Please see letter for appointment details.
Please telephone the Endoscopy department on 01234 792269 if this is not convenient for you.
Please contact 07392 126603 if you would like to discuss any aspects of the procedure before your appointment.
If you have not attended a Pre Assessment appointment you will receive a phone call for you to be pre assessed over the phone. This may come through as an unknown number.
Introduction
You have been advised by your GP or hospital doctor to have an investigation known as Cystoscopy to help find the cause of your symptoms. We will need to have your formal consent before we can carry out this examination. This leaflet explains how the examinations are carried out and what the risks are. This will help you to make an informed decision when agreeing to the examinations. This leaflet may not answer all your questions so if you have any worries please don’t hesitate to ask.
What is a Flexible Cystoscopy?
A cystoscopy is a medical procedure that allows your doctor to inspect the bladder and the urethra. Your doctor will slowly insert a small tube affixed with a light and a lens into your uretha. The cystoscope acts like a telescope, allowing your doctor to visually examine your bladder and urethra.
An anaesthetic jelly may be used to numb your urethra.
The procedure takes about 5-10 minutes to complete.
Does it hurt?
People often worry that a cystoscopy will be painful, but it does not usually hurt. Tell your doctor or nurse if you feel any pain during it. It can be a bit uncomfortable and you may feel like you need to pee during the procedure, but this will only last a few minutes.
Reasons for Cystoscopy Procedure
A cystoscopy procedure helps your doctor diagnose, monitor and treat conditions affecting your bladder and urethra. Your doctor may recommend this procedure to:
- Inspect stones that are too large to pass (larger than 5 millimetres)
- Help diagnose the underlying cause of gross haematuria (visible blood in urine), microscopic haematuria (blood in urine visible only with a microscope), incontinence, overactive bladder, and painful urination.
- Look for an underlying reason for recurrent urinary tract infections, though the procedure is often postponed if there is an active infection.
- Diagnose an enlarged prostate. A cystoscopy allows your doctor to see if an enlarged prostate (BPH) is causing the urethra to constrict, resulting in urinary problems. Your doctor may also perform a cystoscopy before other BPH treatments like Rezum of surgery like TURP to take measurements and inspect the area. This will help your doctor evaluate the likelihood of procedure success and measure the effectiveness of the treatment.
- Diagnose bladder conditions, including bladder stones, bladder cancer and bladder inflammation.
What are the potential risks?
- Infection
- Excessive bleeding
- Blood in urine (haematuria)
- Pain with urination
- Temporary inability to urinate, which may require additional treatment (urinary retention)
How do I prepare for my Flexible Cystoscopy?
Please follow these instructions:
- Bring a sample of your urine in with you in a clear container
- You may eat and drink as usual, as only a local anaesthetic is used.
- Bring a dressing gown with you (optional)
- Let us know if you have any mobility problems that would make it difficult for you to transfer yourself onto the treatment couch
- Please bring a list of all your current medications
- The majority of patients can take themselves home after the procedure but if you are frail or infirm you may prefer to arrange an escort
What will happen when you arrive?
You should be able to drive to and from you appointment. You may prefer for someone you can contact if you are not feeling up to driving after your procedure.
Although this is an intimate procedure, the doctors and nurses will do their best to maintain your dignity as much as possible. We would like to make you aware that most flexible cystoscopies are performed by male doctors.
Please report to the reception written on your appointment letter on the day of your procedure. The nurse will test your urine sample, ask you some questions about your general health and take your blood pressure. Once all the checks have been carried out you will be asked to change into a gown. If possible please pass urine prior to your procedure as this helps the nurse or doctor have clearer views inside your bladder.
You will wait in a private room until it is time for you to go into the clinic room. The doctor or nurse carrying out your procedure will come and see you and go through the consent form with you.
When you are taken into the treatment room you will be asked to lie on the couch. In order to insert the camera into the bladder, female patients will be asked to adopt a similar position to that when having a smear test. A nurse will remain with you throughout the procedure. If you wish, you may watch the procedure on the screen.
Sometimes male patients may be asked to have a rectal examination to assess the prostate gland. This is done by the doctor or specialist nurse by inserting a finger into your bottom.
Female patients may require a vaginal examination. The doctor will gain verbal consent for any such additional examinations that need to be undertaken.
The doctor or specialist nurse will be able to tell you straight away what the findings of the cystoscopy were. They will also tell you if any further appointments or investigations are required.
What happens next?
After the procedure you will get taken back to your private room and be asked to go to the toilet to urine as well will have filled your bladder with sterile water. Some soft wipes will be available if you need to freshen up, you will then be able to get dressed.
A nurse will go through the discharge information, this includes receiving a clear post procedure leaflet and then you will be free to leave.
When you get home you may experience some discomfort when passing urine, however, this should settle within a day or so. You will be advised to drink extra fluids for 24 hours after the procedure.
An occasional problem after flexible cystoscopy is a water infection. If you have a temperature, severe pain, persistent burning or bleeding contact your GP immediately.
Potential risks
Complications are rare however a Cystoscopy can result in complications such as:
- An infection of either the bladder of urinary tract.
Please see your GP
Other symptoms can include:
- Abdominal pain
- Serious bleeding, (bright red blood or blood clots in the urine), this can cause difficulty in passing urine.
- Nausea
- Pain of burning on passing urine accompanied by fever and chills
- A need for the temporary insertion of a catheter
- Injury to the urethra causing delayed scar formation
If you experience any of these signs and symptoms please call your GP or attend the Accident and Emergency Department
Points to remember:
- If you are unable to keep your appointment please notify the Endoscopy unit as soon as possible
- It is our aim for you to be seen and investigated as soon as possible after your arrival. However the department is busy and your investigation may be delayed. If emergencies occur, these patients will obviously be given priority over less urgent cases.
- The hospital cannot accept any responsibility for the loss or damage of personal property during your time on these premises.
Concerns
If you have any queries regarding the procedure please contact the Endoscopy unit between 8am and 6pm Monday to Friday and the nursing staff will be happy to give you information or advice
FOLLOWING THIS PROCEDURE YOU MUST NOT DONATE BLOOD FOR 4-6 MONTHS
The reason for this is that your ability to donate blood in the future is dependent upon your diagnosis and the possibility that you might need to undergo further investigations or complete treatments (British Society of Gastroenterology, 2019).