Flexible cystoscopy and stent removal

A cystoscopy is an internal inspection of the bladder. It involves passing a small tube containing a miniature telescope along the urethra into the bladder. The urethra is the tube from your bladder through which urine drains.

It is called flexible cystoscopy because the tube passed into the urethra can bend easily and freely. This allows it to be passed with minimal discomfort using local anaesthetic gel and does not require a general anaesthetic. The procedure is performed with the patient lying flat in a comfortable position.

A small forceps is passed through the telescope which grabs one end of the stent and then it is pulled out slowly. The telescope comes out at the same time.

The procedure will be performed in the urology department (please see your appointment letter for directions) at the Princess Royal Hospital. The procedure will be undertaken by a specifically trained health care professional.

No special preparations are required. You can eat and drink normally. You can leave the department shortly after the procedure.

When you arrive at the department please report to the receptionist. Just before your procedure is due you will be asked to change into a hospital gown. You will also be asked to provide a urine sample. Once you are in the procedure room, the health care professional will explain the entire procedure and your consent will be obtained.

Your health care professional will clean the area first and then instill an anaesthetic jelly into the urethra which lubricates, anaesthetises and acts as an aseptic as well. The surrounding area will be covered with a sterile paper sheet and sterile towels.

The cystoscope will be introduced the into the urethra and then carefully passed into the bladder. The area of the sphincter may be slightly sensitive and you may be asked to take a deep breath or to try and pass water, both of which help the sphincter to relax.

Once inside the bladder the tip of the cystoscope can be manoeuvred to allow the entire bladder to be viewed. To assist the thorough examination fluid is run through the cystoscope to stretch out any folds in the bladder lining; so it is normal to feel that the bladder is full towards the end of the procedure. The stent can be seen easily once inside the bladder and with the help of forceps it is pulled out. The bladder may be emptied at the end of the procedure or you may be instructed to pass water in the toilet.

Most patients have no problems at all following a flexible cystoscopy and stent removal. There may be some mild burning discomfort on passing urine for a day or two and a little bleeding is not uncommon. Normally you will not be given antibiotics unless the doctor suspects you have, or are at particular risk of developing, an infection, but nevertheless a urine infection can occur.

You should drink plenty of fluids, but if temperature, pain, persistent burning or bleeding occurs you should contact your general practitioner. Occasionally passing water may become difficult following the procedure and if this does occur or you have any other problems or need advice on the day of procedure, please phone.

Please inform healthcare professional undertaking the procedure if you have

• A coronary artery stent.
• A artificial heart valve.
• A heart pacemaker or defibrillator.
• A regular prescription for warfarin, aspirin, clopidogrel.
• Please also let us know if you have any allergies.