This page is about a bladder examination called a cystoscopy. You can find the following information
What is a cystoscopy?
A cystoscopy is a test to look at the inside of your bladder. It can diagnose bladder cancer and find out if other cancers have spread to the bladder. You may have a cystoscopy under a local or general anaesthetic depending on what your doctor needs to do. The doctor looks inside the bladder using a thin, flexible tube with an eyepiece on the end called a cystoscope.
Cystoscopy under local anaesthetic – you have this as an outpatient with no special preparation beforehand. You wear a gown and lie on a couch. Your doctor squeezes some local anaesthetic into the tube where your urine comes out (urethra). Then they put the cystoscope into your bladder through your urethra. It should not hurt but can be uncomfortable. The test takes a few minutes.
Afterwards you can go home. You may have some discomfort when you first pass urine. If the test shows anything abnormal your doctor will arrange for you to have a cystoscopy under general anaesthetic.
Cystoscopy under general anaesthetic – you usually go into hospital on the day of the test. You shouldn’t eat or drink for about 6 hours before the test. You change into a gown and go to the operating theatre where you have the anaesthetic. Your doctor will examine your bladder and take samples of tissue (biopsies) from any areas that look abnormal.
Most people go home on the day of the test. You may need to stay either overnight or for a few days if your doctor takes several biopsies or you have large tumours which need treatment. You may also need a tube in your bladder (catheter) to drain your urine for a few days.
After these tests you may take antibiotics for a few days to prevent infection. Your doctor or nurse will also tell you to drink plenty for a day or two after the test.
You may have the results within a few days. If you had biopsies the results will take longer. Contact your doctor if you have not heard anything after a couple of weeks.
Cystoscopy is a test to look at the inside of your bladder using a thin, flexible tube called a cystoscope. A cystoscope has optic fibres inside it and a light and eyepiece attached to it. Through the eyepiece, your doctor can see down the optic fibres and into the inside of your bladder. The pictures may also be shown on a TV monitor. If necessary, the doctor can pass small instruments down the cystoscope to take samples of tissue (biopsies) from the bladder lining. You can have a cystoscopy under local or general anaesthetic, depending on what the doctor needs to do.
View a transcript of the video showing what happens when you have a cystoscopy. (Opens in a new window)
Cystoscopy for a man
Cystoscopy for a woman
This is the most important test for diagnosing cancer of the bladder. You may also have a cystoscopy if you are having investigations for other types of cancer, to see if there is any spread to the bladder. You may have a cystoscopy to investigate
You usually have this during an outpatient appointment. You will need to undress your lower half and may have a gown to put on. You will have to lie on your back on the bed or couch. The doctor will place a sterile sheet over you. They will clean the area and squeeze some anaesthetic jelly into the tube where your urine comes out (your urethra). In men, this means squeezing the jelly down the penis. It doesn't hurt but can feel uncomfortable.
After waiting a few moments for the local anaesthetic to work, the doctor puts the cystoscope into your bladder. They fill your bladder with sterile water. This may make you feel like you need to go to the toilet. The doctor moves the tube around so that they can examine the whole of the inside of your bladder.
The whole test only takes a few minutes and there are usually no after effects apart from some discomfort passing urine for the first time. If anything looks abnormal, your doctor will arrange for you to go into hospital for a cystoscopy under general anaesthetic so that they can take biopsies. The doctor or nurse may give you antibiotics to take, and will ask you to drink plenty for the next couple of days. This is to prevent infection. It is important to take the antibiotics as prescribed.
For this test, you have to go into hospital. You will probably not have to go in until the day of the test. You will be asked not to eat or drink anything for at least 6 hours before you have the test.
You may have a blood test and a chest X-ray first. This is routine for anyone having a general anaesthetic. Then you will put on a hospital gown and lie down on the theatre trolley. The trolley is wheeled down to the operating theatre, where you have the anaesthetic. In some hospitals, instead of a general anaesthetic, you may have a spinal anaesthetic instead. The anaesthetist puts an injection into your spine (epidural) so that you cannot feel anything from below your waist. You may have some antibiotics before the test.
While you are under anaesthetic, your specialist will thoroughly examine the inside of your bladder and urethra using the cytsoscope. They will take samples of tissue (biopsies) from any areas that look abnormal. Your doctor may also take random biopsies from areas of bladder lining that look normal. This helps to make sure of the diagnosis. The biopsied areas are sealed with a hot probe afterwards (cauterised) to help stop any bleeding.
You can usually go home the same day. This will depend on
- How many biopsies were taken
- How you react to the anaesthetic
- The time of day you have the anaesthetic – if it is very late in the day, it may be better for you to stay overnight
If there are large tumours which need treatment, you will need to stay longer and you may need a catheter (a tube into the bladder to drain urine) for a few days after the operation.
Most people do not have problems after having a cystoscopy but as with any medical procedure, there are possible risks. You may have mild burning or stinging when you pass urine. It may also look slightly blood stained. This may last a day or two. Drinking plenty should help with this. You should contact the hospital if you are still bleeding 48 hours after your test, the bleeding is getting worse or there are blood clots in your urine.
There is a small risk of infection. Symptoms can include
- Going to the toilet more often
- Burning and stinging when passing urine
- High temperature
- Feeling hot and cold or shivery
- Cloudy or offensive smelling urine
- Generally feeling unwell
If you think you have an infection, you should go to your GP. They can prescribe antibiotics to treat the infection.
Rarely, you may have difficulty passing urine after cystoscopy. If this happens, you may need a catheter for a short time. There is also a risk of delayed bleeding and damage to the bladder wall or urethra.
It can take time for test results to come through. How long will depend on why you are having the test. You may get the results within a couple of days. But if you have had biopsies taken, you won't get your results until these specimens have been fully examined. This takes at least a week. The biopsy report will be sent to your specialist, who will then give the results to you. If your GP has sent you for the test, the results will be sent directly to their surgery.
Understandably, waiting for results can make you anxious. If your doctor needs the results urgently, they can make a note of this on the test request form, and the results will be ready sooner. Try to remember to ask your doctor how long you should expect to wait for the results when you are first asked to go for the test. If it is not an emergency, and you have not heard after a couple of weeks, ring your doctor's secretary or GP to check if the results are back.
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