Procedural Module: Flexible Cystoscopy

Cystoscopy is a basic urologic skill necessary for the endoscopic evaluation of the urethra and bladder. Presented is a step-by-step guide for flexible cystoscopy of the male and female patient.

Routine flexible cystoscopy was performed on a male patient with a history of upper tract urothelial carcinoma and a female patient as part of a hematuria evaluation. The male patient was positioned supine, and the female patient frog-leg supine. Preoperative equipment included a flexible cystoscope (Storz 11272 VP; Karl Storz, Inc., Germany), irrigant, lubricating gel, sterile gloves, and towels/drapes. A typical cystoscopy room layout is shown.

This guide outlines the indications, preoperative preparation, and procedural steps for each gender, postoperative care, and troubleshooting recommendations. The video depicts the author's (R.V.C.) typical office cystoscopy procedure. In both cases, the cystoscopies were within normal limits.

A simple, standardized manner for performing office-based flexible cystoscopy is essential to the practice of all urologists. By following the outlined steps, the urethra and the entire bladder, including the bladder neck area, can be thoroughly evaluated.