Cystoscopy

Before your cystoscopy

Be sure your doctor knows about any medicines you are taking, including vitamins, herbs, and supplements, as well as if you have allergies to any medicines.

You might be asked to stop taking blood-thinning medicines, including aspirin, for several days before the test to reduce your risk of bleeding. Your doctor might also ask you to adjust or stop other medicines as well, such as those for diabetes. If you normally take prescription medicines in the morning, talk with your doctor or nurse about how to manage them on the day of your test.

You might be asked not to eat or drink anything for at least several hours before the procedure. Or you might be told to only drink liquids. Your doctor or nurse will give you specific instructions. Be sure to follow them and to ask questions if there’s anything you don’t understand.

Making a transportation plan

If a sedative is used to help keep you more comfortable during the procedure, you will need to arrange for a ride home after the test.

You might be sleepy or dizzy and need someone to help you get safely into your home, so a cab or a ridesharing service might not be a good option. Some centers will not allow you to use a cab or rideshare after this procedure.

If transportation or help getting home might be a problem, talk with your health care provider. There might be other resources available, depending on the situation.

During your cystoscopy

Cystoscopy can usually be done as an outpatient procedure, where you don’t need to stay overnight in a hospital. Your doctor will review the procedure with you and ask you to sign a consent form.

You will be asked to empty your bladder and change into a hospital gown. For this test, you will lie on your back and you might have your feet up in stirrups. Your blood pressure, heart rate, and breathing will be monitored.

The doctor will apply numbing medicine around the opening of your urethra, and maybe inside the urethra as well.

You might get a sedative through an intravenous (IV) line to help you relax during the test. For a rigid cystoscopy, you might be given general anesthesia (where you are in a deep sleep) for the test.

The cystoscope will be placed into your urethra and up into your bladder. Sterile salt water is often injected through the cystoscope to fill your bladder and make the inner lining easier to see. If you’re awake, you might feel like you need to pee during the test. If any abnormal areas are seen, they can be biopsied at this time.

The procedure usually takes about 10 to 20 minutes, but it might take longer, depending on what’s being done.

Is a cystoscopy painful?

While the numbing medicine applied to the opening of the urethra helps reduce pain, people might feel some discomfort during a cystoscopy, depending on the type of sedation that is used.

For those undergoing flexible cystoscopy, often no more than a mild sedative is used and you are still awake during the procedure.

Rigid cystoscopy is often done with greater amounts of sedation:

• Conscious sedation helps you relax and be less aware of what’s happening. You might be awake or fall asleep.
• Deep sedation with general anesthesia is when you are fully asleep and closely monitored by an anesthesia specialist.

After your cystoscopy

After the procedure, you will be watched closely for any problems. If you had a sedative, you might not remember the procedure.

If you had the procedure as an outpatient, you should be able to go home after a few hours. If you were under general anesthesia during the test, you might need to stay at the center for a few hours before you are able to go home.

If you were given a sedative, someone will need to drive you home and stay with you until it wears off. Your doctor or nurse will give you specific instructions to follow after the test, including when to start taking medicines again that might have been stopped for the procedure.

You will likely be told to drink plenty of fluids after the procedure to help flush out the bladder. You might notice some blood in the urine. You might also have a burning sensation when peeing or feel like you need to pee often or suddenly for a day or two after the test.

If samples were taken, your results are usually ready within a few days, although some might take longer. You will need to follow up with your doctor after the procedure to get your results.

Possible risks of cystoscopy

Cystoscopy is usually safe, but there is a small risk of certain complications.

Bleeding: If a biopsy or brushing was done, a small amount of bleeding could happen where the doctor removed tissue samples.

Infection: In rare cases, you could get a urinary tract infection.

Injury to the bladder or urethra: The bladder or urethra can sometimes be injured during the procedure, leading to irritation or bladder spasms. Rarely, it can cause a small tear or hole in the bladder wall or long-term scarring (stricture) of the urethra.

Drug reactions: Sometimes the drugs used to help you relax and stay comfortable during the test can cause changes in blood pressure, confusion, dizziness, trouble breathing on your own, or even an allergic reaction. You will be watched closely for any medicine side effects, and they will be treatedurin if needed.

Some problems might go away on their own, but if they’re causing symptoms, they might need to be treated.

Before you go home, your doctor or nurse should give you specific instructions on when you might need to call the doctor’s office for problems. In general, these include:

• Fever

• Blood in urine that continues after 24 hours

• Pain or burning when peeing for a few days
• Cloudy or foul-smelling urine

Call 911 or go to the emergency room if you have: 

• Chest pain
• Shortness of breath
• Bright red blood or large clots in your urine
• Severe abdominal (belly) or pelvic pain
• Inability to pee

Be sure you understand what you should watch out for, the possible timing of when problems might occur, and when you should call about problems.