Flexible Cystoscopy

What is this procedure?

Flexible cystoscopy is a diagnostic procedure in which a slim, flexible telescope (cystoscope) is passed gently through the urethra into the bladder. It allows Dr Hadjipavlou to inspect the lining of the urethra and bladder directly and in real time, looking for abnormalities such as tumours, inflammation, stones, or the position of a ureteric stent. Cystoscopy does not require general anaesthesia — it is performed with local anaesthetic lubricating gel instilled into the urethra, and takes only 5–10 minutes. It is a very common and well-tolerated procedure.

Before your procedure

• No fasting required for a routine flexible cystoscopy under local anaesthesia.
• Urine sample: You may be asked to provide a urine sample on arrival. If you are known to have a urinary infection, inform the team — the procedure may need to be postponed and an antibiotic prescribed.
• Medications: You can take all your regular medications as normal. Blood thinners do not usually need to be paused for a diagnostic flexible cystoscopy.
• Driving: Because only local anaesthetic gel is used, you may drive yourself to and from the appointment. If sedation is offered and you accept it, arrange a lift.
• What to bring: Photo ID, insurance documents, and any relevant imaging or previous cystoscopy reports.

What happens during the procedure

You will lie on a couch. Local anaesthetic gel is instilled through the urethra and left to work for a few minutes. The flexible cystoscope — approximately the width of a drinking straw — is then gently guided along the urethra into the bladder. The bladder is filled with sterile saline to allow a clear view. Dr Hadjipavlou will systematically examine the entire bladder lining and urethra. Small instruments can be passed through the cystoscope to take a biopsy, remove a stent, or perform minor treatments if required. The examination itself takes 5–10 minutes.

After the procedure and recovery

• Burning and frequency: Mild stinging or burning when passing urine, and increased frequency, are very common for 24–48 hours after the procedure. This is normal and settles quickly.
• Fluids: Drink 2–3 litres of water or clear fluid over the next 24 hours to flush the bladder and reduce discomfort.
• Haematuria: A small amount of blood in the urine for 24–48 hours is normal. If heavy bleeding persists, contact us.
• Return to normal activities: You can return to normal activities, including work, immediately (or after the anaesthetic wears off if sedation was used).

When to seek medical help

Contact the secretary on 22 444 444 or El Greco Medical Centre +357 22 782 000 if you experience:

• Fever above 38 °C or rigors (shivering)
• Inability to pass urine
• Heavy or persistent bright-red bleeding lasting more than 48 hours
• Severe or worsening pain

Attend the nearest Accident & Emergency department if you feel acutely unwell or cannot reach us.