Outpatient Cystoscopy

What is cystoscopy?
Your specialist has arranged for you to have a cystoscopy. This is a minor procedure carried out under local anaesthetic. It involves passing a fine telescope through the urethra, which is the tube leading from the bladder to the outside, and inspecting the inside of your bladder. A small biopsy, a tissue sample, may also be taken.

Why is a cystoscopy performed?
A cystoscopy will check if there is a problem with the lining of your bladder, which could be causing your symptoms of urgency (when you need to pass urine urgently), passing urine frequently, pain or blood being present in the urine. It is also performed for patients needing Botox injections into the bladder for treatment of an overactive bladder.

Are there any complications?

• After the procedure you will experience a burning sensation when you pass urine the first few times.
• You may have some discomfort, this should settle in 1–2 days. Taking pain killers such as paracetamol should help to reduce the discomfort. If it does not settle, you could have a bladder infection and you may need antibiotics, therefore you should see your GP. Taking warm baths may also help to reduce any discomfort.
• It is not unusual to have a little bit of bleeding afterwards. This should settle in 1–2 days.
• There is a small risk of damage to the urethra or bladder.

BOTOX™
BOTOX™ or Botulinum toxin comes from a bacterium called Clostridium Botulinum. It has been safely used in medicine for many years. It is approved by the National Institute of Clinical Excellence (NICE) for problems with incontinence. Evidence suggests that approximately 70% of suitable patients experience an improvement in their bladder symptoms and in their quality of life after BOTOX treatment for overactive bladder symptoms, reducing urinary frequency and leakage. BOTOX™ acts on the end of nerve fibres, stopping signals passing down them that stimulate muscles to contract. The effects may take a few weeks to start but can last between 3 and 18 months. Some patients require further injections.

Important – About 1 in 20 patients may need to use a catheter for a short time after BOTOX™ treatment to deal with any retention of urine. If this is required the specialist nurse will teach you how to do this. You must be willing to accept this risk and to learn self-catheterisation if needed.

What happens when I come for my appointment?
You will first be asked some brief questions to confirm your medical history, drugs, allergies etc. The procedure will be explained and you will be asked to sign a consent form. You will need to remove clothing from the lower half of your body and your underwear. Once you are positioned on the couch we will clean your genital area and cover the lower half of your body with sterile drapes. A local anaesthetic gel is squirted into your urethra, this takes only a few minutes to work. The telescope is then passed into the bladder and the bladder filled with fluid.

The procedure can be a little uncomfortable but takes less than 10 minutes to perform. Once the procedure is finished, you will be allowed to get dressed. You will be given a drink and asked to take a seat in our waiting area. We would like you to pass urine before you are allowed to go home but would expect you to be able to go home within an hour of the procedure. The doctor or specialist nurse performing the cystoscopy will inform you about follow-up arrangements and we will write to your GP with the details of the procedure.

What if I’m worried or have questions?
For non-urgent queries please contact the urogynaecology secretaries on 01274 364889 or 01274 382691.
For urgent concerns, please contact your GP or GATU 01274 364438 – available 24 hours a day, 7 days a week.