What is a Flexible Cystoscopy?

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This information booklet has been designed for patients undergoing a Flexible Cystoscopy. It will explain to you exactly what this procedure entails and what will happen afterwards.

What is a Flexible Cystoscopy?
 A flexible cystoscopy is a routine examination of your bladder which is carried out using a flexible telescope (cystoscope). It is passed along your water pipe (urethra) and into your bladder.

Why do I need to have the procedure?
 This examination is carried out to find out the cause of any bleeding, pain or irritable urinary symptoms you may have been having. This is also carried out to monitor bladder pathology (i.e cancer) or remove stents from the kidney.

Who will carry out the procedure?
 This examination of your bladder is carried out by a Consultant or a Urology Associate Specialist to the Consultant. Once the procedure has been explained to you, you will be asked to sign a
consent form.

Will I need an anaesthetic for this procedure?
 You will not have a general anaesthetic for this examination. Local anaesthetic jelly is inserted into your urethra to make the examination comfortable.

Can I eat and drink before having the procedure?
 As you will not be having a general anaesthetic (put to sleep) you can eat and drink normally before you have your procedure.

Will I have to stay in hospital?
 You will not have to stay in hospital after the examination but you may need to rest for a short time before you go home.

What preparations are necessary?
 You may have an ultrasound scan in the X-Ray Department before your bladder examination (cystoscopy).
 If you require antibiotics prior to this examination i.e. you have a cardiac valve problem or are prone to urine infections please let us know when you arrive.
 On the day of your cystoscopy please bring with you a list of the medications you are currently taking and inform us if you are taking regular medication such as aspirin or blood-thinning
medication i.e. Warfarin.
 Please bring with you a replacement catheter, catheter bag or catheter valve if you are catheterised.

What happens during the procedure?
 A local anaesthetic jelly is used; it is put into your urethra (water pipe) before the flexible cystoscope is used.
 The flexible cystoscope is passed into your bladder and the bladder is very carefully examined for stones, tumours or abnormalities.
 Tiny samples of tissue (biopsy) may be removed for testing.
 The flexible cystoscope can also be used to remove a ureteric stent, if you have had one put in previously.
 The examination is performed in the Endoscopy Unit and only takes 5-10 minutes. You should not need to be at the hospital for more than an hour.

Risks and Benefits of the Procedure

Benefits
To diagnose and treat urethral and bladder disease.

Risks

Common
• Mild burning or bleeding on passing urine for a short time after the operation.
• Need to biopsy abnormal areas in bladder.

Occasional
• Infection of bladder requiring antibiotics.

Rare
• We may need a temporary catheter inserted if you are unable to pass water after the procedure.
• Slight bleeding may occur following the procedure which may require the removal of clots or further surgery.
• Injury to the urethra causing delayed scar formation due to instrumentation damage during procedure.

Alternative Therapy:

General Anaesthetic Cystoscopy
 Further treatment may be necessary but this will be carried out at a later date.

When can I go home?
 When you feel ready you can go home. You can drive home afterwards.
 Before you go the doctor/nurse will explain to you what has happened and if you need further treatment, and when you will be seen again.

How will I feel after the procedure?
 Afterwards you may feel a little uncomfortable; you may also notice blood in your urine for the first few times you pass urine. Drink plenty of fluids and this should settle.
 If you develop burning, cystitis (infection) or the bleeding continues for more than 24 hours, when you have been home for a day or two you may need some antibiotics and you should contact your General Practitioner (GP).

Please read this leaflet carefully so that you understand what will happen to you during the examination and what follow-up has been arranged for you.

Urology Consultants: Mr H Andrews
Urology Nurse Practitioner: Sonia Harrington

We hope this leaflet has been of help to you, but if we have omitted anything please let us know.