A cystoscopy is a medical procedure allowing a doctor to examine the inside of the bladder and urethra using a thin, lighted instrument called a cystoscope. This diagnostic tool is used to identify issues like stones, infections, bleeding, or abnormal growths within the urinary tract. Proper preparation is necessary to ensure the procedure is safe, accurate, and not delayed. Following specific instructions from your healthcare provider, which differ based on the type of sedation used, is fundamental to a successful experience.
Managing Medications and Logistical Planning
Preparation often begins days or weeks before the procedure with a thorough review of all medications you currently take. You must discuss all prescription drugs, over-the-counter medicines, and herbal supplements with your physician, as some may interfere with the procedure or anesthesia. Medications that affect blood clotting, such as aspirin, ibuprofen, or prescription blood thinners, are of particular concern because they increase the risk of bleeding. Your doctor will provide a specific schedule for when to temporarily stop these substances, often several days in advance.
Patients with diabetes taking insulin or oral agents need personalized instructions on adjusting their dosage. Since the procedure may require fasting, maintaining a normal medication schedule could lead to dangerously low blood sugar levels. A coordinated plan with your endocrinologist or the procedure team is necessary to manage glucose levels safely. Additionally, ensure all administrative requirements are complete, including confirming insurance coverage and pre-authorization, to prevent last-minute cancellations.
You will likely sign informed consent documents before the procedure, acknowledging the risks and benefits of the cystoscopy. You must also arrange for transportation home, which is a non-negotiable requirement if any form of sedation is administered. A responsible adult must be available to drive you home and, in some cases, remain with you afterward. If you are having a flexible cystoscopy under local anesthetic, confirm with the clinic if you are allowed to drive yourself.
Fasting and Immediate Pre-Procedure Instructions
The most specific preparations occur in the 24 hours leading up to your cystoscopy, particularly concerning food and drink intake. If you are receiving general anesthesia or intravenous (IV) sedation, you will be given strict instructions to stop eating solid foods and drinking liquids after midnight the night before. This fasting period is a safety precaution to ensure your stomach is empty, significantly reducing the risk of aspirating stomach contents into the lungs during sedation.
You may be permitted to take necessary oral medications on the morning of the procedure with only a small sip of water, but this must be explicitly cleared by your physician. If a biopsy or more extensive treatment is planned, your doctor may require a specific bowel preparation, though this is usually not necessary for a standard diagnostic cystoscopy. On the morning of the procedure, shower or bathe, but avoid applying lotions, powders, perfumes, or deodorants to your skin.
For comfort and ease of access, wear loose-fitting, comfortable clothing, and leave all jewelry and valuables at home. Upon arrival, you will usually be asked to empty your bladder so the physician can assess residual urine volume. However, if your doctor has requested a pre-procedure urine sample, you may be instructed to arrive with a comfortably full bladder, so clarify this instruction beforehand.
Understanding Anesthesia and Sedation Choices
The type of anesthesia or sedation planned directly dictates the strictness of your pre-procedure preparation, especially the fasting requirements. A flexible cystoscopy uses a narrow, bendable tube and is often performed in an outpatient clinic using only a local anesthetic gel applied to the urethra. This fast-acting numbing agent allows you to remain fully awake, meaning you can typically eat and drink normally and drive yourself home afterward.
In contrast, a rigid cystoscopy, or any procedure involving a biopsy or removal of a bladder lesion, usually requires a more profound level of sedation. This includes IV sedation, spinal anesthesia, or general anesthesia, which provide a deeper state of relaxation or unconsciousness to manage discomfort and allow for complex instrument manipulation. Because general and IV sedation temporarily impair protective reflexes, the pre-procedure fasting rule is strictly enforced to prevent aspiration. Due to the use of deeper sedation, you must have a pre-arranged, responsible adult driver to take you home safely.