Flexible Cystoscopy and Urodynamic Studies

A flexible cystoscopy is an examination of the bladder using a flexible fibre-optic telescope. This enables the doctor to examine the urethra and bladder without a general anaesthetic. It is a simple, quick and generally painless procedure although there may be brief discomfort when the telescope is inserted.

A urodynamics study is an evaluation of the bladder’s ability to hold and empty urine. The evaluation is assisted with a computerized study.

Before the Procedure

  • No special preparation is required for the procedure. You may eat and drink as normal.
  • You have been given the necessary theatre pre-admission documentation to be returned in the enclosed envelope prior to the procedure.
  • If you require time off work for this procedure, please discuss this with your doctor.
  • Keep taking your usual medications.
  • Allow at least 2 hours for the appointment and review by the doctor. You will be able to drive yourself home.
  • Do not feel embarrassed or upset if you have difficulty controlling your bladder during the test, as the test is designed to find the cause of your problem.

During the Procedure – Cystoscopy

  • Sterile drapes will be placed to guard against infection.
  • Local anaesthetic jelly will be used to make the procedure more comfortable.
  • The cystoscope will gently be passed into your urethra and bladder.
  • The bladder will slowly be filled with sterile water to make the lining of the bladder visible.
  • The doctor will explain the procedure as he examines your bladder.

During the Procedure – Urodynamic Studies

  • Two small catheters are placed into your bladder. The first catheter is used to fill your bladder with fluid and the second catheter measures the pressure inside your bladder.
  • A small catheter is also placed into your rectum. This allows the computer to calculate the true bladder pressure.
  • Your bladder will be filled with sterile water.
  • The nurse will ask you to describe the differing sensations you feel during the procedure and the computer will record these.
  • Once your bladder is full you will be asked to pass your water into the flow meter, which can measure the bladder pressure and flow of urine. The computer can then calculate whether your bladder has a normal emptying capacity.
  • A bladder ultrasound scan is performed at the completion of the urodynamics study.

After The Procedure

  • The tubes will be removed and you will be able to get dressed.
  • The results are printed and discussed with you by your doctor.
  • A sick certificate and follow-up appointment will be arranged if necessary.
  • You should be able to resume normal activities the next day.

Post-operative and Discharge Planning

  • After the procedure you may experience:
    • The passing of blood stained urine
    • Frequency, urgency and burning when passing urine, this should settle within 24 hours.
  • You should drink extra water and take Ural sachets (from the chemist) eight hourly if discomfort persists.
  • If the symptoms do not settle within 24 hours, or occur thereafter, please telephone the practice to speak to your doctor or the nurse.

Risks and Complications

Flexible cystoscopy is a safe and commonly performed procedure. Side effects are generally mild and short-lived.

Difficulties passing urine

It is common to notice mild frequency, urgency and burning when passing urine, which should settle in 24-48 hours. Drinking extra water can help this. Ural sachets (from the Chemist) taken 8 hourly can help.

Passing blood in the urine

Should also settle in within 48 hours. It is important to drink water as mentioned above. More likely to occur if a biopsy is taken.

Urinary infection

Occurs rarely and should be suspected if difficulties passing urine do not settle. You may require treatment with antibiotics.

Unsuccessful procedure

Rarely it may be difficult to visualize the bladder and the cystoscopy will need to be repeated.