Cystocsopy is the most important test for diagnosing cancer of the bladder. Find out why and how you have it.
What it is
Cystoscopy is a test to look at the inside of your bladder. The doctor uses a thin, flexible tube called a cystoscope to do this.
A cystoscopy is a test to look at the inside of your bladder. The bladder stores urine and when we empty it the urine passes from the bladder down a tube called the urethra and out of the body.
The urethra in men passes through the prostate gland and down the penis.
In women the urethra is much shorter and passes from the bladder down to an opening just in front of the vagina.
You have the test lying on your back on a couch. The doctor cleans around the opening to the bladder.
Then they put anaesthetic jelly into the tube where urine comes out. This doesn’t hurt but can be uncomfortable.
Once the anaesthetic has worked they put a long flexible tube called a cystoscope into the opening and up into the bladder.
You may find this uncomfortable and feel like you need to pass urine. The doctor puts water in through the scope to make it easier to see the bladder wall
The tube has a light and a camera on the end. This sends pictures to a monitor.
Looking at the monitor they examine your bladder. If they see any abnormal areas they take a tissue sample. This is called a biopsy.
After the test you may have some soreness when you pass urine. Drink plenty of fluids to help prevent infection. You may need to take antibiotics.
Contact the hospital if you have pain or bleeding which becomes worse or lasts longer than two days or if you have signs of infection such as a fever or needing to pass urine more often.
How you have it
Your doctor may use a thin, flexible tube to check inside your bladder. This is called a cystoscopy.
The thin tube is called a cystoscope. It has optic fibres inside it, and a light and eyepiece at one end. The doctor can see down the cystoscope to look at the pictures. These may also be shown on a TV monitor.
The doctor can also pass small instruments down the cystoscope to take samples of tissue (biopsies) from the lining of your bladder, if needed.
You can have a cystoscopy under a local or general anaesthetic, depending on what the doctor needs to do.
This test only takes a few minutes. You usually have it during an outpatient appointment.
You need to undress your lower half and may have a gown to put on. Then you lie on your back on the bed or couch.
The doctor places a sterile sheet over you. They 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. This doesn't hurt but can feel uncomfortable.
Once the local anaesthetic works, the doctor puts the cystoscope into your bladder. They fill your bladder with sterile water. You might feel like you need to go to the toilet.
Then the doctor moves the tube around so they can examine the whole of the inside of your bladder.
After the test
There are usually no after effects apart from some discomfort when you pass urine for the first time.
If the test shows anything that looks abnormal, your doctor will arrange for you to go into hospital for a cystoscopy under general anaesthetic. This is so they can take tissue samples (biopsies).
The doctor or nurse might give you antibiotics to take. You should drink plenty for the next couple of days to prevent infection. It’s important to take the antibiotics as prescribed.
You go to hospital for this test, usually on the day. You are asked not eat or drink anything for at least 6 hours before the cystoscopy.
You may need a blood test and a chest x-ray before the cystoscopy. This is normal for anyone having a general anaesthetic.
You then put on a hospital gown and lie down on the theatre trolley. The trolley is wheeled to the operating theatre, where you have the anaesthetic.
In some hospitals, you may have a spinal anaesthetic instead of a general anaesthetic. This is an injection into your spine (epidural) so you can’t feel anything from below your waist. You may also have some antibiotics before the test.
Your specialist thoroughly examines the inside of your bladder and urethra using the cystoscope while you’re under anaesthetic. They take samples of tissue (biopsies) from any areas that look abnormal. They also take biopsies from areas that look normal, to compare them with. This helps to make sure of the diagnosis.
The sampled areas are then sealed with a hot probe (cauterised) to help stop any bleeding.
After the test
You can usually go home the same day. This depends on:
- how many biopsies were taken
- how you react to the anaesthetic
- the time of day you have the anaesthetic – if it’s very late in the day, it may be better to stay overnight
If there are large tumours which need treatment, you may need to stay longer. You may also need a tube into your bladder (catheter) to drain urine for a few days after the operation.
Cystoscopy for a woman
Why you have it
You may also have a cystoscopy if you’re having investigations for other types of cancer. This is to see if it’ spread to the bladder.
You may have a cystoscopy to investigate:
- cervical cancer
- ovarian cancer
- rectal cancer
- vulval cancer
- vaginal cancer
- kidney cancer
- prostate cancer
- womb (uterine) cancer
Getting your results
Your scan will be looked at by a specialist doctor and you should get your results within 1 or 2 weeks. You won't get any results at the time of the scan.
Waiting for test results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after a couple of weeks.
You might have the contact details for a specialist nurse. You can contact them for information and support if you need to. It may help to talk to a close friend or relative about how you feel.
Contact the doctor that arranged the test if you haven't heard anything after a couple of weeks.