Flexible Cystoscopy (including removal of ureteric stent and biopsy, if required)

What is a Flexible Cystoscopy?

This is a telescopic inspection of the bladder and urethra (water pipe) and it helps us to identify any abnormalities. Occasionally we may take a biopsy (small sample) of your bladder at the same time. The procedure can also be used for removal of a ureteric stent (a tube which has been inserted up into the kidney previously). If your urethra is narrow, we may need to gently stretch it to enable the telescope to be passed through.

You will normally have this procedure as an outpatient in Albany Unit in the Kingston Surgical Centre at Kingston Hospital.

What are the intended benefits of this procedure?

To assist us with diagnosing abnormalities of the bladder or urethra or to remove a previously inserted ureteric stent.

What are the alternatives to flexible cystoscopy?

• A rigid cystoscopy which needs to be performed under a general anaesthetic.
• Relying on observation of your symptoms to make a diagnosis.

What are the most frequently occurring after-effects, events or risks of this procedure?

Common (greater than 1 in 10)

• Mild burning or bleeding when you pass urine for a short period afterwards.

Occasional (between 1 in 10 and 1 in 50)

• Urinary infection, requiring treatment with antibiotics.

Rare (less than 1 in 50)

• Continued bleeding after the procedure (or bleeding starting after internal scabs fall off if biopsies have been taken) requiring removal of clots from the bladder or a further procedure to stop the bleeding.
• Injury to the urethra itself that may lead to abnormal scar tissue which may require additional treatment in the future.
• Temporary insertion of a urinary catheter (a tube passed up the urethra and into the bladder) to drain urine and blood if bleeding is heavy or you cannot pass urine.
• If we are planning to remove a stent and we find that there is excessive calcium build-up on it, we may need to remove it under a under general anaesthetic on different day, instead of during the flexible cystoscopy procedure.

What sort of anaesthetic is used?

Anaesthetic is not usually required but we can insert a local anaesthetic gel into your urethra, if you need this.

What does the procedure involve?

We pass a small telescope into your urethra and up into your bladder to check for any abnormalities. If we take a biopsy or plan to remove a stent, we can also pass small instruments down the telescope.

What do I have to do before the procedure?

What happens after the procedure?

Once the procedure is completed, you will be allowed home straight away.

You may pass some slightly bloodstained urine at first and this may sting a little. Over the next 24 hours, try to drink plenty of non-alcoholic fluids to flush your urinary system and reduce these after effects. We suggest that you try to drink two to three litres (or four to six pints) over the 24 hour period.

You may also be given a short course of antibiotics following the procedure.

What else should I look out for?

Further Appointments or Treatments

If we have taken biopsies during the flexible cystoscopy procedure, you may be asked to return to our Outpatient Clinic approximately two weeks afterwards, or you may receive a letter explaining the results.

If you require other treatments or procedures, you will be given information about these before you leave hospital.

Who should I contact for more information?

• If your flexible cystoscopy was performed an outpatient and you need general advice, please contact the Albany Unit.
• If you have any concerns, please contact our Specialist Urology Nurse.
• For issues relating to bladder function, you may need to speak to the Urodynamics team.
• If you have a known cancer condition and would like further information regarding this, please contact the Clinical Nurse Specialist in Urology Oncology.

Contact details can be found at the bottom of this leaflet.

Alternatively, you can contact:

• Your GP
• Your Urology Consultant when you see them next

 Further Information

Cystoscopy – What happens – NHS (www.nhs.uk)

*How to obtain a mid stream urine collection

1. Your urine sample should be taken after washing, bathing or showering on the day of your appointment.
2. The sample does not need to be the first urine of the day.
3. Unscrew the cap from the bottle and place it onto a clean surface.
4. Pass a small amount of urine directly into the toilet and then stop.
5. Pass a further quantity of urine directly into the bottle then stop.
6. Do not pass urine into a separate container then transfer it.
7. Fit the cap back onto the bottle.
8. Wash your hands.
9. Write your name, date and time on the bottle / container label. If the bottle is broken, please obtain another bottle from your GP surgery or local pharmacy/chemist.

Contacts

Albany Unit	0208 934 3184
Specialist Urology Nurse	020 8934 3547
Urodynamics Team	020 8934 3038
Clinical Nurse Specialist for Urology Oncology	020 8934 2729