others as I managed to get myself in a right state worrying about the procedure and the possible results. The thought is definitely worse than the deed with this procedure. I was so worried I cried myself to sleep the night before and was on the verge of cancelling. The waiting around to have the procedure was the worst bit really (just over an hour from admission to climbing on the table) A nurse explained what was going to happen. She got me ready on the table and applied the anaesthetic jelly (cold but that's all) Then the doctor who was performing the procedure explained it too. All the staff I saw today were very friendly and reassuring. I think he may have had a wee bit of trouble actually inserting the scope initially, it was a wee bit nippy and he used more gel. I'd say the same nippy burning level of pain as when you get cystitis and the peeing broken glass feeling? but that bit was brief, seconds if that. When the scope is inside you it's a peculiar feeling but not painful. I'd say uncomfortable but as the nurse said "we ARE going the wrong way up a one way street!" The nurse kept me talking while it was happening which helped. It was over in two minutes max. The doctor told me that everything was fine, he'd seen nothing abnormal and asked if I'd any questions. If you have to have this procedure done, please try not to worry too much. While I wouldn't exactly look forward to one if I had to get it done again, I wouldn't be half so apprehensive as I was this time. I'm a HUGE baby when it comes to pain and hospitals (and I've been through childbirth too!) but honestly, this isn't a big deal so try not to worry too much.

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omgmeee said on 06 June 2014

After a long 3 weeks of working myself up. I had my flexible cystoscopy today.. I had looked on websites and youtube and got myself into state.
Please dont worry !! i completely freaked out ran out of the treatment room as serious panic attack come over me. Nurses were really good and calmed me down.
I decided to go back in and put my earphones in to listen to my music and lay down. It was all over in less than 2 minutes. I really couldnt believe it.really please dont worry yourself it is over very quickly and you dont feel any pain just a weird sensation
the 3 weeks of waiting had fed my anxiety and beliving there was some thing seriously wrong with me.
Bladder was good and normal and i saw it for myself on screen

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GordyBrock said on 12 May 2014

My appointment for my cystoscopy was two months away so I had plenty time to think about it. I purposely didn't do any research on it; I've learned from past experience that what you don't know doesn't worry you. I am a 64 year old male and I had my cystoscopy this morning at Salford Royal Infirmary. I had worried and fretted for two months needlessly. Let me reassure you it's not as bad as you may fear. It isn't excruciating as some here have said, more uncomfortable than painful. The staff and urologist were fantastic and helped reassure me. Peeing afterwards was a little painful, but it soon passes. Nothing serious was found and I'm glad I had it done. Don’t worry!

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GordyBrock said on 12 May 2014

My appointment for my cystoscopy was two months away so I had plenty time to think about it. I purposely didn't do any research on it; I've learned from past experience that what you don't know doesn't worry you. I'm a 64 year old male and I had my cystoscopy this morning at Salford Royal Infirmary. I had worried and fretted for two months needlessly. Let me reassure you it's not as bad as you may fear. It isn't excruciating as some here have said, more uncomfortable than painful, two minutes it's over...I didn't even feel it being taken out. The staff and urologist were fantastic and helped reassure me. Peeing afterwards was a little painful, but it soon passes. Nothing serious was found and I'm glad I had it done. Don’t worry!

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Frank11 said on 29 April 2014

I had a male flexible cystoscopy done a few days ago. It was only slightly uncomfortable and lasted only a few minutes. I had been very worried about the procedure beforehand but need not have worried. I had slight bleeding for 24 hours after the procedure when passing urine but other than that nothing to report. Dont worry it's a breeze!

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Mizz_Scouse said on 17 March 2014

Had my second flexible cystoscopy done today & I must reassure you it isn't all that bad from a female point of view anyway! Sure it is a little embarrassing at first, but I just remember I'm on a list with a lot of people there for the same reason I am, to have a cystoscopy done, the drs & nurses are used to this kinda thing & it's nothing to be embarrassed about!

They start off by giving you a little wipe & clean down there with some sterile solution, before putting on some numbing gel called "intsillagel", after about a minute or two they pass the scope through which is mildly uncomfortable but painless before filling your bladder with some water, after I'd say all of 2-3 mins they take out the scope & it's all over.

The strangest part I found was going for a wee afterwards, as your still numb down there for a little while so when you urinate it feels really cold and tended to shoot all over the toilet bowl, but I guess that's just because you have been stretched a little.

My urologist was great; she showed me what was what on the screen & explained everything too me.

So to anyone who is having this procedure & is a little anxious; I can honestly say it's not as bad as you think, and for you ladies I would honestly say having a smear test is worse than this!

Good luck to everyone :)

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User524436 said on 28 January 2014

I've just today experienced my first flexible cystoscopy, aged 34, female having had trace amounts of blood in my urine and it was absolutely fine. Having changed into my rather attractive paper pants and hospital backless gown, I was taken to the surgical unit, laid on the bed in much the same position as for a smear and it was over and done with a lot quicker than I imagined. Yes, I did give a firm blink and a deep breath when the camera first went in but it was no worse than the slight pain felt when having a blood test. I'm certainly not walking funny and the strange need to pee has long gone!
I do however need a colonoscopy next week - aren't I the lucky one!

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Springsong said on 02 January 2014

I had a cystoscopy at the start of the week. I had had mixed thoughts on wanting to go ahead but the procedure was over & done with fairly quickly. The anaesthetic gel was surprisingly like a jet of cold & it stung as camera was first entered but otherwise I felt no pain. I was ok for the rest of that day too but woke the following morning feeling delicate & as though I were walking bow-legged.

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C444 said on 08 October 2013

I am a 55yr old male. I had a flexible cystoscopy yesterday. Though I had gel, it didn't seem long before the cystoscope was inserted. I have never felt such excruciating pain in my life......it felt as though was being ripped apart with razor blades! I nearly went through the ceiling! I seem to remember being told it was because I had an infection.........but I wasn't really listening.....I do not want that experience ever again.

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Gran25 said on 18 September 2013

I had a flexible cystoscopy today. I was not looking forward to it or the after effects but I can honestly say it was painless. I don't know if the doctor used anaesthetic gel. He didn't mention it and,if the lubricating gel had anaesthetic in it ,he didn't wait for it to work. However I didn't feel the cystoscope go in or be taken out and the whole thing was over very quickly. No more than a couple of minutes I would say. So far the only after effects I have had is frequency. No burning or bleeding. I took a large bottle of water with me which I drank straight after and have had several large glasses of water since. Maybe I was lucky but the whole thing was nothing to have got so anxious about. Thankfully the doctor found nothing abnormal so I am no wiser about the cause of the blood im my urine.

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SheilaM3 said on 05 September 2013

I wanted to add my experience of a cystoscopy as I was helped by reading others on here before I went .I am female (aged 73) I had had a stubborn E coli urinary infection that didn’t seem to be responding to antibiotics. After 3 months of this my GP suggested that he referred me to a specialist urologist. He said he wanted to rule out anything sinister going on.
To say I was worried about my appointment is an understatement! I take “White Coat Syndrome” to a different level!! The day before, I could hardly function for shaking all over!! I am lucky that I have been fairly healthy all my life and not had much to do with hospitals.(nor ever wanted to!!)
My kidneys and bladder wee scanned first with ultrasound. Quick and totally worry free. I was then sent down for the cystoscopy. The staff there were wonderful. I was told exactly what was going to happen at each step. The nurse who took me into the little room to undress (just garments below the waist) said that if I had ever had a smear test,it wasn’t as bad as that! As I have had several in the past I was reassured greatly.
Iwas washed with antiseptic and the Urologist squirted the anaesthetic gel round my bladder . The nurse stood by my side holding my hand gently. I felt a sensation of cold metal (similar to the speculum used in a smear test but not as uncomfortable!) . One tiny sting as the camera was inserted then no pain at all. The camera puts water into the bladder as it looks around, to make the process more comfortable. It isn’t then resting on the bladder wall. It was literally 3 minutes at most and then it was withdrawn. I was told there and then that the scans were OK and apart from the infection my bladder seemed fine. I could have looked at the TV screen as well but being so squeamish did not bother! I have to have blood tests and another urine test next week and then that is it. Please do not worry about this (I nearly worried myself into a heart attack for nothing!!)

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DonG1 said on 29 August 2013

I am a 55 male who was sent by GP to have a cystocotomy. I felt nervous and apprehensive as I entered the room, the doctor and the staff explained everything to me and was kept informed what was to be expected. As the gel was pushed down the urethra there was a stinging effect that lasted 15 seconds or so not to bad. Next the flexible tube was passed down the urethra and bladder the doctor explained what I was watching on the monitor ( an experience here) If anyone is having a cystocotomy and is worried you should not be, if the first 20 seconds can be handled by breathing there is really nothing to worry about. the whole test takes about 3 minutes. the stinging and wanting to go to the loo is more uncomfortable but this also subsides. Nothing to worry about If I can say this its not that bad, tooth extraction is worse. Good luck and hope this helps anyone who like me was scared.

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braceycase said on 12 August 2013

I am a 23 year old female and I had a rigid cystoscopy today. It was a much better experience than I had anticipated, I was only in hospital for a duration of approximatley 4 hours. The staff on duty were lovely, I was under a general anesthetic for the procedure, no pain afterwards at all, just a slight burning sensation when I urinate. I didn't even feel the cannula go into or come out of my hand thanks to the amazing numbing cream (my hands are still numb 8 hours later). I had absolutley no problems with the anesthetic, no sickness or anything and the surgeon told me I had no abnormalities which is fantastic news, just waiting back on my biopsy now, fingers crossed. I hope everyone has an experience like this, if you are worried, take my advice, and don't worry about a thing :)

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lawns said on 10 July 2013

I had this done today; the staff at the hospital were great. The procedure was near enough painless....no greater pain than having a leg waxed. I felt a little tingly and sore afterwards and felt like I needed to urinate a lot (when I actually didn't need to) but this felt no different to the symptoms of a urine infection and eased quickly. (I am female and 30)

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riff7 said on 10 February 2013

by the way - i am 51 male

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riff7 said on 10 February 2013

i have to agree with 3kkoolguy

the females (and some men) seem to have had a relatively painless experience with the camera going in

for me it was very painful - so much so I had my hands in my face gritting my teeth the whole procedure
the pain too much for me to even consider watching the screen (though i wanted to)

the anaethetic squirted in was painless - in fact quite a cool weird feeling
but the doctor immediately sent the camera in with no delay and the anesthetic had not numbed the area at all
imagine the pain of a camera going in and out whilst feeling the whole thing

im absolutely convinced that the doctor didn't wait anywhere near long enough for the squirted anesthetic to numb the urethra

so my advice to ANY male (even female) patient is to ask the doctor to wait a couple of minutes after the cool anesthetic is squirted in before they insert the camera and you just might have a pleasant experience instead of a very painful one

good luck and insist on a delay for numbing

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stephs207 said on 07 January 2013

I am a 35 year old female, having had this procedure today, I feel I have to comment to help put people's minds at rest. I was extremely anxious and worried. In truth it is absolutely nothing to worry about I didn't experience any pain, just slight discomfort, I watched the whole procedure on the screen and the doctor kept me informed throughout. It lasted no-more than 5 minutes and I certainly wouldn't be afraid to have it again. My advice is to relax as much as you possibly can it will help you and the doctor. I had very slight burning passing urine after it but nothing compared with the infections I have had.

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3kkoolguy said on 20 October 2012

Having just read the above comments i have to say that u were very lucky that u never had any pain during this procedure. To be honest i have never suffered as much pain in my life as i did that day last year. I am a 56 year old male with a slightly swollen prostate and the doctor wanted to check that everything else was in good working order. the pain i had was excruciating and although they discovered that everything was fine other than the slight swelling of the prostate, I will never go through that again unless it is expected that i have a life threatening condition. As for the gel being put inside, I didnt look to see if they did or did not but i was told it would be put in.

Good luck to anyone going through this and I hope like the others that you have a painless experience.. as for me... Never again in my life.

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jola bee said on 15 October 2012

I'm a 28 female I suffer with cystitis a lot, I had this procedure this afternoon I worked myself up a lot with nerves before. The procedure for me was painless and not at all uncomfortable! Lasted 5 mins at most!!! I watched the whole thing on tv screen I haven't even had any burning since. - my advice if your having one of these is too just to relax there nothing to worry about it sounds worst than it actually is =) !!!

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Valdansam said on 12 October 2012

I am a female 41, had a cystoscopy today, the procedure lasted about 5 mins in total, I could feel a little discomfort but nothing to make me squirm or jump. I watched it all on the screen and got results immediately. SInce the procedure I've felt a slight burning sensation in the area (only to be expected)! I wanted to share my experience to help reduce other peoples anxieties who require the procedure, it really is a quick and simple, absolutely nothing to sweat over :0)

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333darrell said on 05 April 2012

I am a male aged 67. I was diagnosed with prostate cancer in 2003 which was successfully treated with radiotherapy and hormone treatment. I had a flexible cystoscopy completed today to investigate a situation where when I urinated I often experienced a split stream . Previous consultations had concluded that I might have a stricture of the urethra (water pipe).
The procedure was very quick, lasting all of 5 minutes!
First, anesthetic gel was shot (with just a plastic syringe, no needles! ) into the urethra opening at the tip of my penis to knumb the water pipe. Next the flexible scope was inserted and passed up into my bladder : although I could feel the sensation of this inside me there was absolutely no pain or real discomfort at all. Finally, some water was squirted
through the scope into my bladder which created a slight feeling of wanting to urinate, but this soon passed. The scope was then withdrawn and the prcedure was finished.
I had dreaded having this procedure done as I am 'the world's biggest coward' but I now know my fears were completely unjustified.Seriously, if you have to have a flexible cystoscopy there really is nothing to worry about, trust me.
I felt I had to write this comment to spare others the anxiety I had experienced (completely unnecessarily ! )
Good luck !

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bobbyG1973 said on 13 March 2012

I'm male, 38 years old. I'm fit and exercise regularly. Over a period of 15 months I had 3-4 episodes of blood in my semen. I had a testicular and prostate ultra sound, semen and urine cultures, all of which returned normal results. Finally I had a cystocopy scheduled as a final examination to rule out any other abnormalities. I was pretty concerned about the procedure and had serious doubts as to whether it was really necessary as this appeared to be something connect to urinary disfunction! Anyway I went ahead and can say without a shadow that this is nothing to fear. The procedure is very quick, anaesthetic is injected into the penis before hand. I can't reiterate enough how painless this is. The prostate (via the arse!) ultra sound is far more uncomfortable. The only real discomfort was maybe 5-10 minutes after when the anaesthetic wears of you have maybe 20 mins of burning sensation in the penis, this doesn't last long. I had no continuing pain passing urine or secondary infection - it was fine. The test showed everything as normal and I was discharged with no cause found for the blood and leaving the suspicion that it was a reoccurring low grade infection.
Which I hope is the end of it!

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