Flexible Cystoscopy

What is a flexible cystoscopy?

Flexible cystoscopy is a common procedure typically performed to diagnose or monitor conditions affecting the bladder, urethra, or prostate. The procedure involves inserting a thin, flexible tube with a light and camera (cystoscope) into the bladder via the urethra. The camera allows the doctor to view the inner lining of the bladder and urethra in real time. This procedure is often used to investigate symptoms like blood in the urine (haematuria) or frequent urination and may help diagnose conditions like urinary tract infections and bladder cancer. Unlike a rigid cystoscopy, which uses a straight tube, a flexible cystoscopy uses a bendable tube, making the procedure more comfortable for patients and allowing for greater mobility of the instrument.

When is a flexible cystoscopy recommended?

A flexible cystoscopy may be recommended for patients who have symptoms that indicate a problem with their bladder, urethra, or prostate. Common reasons for the procedure include:

• Persistent urinary tract infections (UTIs)
• Blood in the urine (haematuria)
• Difficulty passing urine or painful urination
• Suspected bladder or urethral stones
• Monitoring bladder cancer or other urological conditions
• Investigating symptoms of an enlarged prostate

This procedure can help to diagnose and monitor conditions providing doctors  with essential information to plan appropriate treatment or follow-up care.

What does the procedure involve?

Patients are asked to lie down on their back, usually with the knees slightly bent. The doctor will apply a local anaesthetic gel to numb the urethra. The flexible cystoscope is then gently inserted into the urethra and guided up into the bladder. The procedure usually takes about 5 to 10 minutes. As the cystoscope reaches the bladder, sterile water may be used to fill the bladder slightly, providing a clearer view of the bladder’s lining. Patients may feel some discomfort or the urge to urinate during this part of the procedure, but it is generally well-tolerated. Your doctor will be able to view the images from the cystoscope on a monitor, allowing them to examine the inside of your bladder and urethra in real time. If necessary, small instruments can be passed through the cystoscope to take tissue samples (biopsies) or remove small stones during the procedure.

What are the potential risks and complications?

While flexible cystoscopy is generally a safe procedure, there are some potential risks and side effects. These may include:

• Urinary tract infection (UTI)
• Temporary discomfort or pain during urination
• Blood in the urine
• Rarely, injury to the bladder or urethra

 The doctor will discuss these risks with you before the procedure.

After the procedure

After the procedure, patients may feel mild discomfort, burning during urination, or need to urinate more frequently for the next day or two. Drinking plenty of water can help ease these symptoms and flush out any remaining local anaesthetic. It is normal to notice a small amount of blood in the urine, but this should clear up within 24-48 hours. Most patients can return to their normal activities within a day or two. If patients experience severe pain, heavy bleeding, or signs of infection, such as fever or cloudy urine, contact your doctor immediately.