Before and After Cystoscopy

This guide is general information; the instructions you receive personally always take priority.

Cystoscopy is performed for reasons such as blood in the urine, bladder tumour follow-up, recurrent urinary tract infections and suspected narrowing of the urethra. Double-J stents placed after stone or kidney surgery are also usually removed by cystoscopy. The procedure can be done in two ways:

• Flexible cystoscopy: Performed with a thin, bendable instrument as an outpatient procedure, using a numbing gel placed in the urethra.
• Rigid cystoscopy: Used for procedures such as a biopsy, breaking up stones or removing tumours; in men it is usually performed under spinal or general anaesthesia.

You will be told in advance which method is planned for you.

Before the procedure

• A urine test is usually done beforehand. Let us know if you have signs of infection such as burning when passing urine, a fever or cloudy urine; the procedure may be postponed until the infection has been treated.
• Do not stop or change your blood thinners without talking to your doctor. If a biopsy is planned, your medicine may need adjusting; you will be told exactly how.
• For procedures with numbing gel you usually do not need to fast. If sedation or anaesthesia is planned, do not eat or drink for the period you have been told.
• The need for antibiotics depends on your individual risk; most patients having a simple diagnostic cystoscopy do not need them.
• If you are having sedation or anaesthesia, arrange for someone to accompany you home.

What to bring:

• Your identity document
• An up-to-date list of your medicines
• Previous cystoscopy, pathology and imaging reports

On the day

You may be asked to pass urine just before the procedure. You lie on your back on the examination couch, the genital area is cleaned and sterile drapes are placed. For flexible cystoscopy, a numbing gel is placed in the urethra and left for a few minutes. As the bladder is filled with sterile fluid you may feel the need to pass urine; this is expected. Diagnostic flexible cystoscopy usually takes 5–15 minutes, and the findings are shared with you at the end.

When cystoscopy is done to remove a stent, the procedure is usually even shorter.

After the procedure: the first days

The following are common and usually settle on their own within a few days:

• Mild burning when passing urine
• Pink urine or a small amount of blood; this may be a little more noticeable if a biopsy was taken
• Passing urine often and a sense of urgency
• If a stent was removed, brief side pain

Care at home

• Fluids: Drink plenty of water spread through the day for the first few days; this helps symptoms settle more quickly. If you have been told to limit fluids, ask your doctor how much to drink.
• Activity and work: After a procedure with numbing gel, most people can return to their daily activities and work the same day. If a biopsy was taken or you had an anaesthetic, avoid heavy lifting and strenuous exercise for a few days.
• Showering: You can shower the same day.
• Driving: After a procedure with numbing gel you can usually drive. If you have had sedation or anaesthesia, do not drive for at least 24 hours.
• Sex: You can resume once the burning has settled and you feel comfortable; if a biopsy was taken, follow the period your doctor recommends.
• Medicines: Take any prescribed medicines as instructed. If your blood thinner was adjusted, ask when to restart it.

Follow-up

• If a biopsy was taken, the result is usually available within a few days to one or two weeks and is discussed with you at your follow-up appointment.
• If you are being monitored for a bladder tumour, write down the dates of your check cystoscopies and do not miss them.
• Even if a cystoscopy for blood in the urine is normal, the kidneys and ureters may need separate imaging.

For more information, see the cystoscopy page.

Contact

• Appointments and follow-up visits: Özel Medicabil Nilüfer Hastanesi, 444 8 112 (weekdays 08:30–12:00); Özel Jimer Hastanesi, 444 45 67 (weekdays 13:00–17:00).
• Emergencies: Call 112 or go to your nearest emergency department. Do not use messaging apps (such as WhatsApp) for emergencies.