• Reference Number: HEY-665/2021
• Departments: Urology
• Last Updated: 11 June 2021

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a Flexible Cystoscopy?

A flexible cystoscopy involves a telescopic examination of the bladder and urethra.  Local anaesthetic lubricating jelly will be used to make the passage of the cystoscope as comfortable as possible.  Most patients find the procedure uncomfortable rather than painful.  A flexible tube containing a tiny telescopic camera and light source will be inserted through your urethra (from where you pass urine) and into your bladder.

The doctor or specialist nurse will then fill your bladder with sterile fluid so that it is possible to inspect the whole lining of the bladder. The procedure will only take a few minutes.

Why do I need a Flexible Cystoscopy?

You may have experienced some problems with your bladder, or symptoms that concern your doctor and need further investigation. Your doctor feels it is necessary to check your bladder and urethra for any abnormalities.

Are there any side effects?

Common (greater than 1 in 10)

• Mild burning or bleeding on passing urine for a short period after the operation.

Occasional (between 1 in 10 and 1 in 50)

• Infection of the bladder requiring antibiotics.

Rare (less than 1 in 50)

• Temporary insertion of a catheter.
• Delayed bleeding requiring removal of clots or further surgery.
• Injury to the urethra causing delayed scar formation.

How do I prepare for my Flexible Cystoscopy?

Please follow these instructions:

• Bring a sample of urine with you in a clean container.
• You may eat and drink as usual, as only a local anaesthetic is used.
• Complete the Flexible Cystoscopy Information Checklist as the doctor or specialist nurse will require this information.
• Bring a dressing gown with you.
• The accompanying letter will advise you if you need an Ultrasound scan first. If this is the case, please report to the reception desk in the Radiology department, entrance 2, Castle Hill Hospital.
• Let us know if you have mobility problems that would make it difficult for you to transfer yourself onto a treatment couch.
• Please bring a list of the current medication you are taking.
• Contact the Day Services department if you think you may be pregnant, or have had orthopaedic surgery within the last 3 months.
• If you have a latex allergy, please contact the Urology Day Services department 3 days prior to your appointment.

What will happen?

You are able to drive to and from your appointment.

Although this is an intimate procedure, the doctors and nurses will do their best to maintain your dignity as much as possible and a chaperone will always be present.  We would like you to be aware that most flexible cystoscopies are performed by male doctors or a male specialist nurse.  If you feel very concerned about this, please contact our department and we will ensure that arrangements are put into place for you to have your examination performed by a female doctor or specialist nurse.

Please report to the reception desk on Urology Day Services.  The nurse will test your urine sample and will then ask you to change into a gown and your dressing gown.  If possible please pass urine just before your procedure as this helps the nurse or doctor to have a clearer view inside your bladder. You will be able to wait in a private area until it is time for your procedure.

You will be called through into the cystoscopy suite where the doctor or nurse will ask you some questions and explain what happens next. Please feel free to ask any questions you may have.

You will be asked to lie on the treatment couch.  In order to insert the camera into the bladder, female patients will be asked to adopt a similar position to that when having a smear test.  A nurse will remain with you throughout the procedure.  If you wish, you may watch the procedure on the screen next to the couch.

Sometimes male patients may be asked to have a rectal examination to assess the prostate gland.  This is done by the doctor who will insert a finger into your bottom.

The doctor or specialist nurse will be able to tell you straightaway what the findings of the cystoscopy were.  They will also tell you if any further appointments, investigations or treatment are needed.

What happens next?

You will be asked to go to the toilet and pass the fluid that has been used to fill your bladder, just the same as if you were passing urine.  Some soft wipes will be available if you need to freshen yourself up. You will then be able to get dressed and go home.

When you get home you should drink plenty of fluids for 1 – 2 days to ‘flush’ your system through and help prevent any infection.  It is normal to experience some mild stinging or burning for the first few times that you pass urine. You may also notice that your urine is slightly blood stained – these symptoms should clear up after a couple of days.

It is sensible to take things easy for the rest of the day. You will be able to resume normal activities after this.

If you develop a fever, severe pain on passing urine, inability to pass urine, or the blood in your urine increases, you should contact your GP immediately.

Should you require further advice or information on the issues contained in this leaflet, please do not hesitate to contact:

• Urology Day Services — (01482) 622193
• Ward 15 — (01482) 623015

Flexible Cystoscopy Information Leaflet Checklist

This will form part of the consent for your flexible cystoscopy procedure. Before attending for your procedure, please ensure this section is completed and signed. Your procedure may be cancelled if this has not been completed beforehand.

Please complete and sign the checklist below:

I have read the flexible cystoscopy leaflet.	Yes	No
I understand the information it contains.	Yes	No
I understand why I am having the test, and the possible risks of bleeding, perforation (puncture, tear, hole) or infection.	Yes	No
I understand I will be given every opportunity to discuss this with my consultant and/or the person performing the flexible cystoscopy.	Yes	No
I understand and accept that biopsies (samples of tissue) may be taken.	Yes	No
I understand the purpose of my flexible cystoscopy intended benefits and alternative tests.	Yes	No
I understand that I will have the opportunity to seek further information and ask questions about my flexible cystoscopy.	Yes	No

 

Patient Name…………………………………………………………………………..

Date of Birth……………………………………………………………………………

Hospital Number of NHS Number……………………………………………………

Signature: …….………………………………………………………………………..

Date: ……………………………………………………………………………………

 

ANY QUESTIONS YOU MAY HAVE:

 

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

During the course of your procedure the radiology staff will ask questions that may appear unnecessary to you and these may be repeated at certain intervals. Please be assured that these questions are necessary to ensure that all aspects of your care during the procedure are maintained to a high standard.

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.