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Rigid cystoscopy

Published by Bupa's health information team, December 2008.

This factsheet is for people who are planning to have a rigid cystoscopy, or who would like information about it.

Rigid cystoscopy is a procedure that allows your surgeon to look inside your bladder and take a tissue sample (biopsy) from the bladder wall or treat certain bladder conditions.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About rigid cystoscopy
Preparing for your procedure
About the procedure
What to expect afterwards
Recovering from rigid cystoscopy
What are the risks?
Questions and answers
Related topics
Sources

About rigid cystoscopy

Rigid cystoscopy is done using a narrow, rigid, tube-like telescopic camera called a cystoscope. The cystoscope is passed into your bladder through the tube that carries urine from the bladder and out of the body (urethra). It's often done to remove tissue from the bladder wall or treat conditions affecting the bladder or urethra.

A flexible cystoscope is often used to do check-ups and diagnose bladder conditions. For more information about flexible cystoscopy, see the related Bupa factsheet.

Illustration showing where a cystoscope is passed
Where a cystoscope is passed

Preparing for your procedure

Your surgeon will explain how to prepare for your procedure.

Rigid cystoscopy may require an overnight stay in hospital. This will depend on the type of treatment you are having.

Rigid cystoscopy is usually done under general anaesthesia. This means you will be asleep during the procedure. Alternatively, you may prefer to have the surgery under regional anaesthesia. This completely blocks feeling from the waist down and you stay awake. A sedative may be given with regional anaesthesia to help you relax. Your surgeon will advise which type of anaesthesia is most suitable for you.

If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

About the procedure

Rigid cystoscopy may take 15 minutes or longer depending on what needs to be done.

The cystoscope is passed through the urethra into the bladder. Sterile fluid is passed through the cystoscope to fill the bladder. This makes the bladder wall easier to see.

A camera lens at the end of the cystoscope sends pictures from the inside of your bladder to a video monitor. Your surgeon will look at these images to examine the bladder, treat your bladder condition and, if necessary, take a biopsy. The biopsy is sent to a laboratory for tests.

Afterwards, the cystoscope is taken out and a thin flexible tube (catheter) may be passed into the urethra and left in place for about 24 hours. The catheter will drain urine from your bladder into a bag.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You may be given antibiotics to help prevent bladder infection.

Your catheter may be connected to a system which washes any blood and blood clots out of your bladder. This is called bladder irrigation. The catheter is usually removed before you go home.

You will be given a date for a follow-up appointment before going home.

If you are going home on the same day as your procedure, you will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Results

If you have a biopsy the results will be ready several days later and will usually be sent in a report to the doctor who recommended your test. Other findings may be discussed before you leave the hospital.

Recovering from rigid cystoscopy

If you have been prescribed antibiotics, it's important to complete the whole course. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

General anaesthesia temporarily affects your coordination and reasoning skills, so you must not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards.

You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon's advice.

You are at increased risk of developing a bladder or urinary tract infection (UTI) until the bladder fully heals. Drink plenty of clear fluids to help flush out any possible infection.

Contact your GP or the hospital if you develop any of the following symptoms, as you may have developed an infection:

severe pain or pain that lasts for more than 48 hours
high temperature
burning sensation on passing urine or if your urine starts to smell
heavy blood-stained urine

What are the risks?

Rigid cystoscopy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly temporary effects of a successful procedure, for example feeling sick as a result of the general anaesthetic.

Side-effects of rigid cystoscopy include:

mild discomfort
mild stinging when you pass urine for a day or two
blood in the urine for 24 hours

Complications

This is when problems occur during or after the procedure. Most people are not affected. Your surgeon will be experienced at performing cystoscopies, but even so, a few are not successfully completed and may need to be repeated.

Complications of rigid cystoscopy are uncommon but can include:

urinary tract or bladder infection (cystitis) - you may need antibiotics to treat this
damage or injury to the urethra or bladder - this can lead to bleeding and infection, which may require treatment with medicines or further surgery
urinary retention - an inability to pass urine because of swelling or inflammation of the urethra

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.