A cystoscopy is an examination of the inside of the bladder and urethra, the tube that carries urine from the bladder to the outside of the body. In men, the urethra is the tube that runs through the penis. The doctor performing the examination uses a cystoscope — a long, thin instrument with an eyepiece on the external end and a tiny lens and a light on the end that is inserted into the bladder. Cystoscopy is performed with a cystoscope — a specialized tube with a small camera on the end (endoscope). There are two types of cystoscopes: • Standard, rigid cystoscope • Flexible cystoscope The way the cystoscope is inserted varies, but the test is the same. Which cystoscope your doctor uses depends on the purpose of the exam. If the standard rigid cystoscope is used, you will lie on your back with your knees up and apart. If a flexible cystoscope is used, this position will not be necessary. The procedure usually takes 5 — 20 minutes. The urethra is cleansed. A numbing medicine is applied to the skin lining the inside of the urethra, without using any needles. The scope is then inserted through the urethra into the bladder. Water or salt water (saline) flows through the cystoscope to fill the bladder. As this occurs, you will be asked to describe the feeling. Your answer will reveal information about your condition. As fluid fills the bladder, it stretches the bladder wall. This lets your health care provider see the entire bladder wall. You will feel the need to urinate when the bladder is full. However, it must remain full until the examination is complete. If any tissue appears abnormal, a small sample can be taken (biopsy) through the cystoscope and sent to a lab for analysis. How the Test Will Feel You may feel slight discomfort when the cystoscope is passed through the urethra into the bladder. You will feel an uncomfortable, strong need to urinate when your bladder is full. You may feel a quick pinch if a biopsy is taken. After the cystoscope is removed, the urethra may be sore. You may have blood in the urine and a burning sensation during urination for a day or two. Why the Test is Performed • Check for cancer of the bladder or urethra • Diagnose and evaluate urinary tract disorders • Diagnose recurrent bladder infections • Help determine the cause of pain during urination