Flexible Cystoscopy
Flexible cystoscopy is a modern diagnostic procedure used to examine the inside of the urethra and urinary bladder. It is performed using a flexible cystoscope, a thin, bendable instrument equipped with a camera and light source at its tip, which allows the urologist to obtain a detailed view of the mucosa on a high-resolution monitor.
Flexible urethrocystoscopy is usually recommended when symptoms or suspicion of urinary tract problems are present, such as:
- pain during urination
- blood in the urine
- recurrent urinary tract infections
- unexplained bladder pain
It may also be used to monitor the effectiveness of certain therapies or surgical procedures involving the urinary tract.
What does the procedure involve?
During the diagnostic procedure, the patient lies on their back (supine position). Unlike rigid cystoscopy, leg holders are not required, which significantly reduces discomfort and the feeling of vulnerability.
The examination typically lasts 5 to 10 minutes and is performed on an outpatient basis:
- The first step is the application of anesthetic gel into the urethra. The gel serves a dual purpose: it acts as a lubricant to facilitate instrument insertion and as a local anesthetic to numb sensation in the urethra.
- Thanks to its softness and flexibility, the flexible cystoscope gently advances through the urethra, following its natural anatomy. In men, the instrument easily passes through the curves of the urethra and beyond an enlarged prostate, which represents a key advantage compared to a rigid instrument.
- Once the instrument reaches the bladder, sterile fluid is instilled to expand the bladder walls and allow a clear view. At this point, the patient may feel an urge to urinate.
- The tip of the cystoscope can bend in all directions, enabling the physician to examine blind spots. After the examination, the instrument is removed and the patient can immediately empty the bladder.
What are the advantages of flexible cystoscopy?
Rigid cystoscopy is performed using a straight metal tube and is now most commonly used during surgical procedures in the operating room. For diagnostic purposes, flexible cystoscopy has become the gold standard for the following reasons:
- Significantly less pain and discomfort - the soft instrument adapts to the body, and the procedure is virtually painless, performed using local anesthetic gel only.
- More comfortable body position - the patient lies flat on their back in a natural and relaxed position.
- Improved visualization (quality of examination) - the tip of the instrument can bend backward (retroflexion), allowing the physician to examine 100% of the bladder surface, including areas inaccessible with a rigid instrument.
- Faster recovery - there is no need for hospital stay after flexible cystoscopy. Patients can leave immediately after the examination, are able to drive, and resume daily activities. The risk of bleeding or urethral injury is minimal.
When is flexible cystoscopy needed?
Flexible cystoscopy is recommended when a detailed examination of the inside of the urethra and urinary bladder is required, especially in situations where other diagnostic methods, such as ultrasound, urine analysis or CT scan, do not provide sufficiently clear answers.
The most common indication is the presence of blood in the urine, even if it occurred only once, as it is important to rule out more serious causes such as bladder tumors. The examination is also essential when tumor changes are suspected, as it allows direct visualization of the mucosa and detection of very small lesions that other methods may not reveal.
At our Center for Urology, we combine the expertise of leading urologists with state-of-the-art diagnostic equipment to ensure precise diagnosis, an individualized approach, and the most effective treatment options for every patient.
