Flexible Cystoscopy

What is a flexible cystoscopy?

Flexible cystoscopy is a routine procedure used to diagnose or monitor conditions affecting your bladder, urethra, or prostate. During the procedure, a thin, bendable tube with a light and camera, called a cystoscope, is inserted into your bladder through the urethra. This allows your doctor to see the inside of your bladder and urethra in real-time.

Flexible cystoscopy is often used to investigate symptoms such as blood in your urine (haematuria), frequent urination, or difficulty urinating. It can also help diagnose conditions like urinary tract infections, bladder stones, or bladder cancer. Compared to rigid cystoscopy, the flexible tube makes the procedure more comfortable.

When is a flexible cystoscopy recommended?

Your doctor may recommend a flexible cystoscopy if you are experiencing symptoms that suggest a problem with your urinary system. Common reasons include:

• Persistent urinary tract infections (UTIs)
• Blood in the urine (haematuria)
• Painful or difficult urination
• Suspected bladder stones
• Monitoring for bladder cancer or other conditions
• Investigating symptoms of an enlarged prostate

This procedure provides valuable information that can help diagnose or monitor conditions, allowing your doctor to plan the most effective treatment for you.

What preparation is needed for a flexible cystoscopy?

Flexible cystoscopy is usually performed as a day-case procedure, meaning you can go home the same day. It does not require general anaesthesia. Instead, a local anaesthetic gel is applied to your urethra to minimise discomfort.

If you’re having sedation, you may need to avoid eating and drinking for a few hours before the procedure. You will also be asked to provide a urine sample beforehand to check for infection. Let your doctor know if you have a urinary tract infection or if you’re taking blood-thinning medication, as this may require adjustments before the procedure.

What happens during the procedure?

You will be asked to lie on your back with your knees slightly bent. The doctor will apply a numbing gel to your urethra before gently inserting the flexible cystoscope. The tube is then guided into your bladder.

Sterile water may be used to fill your bladder slightly, providing a clear view of the lining. You may feel a mild urge to urinate or slight discomfort during this part, but the procedure is generally quick and well-tolerated, lasting about 5 to 10 minutes.

The doctor will examine your bladder and urethra on a monitor, checking for any abnormalities. If needed, small instruments can be passed through the cystoscope to take tissue samples (biopsies) or remove small stones.

Benefits of flexible cystoscopy

Flexible cystoscopy offers several benefits:

• Provides clear, real-time images to help diagnose conditions quickly
• Minimally invasive with no incisions required
• Allows for biopsies or minor treatments during the same procedure
• Helps monitor and manage bladder conditions effectively

What are the potential risks and complications?

Flexible cystoscopy is a safe procedure, but some potential side effects include:

• Temporary burning or discomfort when urinating
• Small amounts of blood in your urine
• A slight risk of urinary tract infection (UTI)
• Rarely, injury to the bladder or urethra

Your doctor will explain these risks beforehand and provide guidance on how to minimise them.

Recovery after flexible cystoscopy

After the procedure, you may feel mild discomfort or a burning sensation when urinating. Drinking plenty of water can help ease these symptoms and flush out any remaining anaesthetic gel.

It’s normal to notice some blood in your urine for 24-48 hours, but this should clear up on its own. Most people can return to their normal activities the next day.

If you experience severe pain, heavy bleeding, or signs of infection, such as fever or cloudy urine, contact your healthcare provider immediately.

Flexible cystoscopy is an effective way to investigate and manage urological conditions, giving you peace of mind and helping ensure you receive the right treatment.