What is Cystoscopy? Preparation, Risks and Recovery

Your doctor may recommend a cystoscopy for several reasons, but the most common are urinary issues such as the constant need to urinate or painful urination. There are other issues that may require a cystoscopy too, such as:  

• Blood in urine  

• Recurrent or chronic UTIs  

• Overactive bladder   

• Pelvic pain  

• Pelvic pressure  

Cystoscopy can reveal various issues within the bladder, including:   

• Cancerous tumours  

• Noncancerous growths  

• Blockages   

• Enlarged prostate   

• Issues with the ureters    

Cystoscopy can also be used to take a biopsy of bladder tissue for further testing.  

Your doctor should clearly explain to you the purpose of your examination and why it is necessary. If you’re unsure on why you’re undergoing a cystoscopy, do talk to your doctor – they’ll be more than happy to explain why the procedure is necessary.  

Preparing for a cystoscopy procedure can involve several different steps depending on your personal health status. There’s no need to be anxious – try to remember that this is a minor and routine procedure.  

Cystoscopy works by inserting a thin tube, with a camera and light on the end, into the bladder via the urethra. This allows for inspection of the inside of the bladder to help diagnose various urinary health issues. 

If you’re suffering from a UTI or have weakened immune system, you may be required to provide a urine sample before your cystoscopy. 

• You may also be prescribed antibiotics before the procedure to help prevent a UTI from occurring due to the cystoscopy. This is necessary to reduce the risk of infection, as although the cystoscope is sterilised, it can still transfer bacteria from outside your body or lower part of your urethra further into the urinary system. 

• You should make sure that you are able take any regular medication before and after the procedure, as some medications may need to be temporarily paused in certain circumstances. This should be discussed with your doctor and planned for with their guidance.  

• If you are going under general anaesthetic, you may need to arrange to be collected after your surgery as you won’t be able to drive yourself home. You should allow yourself time after the procedure to rest and recover and shouldn’t head straight back to work or undertake any strenuous activity.  

• During recovery after cystoscopy, you may experience some urinary issues and localised pain. We recommend keeping some TENA incontinence products such as incontinence pads or underwear on hand, as these can help give you peace of mind, and make you feel more comfortable throughout your recovery.  

Anaesthesia for a cystoscopy 

Not all cystoscopy procedures take place in the hospital or use the same type of anaesthetic. However, you will have to undergo some form of anaesthetic and should discuss your options with your doctor. The main types of anaesthetic options are:  

• Local Anaesthetic – If you’re being treated at your local doctor’s surgery, or as an outpatient, you’re likely going to be awake for the procedure. This will involve use of local anaesthetic to numb a very specific area of your body, meaning you will be able to eat and drink normally on the day of the procedure and go home straight afterwards.  
• Regional Anaesthetic – Regional anaesthesia will numb a larger area of the body and can be administered into the back, numbing you below the waist. This is a more significant anaesthetic, meaning you may need to stay at the hospital for a while after while the anaesthetic wears off.  
• General Anaesthetic – This form of anaesthesia will mean you are unconscious for the procedure. You may not be able to eat for some time beforehand and will need time to recover from the effects of the anaesthetic. You won’t be able to go home straight afterwards, as you’ll need time to recover.  

If you’re nervous about your cystoscopy, it can be helpful to learn more about what happens during the procedure, so you’re not surprised by anything.  

1. The first thing you’ll need to do before the procedure begins is to empty your bladder. You will then change into a hospital gown and get comfortable on the treatment table. UTIs after cystoscopy can be problematic, so at this point you may be given an antibiotic to help prevent this.  
2. You will then be administered the anaesthetic planned for you (either local, regional, or general). A numbing gel will be applied to the urethra also. It’s important to note that you may still have some reduced sensation unless you’re under general anaesthetic.  
3. The doctor will then lubricate the cystoscope and will begin to insert it into the urethra. The sensation may burn slightly and may cause a sensation similar to urinating or the urge to urinate. The type of cystoscope used can vary depending on the purpose of the examination. For an exploratory procedure, a flexible cystoscopy will be performed, but for a biopsy a slightly thicker, rigid cystoscopy is needed. The rigid cystoscope can cause a little more discomfort.  
4. Once inside the urethra, the cystoscope will enter the bladder and a sterile liquid will flood it. This helps the doctor to make their observations. When this fluid enters your bladder, it may feel strange, or like you need to urinate.  
5. The entire process may only take 5 minutes whilst under local anaesthetic, but if you go under general anaesthetic, the procedure can take 15 to 30 minutes.  

Almost all types of medical procedure come with some  risks, and a cystoscopy is no different. Thankfully the risks are usually minor. A few of the most common minor side effects of cystoscopy are that you may experience:  

• Burning sensation when urinating  
• Needing to urinate more frequently (don’t attempt to resist the urge to urinate as any blood left in your bladder could clot causing a blockage.)  
• Blood in the urine  

These typically last no more than 2-3 days after the cystoscopy examination.  

More serious cystoscopy risks include:  

• Swollen Urethra (urethritis) – This is a common complication and can make urination very difficult or uncomfortable. If you’re still unable to urinate 8 hours after the procedure, seek urgent medical assistance.   
• Infection – While uncommon, it is possible to get a UTI from cystoscopy. If you come down with a fever, nausea, or are experiencing pain in the lower back, you may have an infection. Contact your doctor for antibiotics to help clear the infection and aid your recovery.  
• Bleeding – If you are bleeding a lot or it isn’t stopping, seek medical assistance urgently.  
• High fever – If you develop a high fever, you should seek medical assistance urgently.  
• Blood or clots in the urine – You should also seek medical help of you notice bright spots of blood or clots of blood in the urine.  
• Stomach pain – If you experience stomach pain after a cystoscopy you should also seek medical help.  

   

This is a natural concern when getting a cystoscopy.  

The level of sensation you have during a cystoscopy will vary depending on various factors mentioned above, such as the type of cystoscopy and the anaesthesia you are given (as highlighted above).  
  
If you are under general anaesthetic, you will be unlikely to have any sensation during a cystoscopy, and so the procedure is unlikely to hurt while its underway. However, you may have some discomfort after the procedure is complete. General anaesthetic can also make people feel unwell for a time once they are awakened.  

If you are only given local anaesthetic, you may still have some sensation during the cystoscopy, which may burn slightly or feel similar to urinating, but your sensation should be substantially reduced.   

If you are concerned about this, make sure to discuss your options with your doctor and get clarity from them to reduce stress and concern.  

Prioritising your recovery after cystoscopy is  important, as this will help reduce the risk of complications or side effects from the procedure.   

There are a few things you can do to aid your recuperation:    

• Drink plenty of water and urinate as often as you need to.   
• You can relieve some of the discomfort by laying a warm, damp washcloth/flannel over your urethra.   
• Using TENA incontinence pants can also help give you deal with any incontinence issues that may occur after the cystoscopy procedure.  
• If you have been given permission by your doctor, you can take certain painkillers, but make sure they have given explicit permission. 

What can you not do after a cystoscopy? 

If you were given a general anaesthetic, recovery after cystoscopy can take a day or two. You may feel drowsy or tired and should not use heavy machinery or drive in this condition. Ideally you should have someone look after you.  

If you had a biopsy, you should not have sex or perform heavy lifting for at least two weeks and should consult your doctor before resuming these activities.  

Cystoscopy results can take anything from a few days to a few weeks to come back, depending on the specific aim of the procedure. Biopsy results take the longest to come back, but if its taking too long you should ask your doctor for N updated. 

We hope that learning more about what cystoscopy involves will make the procedure less stressful and worrisome for you. If you’re suffering from urinary issues you can learn more how TENA can support you in dealing with them, whether it’s UTIs or incontinence. 

We also have a wide range of TENA pads and incontinence products for men and women that you should consider stocking up on ahead of your procedure, to ensure you have all you need to feel comfortable while recovering. 

Sources:  

1. https://www.nhs.uk/conditions/cystoscopy/ 

2. https://www.mayoclinic.org/tests-procedures/cystoscopy/about/pac-20393694  

3. https://www.webmd.com/prostate-cancer/guide/cystoscopy