Rigid cystoscopy

It is a visual examination of the inside of the bladder. It is performed using either a general anaesthetic, where you are asleep, or a spinal anaesthetic, where you have no feeling below the waist.

A cystoscopy can help to diagnose the causes of symptoms such as:

• Blood in your urine (haematuria).
• Frequent urinary tract infections.
• Difficulty or pain when urinating.
• Incontinence (inability to control when you urinate).
• Unusual cells found in a urine sample.

Other reasons when you need a rigid cystoscopy are when:

1. You need a biopsy.
2. Following Intravesical treatments.
3. You are unable to tolerate flexible cystoscopy under local Anaesthesia.
4. To perform other procedures on urethra (which are small tubes that drain urine from the kidneys to the bladder), prostate gland and bladder neck.

You will be asleep during the procedure so that any further interventions such as biopsies etc can be done easily. You will be informed of this prior to your procedure.

Rigid cystoscopies are usually performed without any complications. However, as with any other procedure, there are potential complications. This will be discussed with you by your doctor prior to signing the consent form.

Specific risks that could be expected are as follows:

• Bleeding, you may notice some bleeding for first 24hrs. The urine may remain pinkish for up to 7 days. Drink plenty of fluids (2 litres – 2.5 litres) to keep your urine clear. Contact your GP if the bleeding continues for more than 3 days and if your urine does not clear within 7 days.
• Pain on passing urine, some patients may experience pain for few days after the procedure. This may be due to any bruising or swelling around your urethra. This should clear up after few days.
• Infection, If you feel that you have stinging, burning and discomfort in passing urine then you may have a urine infection. Drink plenty of fluids and if it does not settle then contact your GP for a urine test and antibiotics.
• Retention of urine, There is a possibility that you may not be able to pass urine after the procedure, You may require a catheter for a short period if this happens.
• Bladder Injury, It is possible to damage or tear your bladder with the cystoscope or when taking biopsies. This tear (perforation) is usually very small and heals itself. You may require a catheter till it heals.

The procedure will be done under general or spinal anaesthesia. You will not have any pain or discomfort during the procedure. The cystoscope will be passed through your urethra (waterpipe) into your bladder. A biopsy will be taken if needed. Sometimes you may need a catheter which may be removed later on the ward or next day. The procedure would normally take about 10 minutes. You will then be taken to recovery unit until the anaesthetic wears off. Once you are awake you will then be transferred to the ward. Most patients will go home on the same day. Make sure you have someone to drive you home and someone to stay with you overnight.

The doctor will be able to tell you the results straight after the procedure. If you have biopsy taken then then it will be sent for analysis and the results can take up to 3-4 weeks.

• Drink plenty of fluid, approximately two litres per day, especially if the urine is blood stained or it is painful to pass urine.
• Eat a normal balanced diet.
• Avoid constipation or straining to go to the toilet.
• Avoid heavy lifting or strenuous activity for one week.
• Do not drive a motor vehicle or operate machinery for 24-48 hours.
• It is quite normal to notice some increased blood in your urine after 10 days. This is part of the healing process.