A flexible cystoscopy is a simple and safe procedure that allows your urologist to examine the inside of your urethra and bladder using a narrow, flexible fibre-optic telescope (approximately 5 mm wide).

This procedure is often performed under local anaesthetic (in the form of a gel inserted into the urethra), but may also be done with light sedation. It is a day procedure, meaning you can go home the same day.

Who May Need a Flexible Cystoscopy?

You may be referred for a flexible cystoscopy for a number of reasons, including:

  • Investigation of blood in the urine (haematuria)
  • Ongoing surveillance after treatment for bladder cancer
  • Assessing for blockage or obstruction in the urinary tract
  • Removal of a ureteric stent
  • Bladder biopsy
  • Investigation of other bladder or lower urinary tract symptoms

Benefits of Flexible Cystoscopy

  • A quick, simple and minimally invasive diagnostic procedure
  • Can be performed with local anaesthetic or light sedation
  • Typically completed in 5–10 minutes
  • Provides valuable insights into the bladder and urethra anatomy
  • Can assist with diagnosis, monitoring, and treatment planning for urinary tract conditions

How Is the Procedure Performed?

  • A local anaesthetic gel is inserted into the urethra to minimise discomfort. Some patients may receive light sedation instead.
  • A flexible cystoscope is gently passed through the urethra and into the bladder.
  • The bladder is filled with sterile saline fluid to allow a clear view during the procedure.
  • You may feel a sense of bladder fullness and some mild discomfort.
  • The entire procedure typically lasts 5–10 minutes.
  • If sedation is used, you must arrange for someone to drive you home.

What to Expect After the Procedure

  • You may feel the need to urinate immediately due to the bladder being filled during the procedure.
  • Burning or stinging when passing urine is common and usually settles in a day or two.
    • Tip: Ural sachets (available over the counter) can help relieve symptoms.
  • Mild blood in the urine may occur for a few days—this is common and usually resolves with increased fluid intake.
  • You may experience urinary urgency, frequency, or nocturia (waking at night to urinate) for a few days.
  • You may resume normal activities unless otherwise advised by your urologist.
  • The results of the cystoscopy will be discussed with you before discharge, and any necessary follow-up will be arranged.

Post-Operative Care Instructions

Symptoms to Expect

  • Burning and stinging with urination for up to a few days
  • Blood in the urine, which may be intermittent
  • Urgency and frequency of urination
  • Bladder fullness immediately after the procedure

Returning to Normal Activities

  • Driving: Do not drive for 24 hours if you received sedation
  • Work: Most patients can return to work the following day
  • Exercise and lifting: No restrictions unless advised otherwise
  • Sexual activity: No restrictions unless advised otherwise

Pain Relief and Medications

  • You may take Ural sachets to ease burning or discomfort when urinating.
  • Paracetamol may also be used if needed for discomfort.

When to Seek Urgent Medical Attention

Go to your nearest emergency department if you experience:

  • Inability to urinate
  • Fever, chills, or shakes, which may indicate an infection