A cystoscopy is an examination of the lining of the bladder. It is the main test used to diagnose bladder cancer. Some types of cystoscopy use a light sensitive drug, which makes cancer cells glow pink under a blue light. You may be given this drug an hour before your cystoscopy.

You usually have this test under a local anaesthetic. The doctor or nurse used an anaesthetic gel to numb the opening of the urethra (the tube you pass urine through). You may also have a sedative.

The doctor or nurse gently passes a thin tube with a camera and light on the end (a cystoscope) through your urethra into the bladder. They then examine the inside of the bladder. The test should only take a few minutes.

You may have symptoms, such as a burning pain when passing urine, for a few days after the test. Speak to your doctor if your symptoms get worse or don’t go away after a couple of days.

Before the test

This is the main test used to diagnose bladder cancer. A doctor or specialist nurse uses a cystoscope (a thin tube with a camera and light on the end) to examine the inside of your bladder.

During a standard cystoscopy, the doctor uses white light to see inside the bladder. But, sometimes doctors use a technique called “blue light” cystoscopy or photodynamic diagnosis (PDD).

This involves having a light sensitive drug put into the bladder about an hour before the cystoscopy. The drug is absorbed by cancer cells. During the cystoscopy, instead of a white light a blue light is used to show up the inside the bladder. The blue light makes areas of cancer glow pink so that they can be easily seen.

“Blue light” cystoscopy makes it possible to pick up small bladder tumours and carcinoma in situ (CIS).

What happens

A cystoscopy is usually done under a local anaesthetic using a flexible cystoscope. You may be asked to drink lots of fluids before the cystoscopy and to provide a sample of urine, which will be checked for infection.

The doctor or nurse will squeeze a jelly containing anaesthetic into the opening of your urethra (this is at the tip of the penis or just above the vagina). The anaesthetic jelly will numb the area so that you feel more comfortable during the procedure. It takes a few minutes to work. Some people also have a sedative to help them relax.

The doctor or nurse gently passes the cystoscope through your urethra and into your bladder. This makes it possible to examine the lining of your bladder and urethra. The test takes a few minutes and you can usually go home after it is finished.


You may have some burning or mild pain when you pass urine for the first couple of days after the test. And, there may be some blood in your urine. This should clear up after a day or two. You’ll be asked to drink lots of fluids to help flush out your bladder.

If these symptoms don’t go away or you have a high temperature, it’s important to see your doctor to make sure you don’t have an infection.

After the cystoscopy, the doctor will be able to tell you if they have seen a bladder tumour. If they have, they will then arrange for you to have another cystoscopy. This time it will be done under a general anaesthetic. The doctor will pass instruments through the cystoscope to take a small piece of tissue (biopsy), or to remove the tumour.

Tissue from the biopsy or tumour is sent to be examined by a pathologist (an expert who identifies diseases by looking at cells under a microscope).