Flexible Cystoscopy

What is Flexible Cystoscopy?

Flexible cystoscopy is a medical procedure used to examine the inside of the bladder and urethra using a flexible, thin tube (a modified catheter) with a camera called a cystoscope. This minimally invasive procedure helps diagnose and treat various urinary conditions, such as recurrent urinary tract infections, blood in urine (haematuria), urinary blockages, and bladder abnormalities. It is also commonly used for surveillance after treatment of bladder cancer.

Flexible cystoscopy can be performed under local anaesthetic or under sedation (twilight anaesthetic).

Before the Procedure:

Before undergoing flexible cystoscopy:

1. Preparation: If you are having sedation, you will need to fast (no food or fluids) for 6 hours before your procedure. You can still take medication with a sip of water. We will advise you about any medications to withhold (usually diabetic medications and some blood pressure medications).

2. Arrangements: Arrange for someone to drive you home after the procedure if you are having sedation.

During the Procedure:

During the flexible cystoscopy:

1. Anaesthesia: Most patients will have sedation (twilight anaesthetic) given by an anaesthetist, who will discuss this with you beforehand. You will also receive a local anaesthetic gel into the urethra, which is given while you are asleep. If you elect to have the procedure awake, the local anaesthetic gel will be given before the cystoscopy.

2. Insertion of Cystoscope: The flexible cystoscope is gently inserted through the urethra (urine passage) and advanced into the bladder. Fluid (saline) is instilled into the bladder to help fill it to allow the surgeon to see.

3. Examination: The camera at the tip of the cystoscope allows your surgeon to visualise the bladder and urethra, identifying any abnormalities or conditions.

4. Treatment (if necessary): Some problems, if identified, can be treated using flexible cystoscopy. Urethral strictures (narrowings of the urethra caused by scar tissue) can be dilated, a catheter can be placed, and the bladder can be washed out. Injections to treat overactive bladder can also be given. However, if more significant problems are found such as bladder stones or bladder tumours, your surgeon will discuss having a further procedure under general anaesthetic.

Recovery Expectations:

After flexible cystoscopy, you can expect the following:

1. Post-Procedure: You may experience mild discomfort or a burning sensation when urinating, which should improve within a day or two.

2. Urination: It is common to experience some frequency and urgency to urinate for a short period after the procedure. This usually subsides within a day or so. You may also have a small amount of blood in the urine for a couple of days.

3. Fluid Intake: Drink plenty of fluids to help flush out any blood.

4. Physical Activity: There are no restrictions on activity after flexible cystoscopy.

5. Return to Work: Most patients can return to work the next day after flexible cystoscopy.

6. Follow up: Your surgeon will make a plan for follow up, and will see you before you go home.

Potential Risks and Complications:

Flexible cystoscopy is a very safe procedure, and serious complications are very rare:

- Urinary Tract Infection (UTI): The procedure can sometimes introduce bacteria into the urinary tract, leading to a UTI. Inform your surgeon if you experience symptoms such as burning during urination, frequent urination, or fever.

- Bleeding: Some patients may experience minor bleeding after the procedure, especially if biopsies or treatments were performed. It is usually mild and resolves on its own. Drink fluid to flush any blood through.

If you think you may require a flexible cystoscopy, Mr Sewell can perform these on short notice for both insured and uninsured patients. Please contact reception and we will be happy to organise an appointment for you.