What to expect during a cystoscopy.

Why cystoscopy is done

The bladder is the one organ in the body where we can look directly at the inside lining without a single incision. Cystoscopy lets us evaluate symptoms and findings that can't be fully explained by imaging or labs alone. The most common reasons are:

• Blood in the urine (microscopic or visible) — to rule out bladder cancer or other sources of bleeding.
• Recurrent UTIs — to look for anatomic reasons they keep coming back.
• Difficulty urinating — to evaluate for urethral stricture, prostate obstruction, or bladder issues.
• Surveillance after bladder cancer treatment — routine checks for recurrence.
• Pre-operative planning for procedures like HoLEP, where seeing the prostate anatomy ahead of time is helpful.

What actually happens during the visit

The whole appointment takes about 30 minutes, though the cystoscopy itself is 5–10 minutes. Here's the sequence:

1. Check-in and prep (10 minutes)

You'll give a urine sample to rule out infection. You undress from the waist down and lie on the exam table. The area is cleaned with antiseptic solution.

2. Numbing (2–3 minutes)

A small amount of gel containing lidocaine (a local anesthetic) is placed in the urethra. We wait a few minutes for it to work. This is the part that can briefly sting.

3. The cystoscopy itself (5–10 minutes)

A thin, flexible scope — about the diameter of a piece of cooked spaghetti — is gently advanced through the urethra and into the bladder. Sterile water flows through to keep the bladder gently inflated. Most patients feel pressure and a sense of needing to urinate, but not sharp pain.

You can usually watch on a monitor if you want. The bladder lining is systematically examined, photos are taken if anything looks abnormal, and then the scope is removed.

4. Right after (1–2 minutes)

You get dressed and we briefly review what we saw. You drive yourself home and can return to normal activities immediately.

What it feels like

The honest version: there's a brief burning sensation as the scope passes the urethra, lasting 5–10 seconds. Once the scope is in the bladder, most patients feel pressure (like needing to urinate) but not pain. Most men describe it afterward as less uncomfortable than they expected.

After the procedure

Expect these for 24–48 hours:

• Mild burning with urination — common and normal.
• Pink-tinged urine — common and normal.
• Slight increased urgency or frequency — also normal.

Simple things that help: drink extra water (dilutes the urine and flushes the bladder), take Tylenol or ibuprofen if sore, and avoid heavy exercise or strenuous activity for the rest of the day.

Common questions

Do I need someone to drive me home?

No. We don't use sedation for an in-office cystoscopy, so you can drive yourself to and from the appointment.

Can I eat before?

Yes. Eat normally. No fasting required.

Should I take my usual medications?

Yes. If you're on a blood thinner, check with the prescribing doctor about whether to continue — cystoscopy is generally safe even while on blood thinners, but your cardiologist or primary doctor knows your situation best.

Will I need more tests after?

Depends on what we see. Sometimes cystoscopy provides the complete answer; sometimes it points us toward additional imaging or a biopsy. We'll discuss any next steps immediately after.