Is a flexible cystoscopy painful?

Most patients experience temporary discomfort, pressure or an urge to pass urine rather than significant pain. The procedure usually takes only a few minutes. Please tell the clinical team if you feel uncomfortable at any point.

Do I need an anaesthetic?

Flexible cystoscopy is usually performed using local anaesthetic gel applied to the urethra. A rigid cystoscopy is normally performed with sedation, spinal anaesthesia or general anaesthesia, depending on the procedure planned and your individual circumstances.

Can I drive after a cystoscopy?

You can usually drive after a flexible cystoscopy performed with local anaesthetic, provided you feel comfortable and have received no sedation. After sedation or general anaesthesia, you must not drive and should arrange for someone to accompany you home. Follow the specific instructions provided by your clinical team.

Is blood in the urine normal afterwards?

A small amount of blood in the urine and mild burning may occur for 24–48 hours after cystoscopy. Seek medical advice if bleeding becomes heavy or persistent, you pass blood clots, develop a fever, experience worsening pain or are unable to pass urine.

When will I receive the results?

The appearance of the bladder can usually be discussed immediately after the procedure. If a biopsy or other tissue sample is taken, the final result will be available later once it has been examined by a pathologist. Your clinical team will explain when and how you will receive it.

Private Cystoscopy in London

Private flexible and rigid cystoscopy procedures are available in London with Dr Carlo Bravi, Consultant Urologist.

Cystoscopy, also called bladder endoscopy, allows the urethra and inside of the bladder to be examined using a slender instrument equipped with a light and camera. Flexible cystoscopy is commonly used to investigate blood in the urine, recurrent urinary infections, unexplained urinary symptoms or abnormalities identified on scans. It is normally performed in an outpatient setting using local anaesthetic gel and usually takes only a few minutes. Rigid cystoscopy is performed in an operating theatre when a biopsy or treatment may be required. Depending on the planned procedure, it may be undertaken under sedation, spinal anaesthesia or general anaesthesia.

Procedures that may be performed through a rigid cystoscope include:

Transurethral resection of bladder tumour (TURBT): removal of a bladder tumour or suspicious area for treatment and histological examination.
Transurethral cystolitholapaxy: fragmentation and removal of bladder stones.
Urethrotomy: endoscopic treatment of selected urethral strictures.

Private consultations are available in London and Northampton. Cystoscopy procedures are undertaken privately in London.

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Why Might You Need a Cystoscopy?

Dr Bravi may recommend a bladder endoscopy if you are experiencing:

Blood in the urine (haematuria), to investigate possible causes, including bladder abnormalities or cancer.
Frequent urinary tract infections (UTIs)
Urinary urgency or frequency
Painful urination or difficulty emptying the bladder

Cystoscopy is also used to monitor patients with a history of bladder cancer or investigate abnormalities seen on scans or urine tests.

What to Expect During the Procedure

What you can expect varies depending on whether a flexible cystoscopy (usually diagnostic) or a rigid cystoscopy (often interventional) is performed. The key differences between these two procedures are summarised below.

Flexible cystoscopy

Setting: In the clinic with local anaesthetic gel applied to the urethra.

Flexible cystoscope prepared in a private outpatient urology procedure room.

Process: A flexible cystoscope is gently passed through the urethra into the bladder. Sterile water is used to fill the bladder for better visibility.

Duration: Typically takes 5 to 10 minutes.

Patient experience: May feel slight discomfort or pressure but generally not painful. Patients can watch the procedure on screen if desired.

Aftercare: Go home immediately; mild burning or slight bleeding for 24–48 hours is common. Drink plenty of fluids; resume normal activities same day.

Rigid cystoscopy

Setting: In the operating theatre under sedation or general anaesthesia.

Rigid cystoscope prepared on a sterile instrument trolley in an operating theatre.

Process: A rigid cystoscope is inserted through the urethra into the bladder. Sterile fluid is used to gently fill the bladder and allow its lining to be examined clearly.

Duration: Typically takes 15 to 45 minutes, depending on the complexity.

Patient experience: Post-procedure discomfort expected; mild to moderate burning, urgency, and slight bleeding common for several days.

Aftercare: Monitored post-procedure until sedation wears off; avoid strenuous activity for a few days; pain management and follow-up as advised.

Risks and Possible Side Effects

Temporary burning when passing urine, urinary frequency and a small amount of blood in the urine may occur after cystoscopy. Less commonly, patients may develop a urinary infection, difficulty passing urine or more significant bleeding. The risks vary depending on whether the procedure is flexible or rigid and whether a biopsy or treatment is performed.

You should seek medical advice if you develop a fever, worsening pain, an inability to pass urine, persistent heavy bleeding or blood clots.

What happens after the procedure?

The findings can often be discussed immediately after the procedure. If a biopsy or tissue sample has been taken, the final result will become available after examination by a pathologist.

Further management may include reassurance, medication, imaging, repeat cystoscopy or another procedure. Dr Bravi will explain the findings, expected recovery and any recommended follow-up.

Frequently Asked Questions

If you are experiencing urinary symptoms, have noticed blood in your urine or have been advised to undergo a cystoscopy, Dr Carlo Bravi offers private urology consultations in London and Northampton. Private cystoscopy procedures are undertaken in London.

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