At a glance
Cystoscopy is a procedure in which a urologist (a doctor who specialises in the urinary tract) uses a thin, flexible or rigid tube fitted with a camera to look directly inside the bladder and urethra (the tube that carries urine out of the body).
The instrument, called a cystoscope, is passed through the urethra until it reaches the bladder. A light and a tiny lens at the tip let the doctor see the inner lining of these organs on a monitor in real time. If something unusual is spotted, a small tool can be passed through the same tube to take a tissue sample for testing, though this does not happen in every case.
Medical Condition
Cystoscopy is used whenever a doctor needs a direct view inside the bladder or urethra to find, confirm, or monitor a problem that scans or urine tests alone cannot fully explain.
- Blood in the urine (haematuria), which may or may not be visible to the naked eye.
- Recurrent urinary tract infections (UTIs) that keep coming back despite treatment.
- Bladder stones, which are hard mineral deposits that form inside the bladder.
- Bladder tumours or polyps, including follow-up checks after bladder cancer treatment.
- Interstitial cystitis (a chronic condition causing bladder pain and frequent urination) when the cause is unclear.
- Urinary blockages or narrowing of the urethra (called a stricture).
- Unexplained urinary symptoms such as pain, urgency, or difficulty passing urine.
- Evaluation before or after certain gynaecological or prostate procedures.
Cystoscopy is generally not performed when there is an active, untreated urinary tract infection, because introducing the scope can spread bacteria further. Your doctor will also weigh up whether the procedure is appropriate if you have certain bleeding disorders or are taking blood thinners.
- Active urinary tract infection that has not yet been treated.
- Uncontrolled bleeding tendency without prior correction.
- Situations where the risk of anaesthesia outweighs the diagnostic benefit, as decided by your care team.
Risks & Complications
Cystoscopy is a low-risk diagnostic procedure, and serious complications are uncommon, but patients deserve an honest picture of what can occasionally go wrong.
- Urinary tract infection: the most common complication; antibiotics are often given beforehand or afterwards to reduce this risk.
- Burning or stinging when passing urine for one to two days after the procedure.
- Small amounts of blood in the urine for a day or two, especially if a biopsy (tissue sample) was taken.
- Temporary difficulty urinating due to mild swelling of the urethra.
- Bladder spasms (a cramping sensation in the lower abdomen), which usually settle on their own.
- Rarely, a small tear or perforation (hole) in the bladder or urethra wall.
- Allergic reaction to the gel or local anaesthetic used to numb the urethra.
- Risks related to sedation or general anaesthesia, if used, including nausea, dizziness, or in rare cases breathing difficulties.
Preparation & Procedure
Preparation depends on whether the cystoscopy will be done under local anaesthesia (a numbing gel), sedation, or general anaesthesia. Your care team will give specific instructions, but the following gives you a general picture of what to expect.
If only a numbing gel is used, there is usually no need to fast beforehand. If sedation or general anaesthesia is planned, you will typically be asked to stop eating solid food for at least six hours and to stop drinking fluids for at least two hours before the procedure. Blood thinners or certain other medications may need to be paused for several days; your doctor will tell you exactly which ones and for how long.
Smoking can slow healing and increase infection risk, so most hospitals advise stopping or cutting back before the procedure. You may also be asked to bring a urine sample on the day so the team can check for an existing infection before proceeding.
The following tests are commonly ordered beforehand:
- Urine culture or urinalysis (a laboratory test of your urine) to rule out an active infection.
- Blood tests including a complete blood count and clotting tests, especially if a biopsy is anticipated.
- Imaging such as an ultrasound or CT scan of the urinary tract, if not already done.
- An ECG (a recording of the heart's electrical activity) and basic blood work if general anaesthesia is needed.
On the day of the procedure, the steps usually follow this order:
- You change into a hospital gown and your blood pressure, pulse, and other vital signs are checked.
- You lie on your back with your knees bent and feet supported, in a position similar to a routine gynaecological check for women.
- The urethra and surrounding area are cleaned with an antiseptic solution.
- A numbing gel or local anaesthetic is applied inside the urethra and left for a few minutes to take effect. Sedation or general anaesthesia is given instead if that was planned.
- The urologist gently guides the cystoscope through the urethra into the bladder.
- Sterile water or saline (salt water) is slowly infused through the scope to fill the bladder slightly, which gives a clearer view.
- The doctor examines the bladder wall and urethra, and the images appear on a monitor.
- If a biopsy or minor treatment is needed, small instruments are passed through the scope at this stage.
- The scope is carefully withdrawn, and you rest briefly while any sedation wears off.
Aftercare
Most patients go home on the same day as the procedure, often within an hour or two of finishing, unless sedation or general anaesthesia requires a longer observation period.
- Monitoring: your pulse, blood pressure, and ability to urinate are checked before you are discharged.
- Driving: if you received sedation or general anaesthesia, you will not be allowed to drive yourself home; arrange for someone to accompany you.
- Fluid intake: drinking plenty of water for the first 24 to 48 hours helps flush the bladder and reduces the chance of infection.
- Urinary symptoms: mild burning, stinging, or a small amount of blood in the urine is expected for one to two days. If heavy bleeding, fever, severe pain, or inability to pass urine occurs, contact a doctor promptly.
- Activity: light daily activities can usually resume the same day or the next day. Strenuous exercise is typically avoided for a few days, and your doctor will advise based on whether a biopsy was taken.
- Sexual activity: most doctors advise waiting at least a few days, especially if a biopsy was performed.
- Wound care: there is no external wound. If a catheter (a tube to drain urine) was left in place temporarily, the team will give you specific instructions on how to care for it and when it will be removed.
- Antibiotics: a short course of antibiotics is often prescribed to prevent infection; take the full course as directed.
- Follow-up: a review appointment is usually scheduled within a few weeks to discuss biopsy results or plan next steps, depending on what was found.
Cost & What Determines It
The cost of cystoscopy varies considerably depending on a combination of clinical and logistical factors, and two patients having the procedure for different reasons can face very different bills even at the same hospital.
- Complexity of the procedure: a straightforward diagnostic look costs less than one that also includes a biopsy, removal of a polyp, or treatment of a lesion during the same session.
- Type of anaesthesia: local anaesthetic gel is the least expensive option; sedation and general anaesthesia add anaesthesiologist fees and recovery room time.
- Hospital class and country: a university hospital, international private hospital, or a facility in a country with higher healthcare costs will charge more than a smaller local clinic.
- Type of cystoscope used: flexible cystoscopes, which tend to be more comfortable, may carry a higher equipment charge than rigid ones.
- Length of stay: same-day discharge is standard for most cases, but if an overnight stay is needed after a more involved procedure, ward fees apply.
- Pathology fees: if a biopsy sample is taken, laboratory analysis is billed separately.
- Pre-procedure tests: urine culture, blood tests, imaging, and ECG are usually charged as separate line items.
- Surgeon and specialist consultation fees: the urologist's fee and any pre- or post-procedure specialist reviews add to the total.
Hospital packages for cystoscopy typically bundle the procedure room fee, the cystoscope use, nursing care, and a basic post-procedure check. Items that are commonly billed separately include pre-admission laboratory tests, anaesthesiologist fees, pathology for any biopsy taken, medications dispensed on the day, and follow-up consultation appointments.
For Indonesian patients, BPJS Kesehatan and most Indonesian private insurance policies do not cover medical treatment received abroad. This means the full cost is usually paid out of pocket, or through an international private health insurance plan that explicitly covers overseas care. Before travelling, ask the hospital for a written cost estimate that itemises every expected charge. This makes it easier to compare options and avoids unexpected bills on arrival.
Frequently Asked Questions
Does cystoscopy hurt?
Most people feel pressure or a mild burning sensation, but not sharp pain. The doctor uses a local anaesthetic gel inside the urethra (the tube you urinate through) to reduce discomfort before passing the thin camera. Some light stinging when urinating is common for a day or two afterwards.
How do I prepare for a cystoscopy?
You can usually eat and drink normally before the procedure, since fasting is not required for a standard cystoscopy done under local anaesthesia. Your doctor may ask you to give a urine sample beforehand to check for infection, and to empty your bladder just before the exam. If sedation or general anaesthesia is planned, you will be given separate fasting instructions.
How long does a cystoscopy take?
The procedure itself usually takes between 5 and 30 minutes, depending on what the doctor needs to examine. Getting ready, applying the anaesthetic gel, and a short rest period afterwards means the total time at the clinic is generally closer to one to two hours.
How much does a cystoscopy cost?
The price depends on several factors, including whether local or general anaesthesia is used, the class of hospital or clinic, and whether any tissue samples (biopsies) are taken during the same visit. A written cost estimate from the hospital gives you the most accurate figure for your specific situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
