Flexible Cystoscopy Under Local Anaesthesia

(Code for insurance: M4510 + AC100)


What is a flexible cystoscopy?

A cystoscopy is a procedure that looks at the bladder and other parts of the urinary system. It involves inserting a special tube, called a cystoscope, into the urethra and then passing it through to the bladder. There are two types of cystoscope: rigid and flexible.

Your examination will use a flexible cystoscope, which is a fibre-optic tube that can move around bends in the urinary system. It is about the thickness of a pencil and has a tiny video camera on one end, so the doctor can view an image of your urinary system on a screen.

Flexible cystoscopes are generally used to help make a diagnosis or to see if a treatment has been successful.


Why do I need a cystoscopy?

Some urinary symptoms – such as those outlined below – are due to problems in the bladder or urethra. Sometimes the cause of your symptoms will be clear from X-rays or tests of your blood or urine, but often the only way your doctor can be sure what is going on is to look inside your bladder.

A cystoscopy can help to diagnose the causes of symptoms such as:

  • Blood in your urine (haematuria)
  • Frequent urinary tract infections
  • Difficulty or pain when urinating (passing urine)
  • Frequency in passing urine (going more often day and night)
  • Slow urinary stream
  • Incontinence of urine (inability to control when you urinate).

Are there any alternatives?

A cystoscopy is the only way to have a close enough look at your urinary system to diagnose certain bladder conditions. If there are any alternatives, your doctor will discuss them with you.

What are the risks?

Possible common potential side-effects:

  • Urethral discomfort – you may feel a stinging sensation when you urinate, but this should only last a day or two. If the pain is severe and lasts for more than two days, please contact us or your GP.
  • Blood in the urine – you may have a small amount of bleeding from the cystoscope being passed up the urethra. Some patients do not have any bleeding at all, but some find their urine is slightly pink for a few days after this procedure. Drinking plenty of water (two to three litres spaced out over 24 hours) can help to clear the urine. If your urine remains pink after a few days, please contact us or your GP.
  • Infection – a urine infection can cause a fever and pain when you pass urine. The risk of this can be reduced by drinking plenty of water after the procedure.

Rare potential side effects:

  • Temporary insertion of a catheter – this may be required if you are unable to pass urine normally following the procedure.
  • Delayed bleeding requiring further surgery.
  • Injury to urethra causing delayed scar formation – this may require additional surgery in the future to widen the urethra.

Before the examination

You will be asked to give a urine sample and that will be tested.

You may be given an antibiotic (an injection) before the procedure to reduce the likelihood of developing an infection, depending on the urine test result or previous history of water infection.

You will also be asked to sign a consent form.

During the examination

You will be asked to lie down on your back and the opening of the urethra and surrounding area will be cleaned.

A ‘jelly’ containing anaesthetic will be put in the urethra. This reduces the discomfort when the cystoscope is inserted into the urethra.

When the cystoscope has been gently passed into the bladder, the doctor will insert sterile water or saline into your bladder. This is to help your doctor see the lining of your bladder. It will make your bladder feel full, so you will feel like you need to urinate. This may be slightly uncomfortable.

The procedure will take about five minutes.

You will be informed immediately about the result of the test.

What do I need to do after I go home?

You will be able to return to normal activities the on same day as the procedure. You will be able to take a bath or shower and eat and drink normally. You should drink plenty of water (at least two litres per day) to flush out any infection and clear up any bleeding.

Will I need any dressings?

You may want to wear a pad the day after your cystoscopy to protect your clothing from the small amount of bleeding you may have.


You may be prescribed antibiotics to lower the risk of infection – it is important that you complete the whole course.

What if there are problems at home following the procedure?

Please contact your GP if you are in extreme pain, have continuous or excessive bleeding,  pass blood clots, have a raised temperature – 38ºC (100.4F) or above or have difficulty passing urine.

If you think it is an emergency, please go straight to your nearest A&E department.