What is a cystoscopy?

A cystoscopy is a procedure to examine the inside of your urinary bladder and urethra. Your urethra is the tube that carries urine from your bladder to the outside of your body. Your doctor may recommend a cystoscopy to diagnose problems with your bladder or urethra, including bladder cancer, obstructions, and infections.

A cystoscopy is only one method used to diagnose diseases and conditions of the urinary bladder and urethra. Discuss all of your diagnostic options with your doctor to understand which options are best for you.  

Types of cystoscopy

A cystoscopy uses a cystoscope to see the inside of the bladder and urethra. A cystoscope is a thin, lighted tube with a tiny camera at the tip. The types of cystoscopy include:

  • Flexible cystoscopy is the most common type of cystoscopy. It uses a flexible or bendable cystoscope. A flexible cystoscopy is generally more comfortable for patients, but may not be the best choice for complex procedures.
  • Rigid cystoscopy uses a rigid or unbendable cystoscope. A rigid cystoscopy causes more discomfort, but it allows the doctor to use a variety of instruments to instill fluids or remove tissue samples or foreign objects. 

Other procedures that may be performed 

Your doctor may perform diagnostic procedures in addition to a cystoscopy. These include:

  • Imaging exams, which include cystography (bladder X-ray using a contrast agent), X-ray of the kidney, ureters and bladder (KUB), and computed tomography (CT) scan
  • Tissue biopsy, which involves removing a sample of cells or tissues and testing it for cancer and other diseases
  • Ureteroscopy, which uses a longer and thinner tube to examine your ureters. Ureters are the tubes that carry urine from your kidneys to your urinary bladder.
  • Urodynamic studies, which include cystometry to evaluate the function of the bladder and urinary system

Why is a cystoscopy performed?

Your doctor may recommend a cystoscopy to diagnose diseases and conditions of the urinary tract including:

  • Blockages of the urinary tract including strictures (narrowing) and prostate enlargement
  • Congenital (present at birth) abnormalities including intersex abnormalities
  • Frequent urinary tract infections (UTIs) including frequent bladder infections
  • Injuries including traumatic injury to the urinary tract
  • Tumors including benign growths or polyps and cancer of the bladder or prostate gland
  • Urinalysis abnormalities including blood or abnormal cells in the urine
  • Urinary incontinence including overactive bladder 
  • Urinary symptoms including painful urination, painful bladder, or frequent or urgent urination
  • Urinary tract stones including bladder stones

Who performs a cystoscopy?

A urologist or sometimes an obstetrician-gynecologist (for women) performs a cystoscopy. Urologists are internists or pediatricians who specialize in diseases and conditions of the genitourinary tract. Obstetrician-gynecologists specialize in the medical and surgical care of the female reproductive system.

How is a cystoscopy performed?

Your cystoscopy will be performed in a doctor's office, hospital or outpatient setting. The procedure takes about 30 minutes and generally includes these steps:

  1. You will dress in a patient gown. You will lie on your back on a procedure table with your knees raised and apart.
  2. You may have a medication (a light sedative) to make you drowsy and relaxed, and possibly a pain medication. You may also have deeper sedation or anesthesia, in which you are more relaxed and unaware of the procedure and may not remember it.
  3. Your team will apply a local anesthetic to your urethra to numb it.
  4. Your doctor will gently slide the cystoscope into your urethra and advance it into your bladder.
  5. Your doctor may instill fluid through the cystoscope into your bladder in order to better view the lining of your bladder and urethra.
  6. Your doctor will examine the urethra and bladder and possibly perform treatments or take a biopsy.
  7. Your doctor will gently remove the cystoscope.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel some discomfort or pressure when your doctor inserts the cystoscope. You may also feel the urge to urinate or some discomfort when your doctor instills fluid through the cystoscope into your bladder. You may feel a pinch when your doctor removes tissue for a biopsy.