What is a Cystoscopy?

A cystoscopy is an examination of the inside of the bladder using a telescope-like instrument called a cystoscope. This instrument is carefully passed into the bladder via the urethra – the tube through which you pass urine.

When is a Cystoscopy Required?

A cystoscopy is the most efficient way of finding out what is causing your bladder-related symptoms. These include:

  • Passing blood in the urine – haematuria.

  • Difficulty in passing urine.

  • Changes in the way you normally urinate e.g. too frequently, too slowly.

  • Burning when you pass urine – dysuria.

  • Infections – especially if recurrent or in a man or child.

  • Incontinence.

  • Regular surveillance of bladder tumour.

Unfortunately there is no imaging modality – including ultrasound, CT scan etc. that can adequately image the bladder to allow accurate diagnosis, though they are often used in conjunction to help management of your condition.

How is Cystoscopy Performed?

Cystoscopy is usually performed as a day case procedure – occasionally an overnight stay is required, usually if an ancillary procedure was necessary.

The cystoscope is introduced to the bladder through the urethra and careful visual inspection of the bladder is performed. In the majority of cases if the cause of the symptoms is identified, the problem can be dealt with immediately.

A number of ancillary procedures may be required during your cystoscopy. These could include:

  • Biopsy – of a tumour, ulcer or suspicious area within the bladder.

  • Diathermy – often follows any biopsy to stop any bleeding or treat a small tumour.

  • X-ray – to examine the ureters (the tubes that connect the bladder to the kidneys) and the pelvicalyceal system (the inside of the kidney) known as: Retrograde Pyelogram (RGP).

  • Bladder injection e.g. Botox.

  • Hydrodistension – essentially “stretching” or manipulating the bladder to alleviate certain symptoms.

  • Removal of bladder stones – lithopaxy.

  • Urethrotomy – the opening of a scarred section of the urethra.

Possible Side Effects

Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications.


  • Mild bleeding or burning on passing urine for a short time after the procedure.


  • Insertion of an indwelling catheter – IDC. This is a tube passed through the urethra to empty your bladder. It is only a temporary measure.

  • Infection requiring antibiotics.

  • The finding of cancer or other abnormalities that may require further surgery or treatment.


  • Delayed bleeding requiring removal of clots or further surgery.

  • Injury to urethra causing delayed scar formation (urethral stricture).

  • Very rarely, perforation of the bladder requiring temporary insertion of a catheter or open surgical repair.