Cystoscopy:
Looking Inside the Bladder and Urethra
Learn why cystoscopy may be recommended, what happens during the procedure, and how it helps assess bladder and urinary tract conditions.
What Is a Cystoscopy?
A cystoscopy is a procedure used to examine the inside of the urethra and bladder.
The procedure is performed using a cystoscope, a thin tube with a light and camera at its tip. Images are displayed on a monitor, allowing direct visual assessment of the urinary tract.
Unlike scans, which provide images from outside the body, cystoscopy allows the bladder lining and urethra to be examined directly.
At a Glance
| Purpose | Examine the inside of the bladder and urethra |
| Common Reasons | Blood in the urine, recurrent UTI, urinary symptoms, bladder stones |
| Anaesthesia | Local anaesthetic gel, sedation, or anaesthesia depending on the procedure |
| Procedure Time | Usually 5–20 minutes |
| Hospital Stay | Usually performed as a day procedure |
| Recovery | Most people return to normal activities within 24–48 hours |
Why Might a Cystoscopy Be Recommended?
A cystoscopy may be used to investigate:
- Blood in the urine (haematuria)
- Recurrent urinary tract infections
- Frequent urination
- Urgency or overactive bladder symptoms
- Difficulty passing urine
- Painful urination
- Suspected bladder stones
- Abnormal findings on ultrasound, CT scan, or MRI
- Follow-up after treatment for bladder cancer
The procedure provides direct visual assessment of the urinary tract and may help identify causes that are not always visible on imaging tests.
Why Is Cystoscopy Sometimes Needed Even After a Scan?
Many people wonder why cystoscopy is recommended after they have already undergone an ultrasound, CT scan, or MRI.
While imaging tests provide valuable information about the kidneys, ureters, and bladder, they do not always show the inner lining of the bladder in detail.
Cystoscopy allows direct examination of the urinary tract and may help identify:
- Small bladder tumours
- Areas of inflammation or irritation
- Bladder stones
- Urethral abnormalities
- Sources of bleeding that may not be obvious on imaging
For this reason, cystoscopy is often an important part of investigating blood in the urine and certain persistent urinary symptoms, even when previous scans appear reassuring.
What Can a Cystoscopy Detect?
A cystoscopy may help identify a range of urinary tract conditions.
Bladder Tumours
Some bladder tumours are small and may be detected more easily through direct visual inspection than on imaging alone.
Bladder Stones
Bladder stones can cause urinary symptoms, infections, discomfort, and blood in the urine.
Enlarged Prostate
In men, cystoscopy may help assess whether prostate enlargement is contributing to urinary obstruction.
Urethral Strictures
Narrowing of the urethra may affect urine flow and cause bothersome urinary symptoms.
Inflammation and Bladder Changes
The bladder lining may show changes related to infection, inflammation, chronic irritation, or previous treatments.
Structural Abnormalities
Cystoscopy may identify abnormalities within the bladder or urethra that require further investigation or treatment.
What Happens During a Cystoscopy?
The exact process varies depending on whether a flexible or rigid cystoscope is used.
Before the Procedure
You may be asked to provide a urine sample to check for infection before the procedure.
The reason for the examination and what to expect will be explained beforehand.
During the Procedure
A local anaesthetic gel is usually applied to the urethra.
The cystoscope is gently passed through the urethra into the bladder.
Sterile fluid may be used to fill the bladder slightly, allowing the bladder lining to be examined more clearly.
Images from the camera are displayed on a monitor while the urethra and bladder are assessed.
After the Procedure
Most people are able to return home the same day.
It is common to experience mild burning during urination, urinary frequency, or a small amount of blood in the urine for a short period afterwards.
These symptoms usually settle within a day or two.
Flexible Cystoscopy vs Rigid Cystoscopy
Most outpatient cystoscopies are performed using a flexible cystoscope. The instrument is thinner and more flexible, allowing the examination to be performed comfortably with local anaesthetic gel.
A rigid cystoscope is generally used when biopsies, treatments, or more complex procedures are planned. These procedures are often performed under sedation or anaesthesia.
Your urologist will recommend the most appropriate type based on the reason for the examination.
| Flexible Cystoscopy | Rigid Cystoscopy |
| Usually performed under local anaesthetic gel | Often performed under anaesthesia |
| Thin and flexible instrument | Straight rigid instrument |
| Commonly used for diagnostic assessment | Often used for treatment procedures |
| Usually performed as an outpatient procedure | Often performed in an operating theatre |
Is Cystoscopy Used Only for Diagnosis?
Although cystoscopy is commonly used to investigate symptoms, it can also play an important role in treatment.
Depending on the situation, cystoscopy may be used to:
- Take a bladder biopsy
- Remove small bladder stones
- Insert or remove ureteric stents
- Assess urinary obstruction
- Deliver certain treatments within the bladder
The exact procedure depends on the underlying condition and treatment plan.
Are There Risks?
Cystoscopy is generally considered a safe procedure, but complications can occasionally occur.
Potential risks include:
- Temporary burning during urination
- Small amounts of blood in the urine
- Urinary tract infection
- Temporary difficulty passing urine
- Discomfort after the procedure
Patients should seek medical attention if they develop fever, severe pain, inability to pass urine, or persistent heavy bleeding.
Frequently Asked Questions
Will I Be Awake During the Procedure?
Most flexible cystoscopies are performed while you are awake using local anaesthetic gel. Some procedures may require sedation or anaesthesia.
Can I Eat and Drink Beforehand?
This depends on the type of cystoscopy being planned. If sedation or anaesthesia is required, specific fasting instructions may be given.
How Long Does a Cystoscopy Take?
The examination itself often takes only a few minutes, although the overall appointment may take longer.
Will I Need Time Off Work?
Many people return to normal activities on the same day or the following day, depending on the type of procedure performed.
Can I Drive Home Afterwards?
If local anaesthetic gel alone is used, driving is often possible afterwards. Different advice may apply if sedation or anaesthesia is used.
Is Cystoscopy Painful?
Most people experience some discomfort, pressure, or a temporary stinging sensation rather than significant pain.
Can Bladder Cancer Be Diagnosed With Cystoscopy?
Cystoscopy can identify suspicious areas within the bladder. If necessary, a biopsy may be performed to confirm a diagnosis.
How Soon Will I Know the Results?
In many cases, the findings can be discussed shortly after the procedure. If biopsies are taken, additional time may be needed for laboratory analysis.
Making an Appointment
Whether cystoscopy is recommended depends on your symptoms, medical history, examination findings, and previous investigations.
Appointments with Dr Roger Anthony Idi are arranged through Prince Court Medical Centre.