Cystoscopy or Bladder Scope Test

Medically Reviewed by Poonam Sachdev on June 25, 2024
Written by Frances Gatta
7 min read

A cystoscopy is a test to check the health of your urethra and bladder. You might also hear it called a cystourethroscopy or, more simply, a bladder scope.

It’s an outpatient test, which means you can get it at your doctor’s office, a hospital, or a clinic and go home the same day. The doctor inserts a cystoscope into your urethra during a cystoscopy. A cystoscope is a long, thin instrument. One end has a small lens and light, the middle has a tube, and the other has an eyepiece.

If you have a penis, the urethra is at the end of your penis. If you’re a person with a vagina, it’s just above your vaginal opening. The test lets your doctor check the length of your urethra and the bladder for growths called polyps, narrow areas called strictures, abnormal growths, and other problems.

What happens during a cystoscopy?

Your doctor may insert an IV line into your arm or hand to give you a sedative or anesthetic, which keeps you from feeling pain and makes you sleepy during the procedure. They'll watch your vital signs, including your heart rate and blood pressure, throughout the cystoscopy.

Then, they'll tell you to lie on your back on the table where the test is happening, with your knees raised and apart.

Using a syringe or a thin tube called a catheter, your doctor will apply a numbing medicine to your genitals and urethra so you don’t feel discomfort during the procedure.

Then, your doctor will put the cystoscope into your urethra through your penis or vagina and move it up till it gets to your bladder. Once the cystoscope is in place, they may add saline or sterile water to your bladder to help them see the lining better. Sometimes, they remove a small piece of bladder tissue or collect your urine for testing.

Once the procedure is completed, your doctor will carefully take out the cystoscope.

This test can help your doctor:

Cystoscopes are tube-shaped tools. They have lights and cameras that let your doctor examine the interior of your urinary tract. There are two types of cystoscopes: a standard rigid cystoscope and a flexible cystoscope. The choice of which scope to use depends on the purpose of the exam.

Before a cystoscopy

The procedure generally takes about 15 to 20 minutes. 

You’ll need to pee first. The test is done when your bladder is empty. 

Then, you'll remove everything you’re wearing that may disturb the procedure, including your clothes and jewelry. You’ll wear the gown the hospital or clinic provides.

Types of cystoscopes

Cystoscopes are tube-shaped tools. They have lights and cameras that let your doctor examine the interior of your urinary tract. 

Types of cystoscopes are: 

A rigid cystoscope. This doesn’t bend, and your doctor may use small tools through it to take tissue samples or remove growths. This procedure is typically done under sedation or general anesthesia.

A flexible cystoscope. This type is bendable, and your doctor may only use it to look at the insides of your bladder and urethra.

The choice of which cystoscope to use depends on the purpose of the exam.

During the cystoscopy

You’ll lie down. The position depends on the type of scope your doctor uses:

  • Standard rigid cystoscope. You’ll lie on your back with your knees up and apart. Your feet will probably be in stirrups.
  • Flexible cystoscope. No special position is needed. The doctor will help you find a comfortable position.

You’ll get medicine. You might get a drug to make you sleepy. The doctor will call this a sedative. Or you could get a general anesthetic to help you sleep through the entire procedure.

Your doctor will insert the scope. They’ll clean your urethra and numb the area. The scope goes through the urethra and into your bladder. They’ll use the smallest scope possible. They might need to use a bigger one to take samples or bring surgical tools into your bladder.

The doctor will examine your urethra and bladder. The cystoscope has a lens on the end that works like a telescope. It makes it easier for the doctor to see inside your body. They might put a video camera over the lens to project images onto a screen.

The doctor will fill your bladder. They put water or saline in through the cystoscope. When your bladder is full of water, it stretches, allowing your doctor to see your entire bladder wall. They’ll ask you how it feels when it’s full.

The doctor will take tissue samples. If an area looks abnormal, the doctor will use the cystoscope to cut a small piece that they can send to the lab for analysis. They’ll call this a biopsy or tissue sample.

What can you not do after a cystoscopy?

Your doctor might tell you to go about your usual activities. If you receive sedation or general anesthesia, you may need to stay in a recovery area until the medication wears off before you can leave.

They may also advise you to avoid certain activities for 24 hours, such as:

  • Drinking alcohol
  • Driving
  • Working with heavy or complex machines

What you can do after a cystoscopy

After a cystoscopy, most people recover within a day or two. During your recovery, you can take steps to lower your risk of infection and manage any pain you might have.

These steps include:

  • Drink at least 8 cups of water daily for a few days to flush your bladder and reduce any bleeding. You can drink less in the evening to avoid getting up to use the bathroom at night.
  • Take over-the-counter (OTC) pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen (Tylenol) to relieve the pain you might feel in your belly.
  • To help ease any discomfort you might be feeling around your genitals, you can apply a warm, damp washcloth over the opening where urine leaves or take a warm bath.

You may feel discomfort when the cystoscope goes into your urethra and bladder. You’ll probably feel a strong need to pee when your bladder gets full. You may feel a slight pinch if the doctor takes a biopsy.

After the procedure, your urethra may be sore and it might burn when you pee for a day or two.

Complications of cystoscopy are rare but can happen. Luckily, they’re usually minor.

Minor complications of cystoscopy

Minor complications of a cystoscopy include:

  • Infection
  • Bleeding from the biopsy area -- it will show up in your pee
  • Bladder wall rupture
  • Painful urination

Serious complications of cystoscopy

Rarely, after a cystoscopy, some people may have serious complications such as

  • Kidney injury
  • Hyponatremia (a change to the natural balance of sodium in your body)

Contact your doctor if you notice any of the following after the cystoscopy:

  • Severe pain where the scope went in
  • Chills
  • Fever
  • Peeing less than usual

A cystoscopy is a quick procedure usually lasting 15 to 20 minutes. It's often ordered to diagnose conditions involving the bladder and urethra. After the procedure, you may experience some pain, which you can manage with pain medication. Also, stay hydrated to reduce any infection risks. See a doctor if you experience severe pain, chills, fever, difficulty peeing, or other unusual or disturbing symptoms after the procedure.

How painful is a cystoscopy?

A cystoscopy may feel a little painful, and you might feel like peeing during the procedure. You might not feel any pain after you get anesthesia or a numbing gel for the procedure.

Why would a urologist order a cystoscopy?

A urologist would order a cystoscopy to diagnose a condition involving your urethra or bladder.

How long is recovery from a cystoscopy procedure?

Most people feel better within a day or two after a cystoscopy procedure.

Are you awake for a cystoscopy?

Yes, you’ll likely be awake for a cystoscopy. Your doctor will apply a numbing gel in the area the cystoscope goes through so you don’t feel any pain. But if your doctor does the procedure with a rigid cystoscope, you may be sedated or given anesthesia.