Having a rigid cystoscopy – examining your bladder
This information sheet has been given to you to help answer some of the questions you
might have about having a rigid cystoscopy. If you have any questions or concerns,
please do not hesitate to speak with your doctor or nurse.
What is a cystoscopy
A cystoscopy is a procedure that looks at the bladder and other parts of the urinary system. The
the urinary system is made up of the kidneys, ureter (a tube that links the kidney and bladder),
bladder and urethra (a tube that urine passes through from the bladder before exiting the body). A
cystoscopy 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: flexible and rigid. A flexible cystoscope is a fiber-optic tube
that can move around bends in the urinary system. It is about the thickness of a pencil and is
generally used to help make a diagnosis or to see if a treatment has been successful.
For your examination, a rigid cystoscope will be used, which is a solid, straight tube with a light at
one end. Although both types of cystoscope have side channels where other instruments can be
inserted, a greater variety of instruments can be used with the rigid cystoscope.
A figure used with kind permission of Health Press Ltd. Reference: Norton A 1999, Patient
Pictures Gynaecological Oncology, Health Press Ltd, Oxford
The rigid scope is often used to:
take biopsies (tissue samples)
carry out minor procedures, such as destroying abnormal tissues with heat (diathermy)
remove bladder stones or repair bleeding vessels.
Why should I have 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 the blood
or urine, but often the only way your doctor can be sure what is going on is to look inside your
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
incontinence (inability to control when you urinate)
unusual cells found in a urine sample.
What are the possible complications
Cystoscopies are usually performed with no problems whatsoever. However, there are risks
associated with any procedure. Your doctor will explain these risks to you in more detail before
asking you to sign a consent form. Please ask questions if you are uncertain.
We want to involve you in decisions about your care and treatment. If you decide to go ahead,
you will be asked to sign a consent form. This states that you agree to have the treatment and
you understand what it involves.
If you would like more information about our consent process, please speak to a member of staff
caring for you.
The specific risks of a cystoscopy include:
Bruising and swelling – you may have some bruising and swelling around your urethra from
the cystoscope being inserted. This should clear up after a few days. If it does not, please
contact us or your GP – you may temporarily need a catheter (narrow tube) placed in your
bladder to help drain your urine until the bruising and swelling go down.
Damage to the bladder – it is possible to damage or tear (perforate) your bladder with the
cystoscope or when taking a biopsy. This can lead to bleeding and infection, which may require
further surgery or temporary insertion of a catheter. Please refer to the leaflet, Having a urinary
catheter if this applies to you.
Bleeding - you may have a small amount of bleeding from the cystoscope being passed up the
urethra or from any biopsies taken. 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 (about
three liters spaced out over 24 hours) can help to clear your urine. If your urine remains pink
after a few days, please contact your GP.
Infection – there is a risk that you will develop a urine infection after your cystoscopy, which
could result in a fever and pain when you urinate. Drinking plenty of water after the procedure
can reduce the likelihood of this.
Are there any alternatives
Having a cystoscopy is the only way to diagnose some bladder conditions. Your doctor will
discuss any alternatives with you.
Before the examination
You will need to come to a pre-assessment clinic, where you will be seen by a nurse. The nurse
will complete some paperwork with you, take some blood tests and check your blood pressure.
On your arrival
You may be admitted to:
Day Surgery Unit
Surgical Admissions Lounge (SAL) or
a urology ward.
You may have your rigid cystoscopy in main theatres or the Day Surgery Unit.
You should have received a leaflet Surgical Admissions Lounges (SAL) and Day Surgery
Units (DSU). Please ask for a copy if you would like one.
When you arrive for your procedure, the nurse looking after you will show you around and will
complete all the necessary paperwork. She/he will need to monitor your blood pressure,
temperature, and pulse and will measure your legs for some special stockings called TEDs.
These help to reduce the likelihood of you developing a blood clot in your veins. All patients
going for surgery have to wear them.
Please make sure that you bring all of your medication with you to the hospital.
One of the teams of doctors in charge of your care will visit you before your procedure to ask you
to sign your consent form. You will also see an anesthetist who will run through what happens
in the anesthetic room with you. You should have been given a leaflet called Having an
anesthetic. If you have not received this, please ask a staff member for a copy.
You will need to fast before your procedure. Fasting means that you cannot eat or drink
anything (except water) for six hours before surgery. We will give you clear instructions when to
start fasting. It is important to follow these instructions. If there is food or liquid in your stomach
during the anesthetic it could come up to the back of your throat and damage your lungs.
On the morning of your procedure, you will be asked to remove all your clothing and change
into a gown. For your own comfort, we recommend that you bring your own slippers and
dressing gown with you to wear over the top of your theatre gown while you are waiting. The
nurse looking after you will run through a special checklist to make sure that you are all ready,
and when it is your turn, she will take you to the anesthetic room.
After your procedure, you may go back to either the Day Surgery Unit or a urology ward. You will
leave hospital from one of these locations once the nurses are happy with your recovery.
Please make sure you have someone to take you home as you will not be allowed to leave
without a friend or relative accompany you.
During the examination
You will be given a general anesthetic through a small needle inserted into the back of your
hand. This will make you sleep during the procedure, so you will not feel any pain or discomfort.
When the cystoscope has been passed into your bladder, the doctor may insert sterile water into
help see the lining of your bladder.
When the doctor has finished the examination, which generally takes about five to ten minutes,
the cystoscope will be gently removed. You will be taken to the recovery unit, where you will
stay until you wake up from the anesthetic.
Most patients can go home the same evening, as long as they are able to pass urine and their
doctor feels they are well enough to go home. However, you may need to stay overnight if you
have had a biopsy or required a catheter. If you are well enough to leave hospital on the day of
surgery you will need somebody to collect you.
Before you leave the hospital, your doctor will prescribe you with painkillers if you want them. You
may also be given antibiotics to reduce the risk of infection.
When will I get the results
The doctor may be able to tell you the results straight after the procedure. However, if you have
had any biopsies taken, these will need to be sent away for testing.
Will I have a follow-up appointment
You will be given an outpatient appointment for the following week to discuss the examination
and results of any biopsies and whether any further cystoscopy is required. Any results will also
be sent to your GP.
You will either be given the follow-up appointment before you leave the hospital or it will be sent to
you by post. The follow-up appointment will be discussed with you before you leave the hospital.
On your return home
You might feel dizzy and tired when you go home after the examination. Please rest for the
the remainder of the day and the following day to help you recover from the general anesthetic.
The anesthetic will take 24 to 48 hours to wear off, although you do not need to stay in bed for
this time. Gently moving around your home will help.
You may feel a stinging sensation or have difficulty passing urine for the first day or two. You
should drink extra fluid for the first 24 hours after the procedure to help with this. If the pain is
severe and lasts for more than two days, please contact your GP.
Will I need any dressings
You may want to wear a pad the day after your cystoscopy to protect your clothing from the
a small amount of bleeding you may have.
You may be prescribed antibiotics to reduce the risk of infection and it is important that you
complete the whole course. You must not drink any alcohol until you have finished the
antibiotics and your symptoms have completely cleared. You should also not have sexual
Intercourse until any swelling or bleeding has cleared – again, to reduce the risk of infection.
What if there are problems
Please do not hesitate to contact the ward if you still have the following symptoms a couple of
days after the operation:
continuous or excessive bleeding
passing blood clots
a raised temperature of 38oC (100.4F) or greater
difficulty passing urine.
Please call one of the urology wards for any advice about your operation:
Aston Key 0207 188 0709
Florence 0207 188 8818
If you think it is an emergency, please go straight to your nearest A&E department.