Cystoscopy (Bladder Camera Test)

Seeing blood in your urine is alarming, even when it happens once and doesn't hurt. Other people are sent for this test after repeated urine infections, a stream that has become weak or split, or bladder symptoms that haven't responded to medicines. A scan can suggest a problem in each case, but the most reliable way to check the bladder lining is to look at it directly.

Cystoscopy does that. A thin tube with a camera and light (a cystoscope) is passed through the urethra, the tube you pass urine from, into the bladder. Sterile water fills the bladder so the lining can be seen clearly, and the urologist checks the urethra, the prostate in men, the bladder wall and the openings of the ureters. A flexible cystoscopy takes about 5 to 15 minutes with numbing gel, and you go home straight after.

Most people find it uncomfortable for a minute or two, mainly as the scope passes through the urethra, and it often gives an answer on the spot. If a growth, stone or narrowing is found, a sample can be taken or the problem treated, sometimes with a rigid scope under anaesthesia.

Our urology department has both flexible and rigid cystoscopes, and treats bladder stones, bladder tumours, urethral strictures and overactive bladder. Urine culture, ultrasound and CT scans are done by our diagnostic team, so the tests that usually go with a cystoscopy can happen in the same hospital.

Cystoscopy is used to find a cause, keep an eye on a known problem or carry out small procedures. The most common reasons are these.

Most urologists tell you what they saw before you leave, and you may be shown the pictures. A normal bladder lining is smooth and pink. Common findings include inflammation from infection, small stones, an enlarged prostate narrowing the outlet, a narrowing of the urethra (stricture), or pouches in the bladder wall from years of straining.

If a growth is seen, it's described by size, number and position. Most bladder growths are removed through the urethra with a rigid scope (TURBT, transurethral resection of bladder tumour), which also tells the lab exactly what kind of growth it is. Biopsy results take about a week. If cancer is found, your urologist explains what stage it is and what comes next. Many bladder tumours are caught early and treated through the scope alone, with regular cystoscopies afterwards.

Cystoscopy only shows the bladder and urethra. When blood in the urine is being investigated, it's paired with an ultrasound or CT scan of the kidneys and ureters. If both are normal and blood keeps showing up, a kidney specialist may check for kidney disease.