If your healthcare provider thinks you might have bladder cancer, they will order a test called a cystoscopy. This test can help your doctor diagnose bladder cancer or otherwise figure out what’s going on with your bladder. That way, you can get a diagnosis, prognosis, potential treatment, and other help you need to heal and thrive.

Here’s what you should know about a cystoscopy for bladder cancer. Knowing what to expect can help you feel more prepared and comfortable, and it also gives you insight into what your doctor is looking for — such as signs of bladder cancer or other abnormalities.

What Is a Cystoscopy?

A cystoscopy is a procedure that uses a flexible cystoscope, or scope with a camera, to look inside your bladder. Your healthcare provider may also use it to look at your urethra (the tube that allows your bladder to empty) and the openings of your ureters (the tubes that go from your bladder to your kidneys).

There are two main types of scopes used for a cystoscopy: a flexible cystoscopy and a rigid cystoscopy. A flexible cystoscopy is smaller and can be used in a doctor’s office. This procedure requires local anesthesia so you won’t feel discomfort from the scope.

A rigid cystoscopy is a solid scope used in an outpatient surgery center. For this procedure, you’d get general anesthesia that puts you to sleep. A rigid cystoscopy allows your healthcare provider to collect a sample of cells to check them for cancer (a biopsy) and remove tumors if they find any in your bladder.

How Is Cystoscopy Used To Diagnose Bladder Cancer?

A cystoscopy can help your urology or oncology team diagnose bladder cancer in a couple of ways. First, it allows the team to see what is going on inside your body. The doctors can see if there are visible tumors, lesions, growths, or anything else that would indicate the presence of bladder cancer.

Secondly, doctors can take a biopsy during a cystoscopy for bladder cancer. A very small tissue sample is taken from your bladder lining, bladder wall, or any possible tumors the doctor finds there. The doctor can send the sample to a lab to be examined more closely by a pathologist (a doctor specializing in studying tissue samples under a microscope). The pathologist can help your doctor figure out if you have bladder cancer, the type of bladder cancer you might have, and other details about your case. The process of taking a biopsy may also be called a transurethral resection of bladder tumor, or TURBT for short.

What To Expect When Your Doctor Schedules a Cystoscopy

There are a few things you can expect before, during, and after a cystoscopy. Make sure to find a doctor you trust and ask them any questions you have that are specific to your case or your needs. Note that your doctor will give you specific instructions for the cystoscopy procedure. Always follow those instructions, even if they’re different from the general outline provided below.

Before a Cystoscopy

Before a cystoscopy, your doctor may prescribe antibiotics. Taking antibiotics will help prevent and treat infections you may experience from the procedure. When taking the medication, follow the instructions your doctor provides for you.

If you’re getting general anesthesia, you may be instructed to stop eating and drinking several hours before the procedure. You may also need to find someone to drive you home after your cystoscopy.

Also, make sure that you don’t fully empty your bladder before the procedure. Your doctor may want to get a urine sample before the cystoscopy.

During a Cystoscopy

Every healthcare provider and surgery center will have specific instructions, but your cystoscopy may follow this general sequence of events.

Most cystoscopies take between 15 and 30 minutes, depending on the type of cystoscopy and whether biopsies are taken.

First, a healthcare provider will ask you to empty your bladder. The provider will likely do this even if you don’t need to give a urine sample.

Next, you’ll get an IV line placed if you’re going to have IV general anesthesia. This is usually done in a vein in your hand or arm.

At some point, the doctor will have you lie down. You’ll be on your back, and your feet may be in stirrups. Both knees will be bent to give the doctor easier access to your urethra.

If you don’t have IV anesthesia, your doctor will use numbing cream or gel on the opening of your urethra. This will help make the procedure more comfortable for you.

It usually takes about 10 minutes for the cream to work. Once you’re numb, the doctor will insert the cystoscope. While it’s in your body, your doctor will examine your urethra and your bladder. They may also take biopsies during this time.

Your doctor may choose to fill your bladder with a sterile liquid solution. This helps your bladder expand, which allows your doctor to get a better look inside. If you feel like you need to urinate, you should wait until the procedure is over.

When your doctor is done, they’ll remove the cystoscope and send any samples to the lab. If you have been given IV anesthesia, the doctor will take you to a room where you can rest until you’re awake enough to go home.

After a Cystoscopy

After a cystoscopy, you’ll be allowed to get back to your daily life. You may experience some side effects from the procedure that last for a day or two. These may include urinating more often, seeing blood in the toilet or on toilet paper when you urinate, and feeling a burning sensation when you urinate.

To help you feel better, your doctor may prescribe a pain medication for several days after the procedure. Your doctor may also instruct you to drink more water or apply moist heat to the opening of your urethra. Make sure to schedule and attend any follow-up appointments you may need.

Possible Risks or Complications of a Cystoscopy

Your healthcare provider should also inform you about the risks of a cystoscopy and when to call them or seek emergency medical help.

Complications

Possible risks of a cystoscopy include:

• Bleeding — Severe bleeding is rare but can happen after a cystoscopy. Some bleeding is normal.
• Infection — You may get a urinary tract infection after a cystoscopy. If you are older, smoke regularly, or have an irregular urinary tract, you’ll be more likely to end up with an infection.
• Pain — The majority of people have, at most, minor abdominal pain or burning after a cystoscopy. Significant pain is rare.

Serious Complications

Some complications and symptoms after a cystoscopy may require medical attention. Call your doctor or go to an emergency department if you experience:

• Severe abdominal pain
• Severe nausea
• Pain or burning that lasts more than two days after the procedure
• Bright red (not pink) blood in your urine
• Blood clots in your urine
• Chills
• A high fever (Your doctor should tell you how high it can get before you need help.)
• Inability to urinate after the procedure

Your doctor should tell you what to do if you have these symptoms, and it’s important to follow their recommendations. Make sure you and the people caring for you know what to do if you experience any of these symptoms.

Talk With Others Who Understand

MyBladderCancerTeam is the social network for people with bladder cancer and their loved ones. On MyBladderCancerTeam, members and their families come together to ask questions, give advice, and share their stories with others who understand life with bladder cancer.

Have you had a cystoscopy for bladder cancer? What helped you prepare for the procedure? Share your experience in the comments below, or start a conversation by posting on your Activities page.