Cervical cancer staging with a cystoscopy
After we find a cancer, it's important to know what areas of the body are affected. This is called staging. Staging is important as it helps the doctors decide which treatments are likely to be most effective for you.
When a cervical cancer starts to spread it is most likely to affect the parts of the body close to where the cancer has started. So for cancer of the cervix, it is important to check the bladder, bowel, vagina and the womb for any signs of cancer.
We will examine you while you are under general anaesthetic using a fine tube with a camera on the end. This procedure is called examination under anaesthetic (EUA) and cystoscopy.
A cystoscopy is when a fine tube with a light and a camera (cystoscope) is inserted into the urethra. This is the tube that drains your wee from your bladder away from the body.
Once the camera is in place, your bladder will be filled with liquid or gas. This gives your doctor a better view of the bladder lining making it easier to spot anything unusual. If the doctor sees anything unusual, they might take biopsies (samples) to send to the laboratory. Your doctor will discuss this with you before the procedure.
Sometimes, we may also want to look inside your womb during the examination, using an instrument similar to the cystoscope, called a hysteroscope. If this is necessary, your doctor will discuss this with you.
You can read more information about having a hysteroscopy.
Most types of surgery have some risks. These risks can increase when the person also has a general anaesthetic but most people do not have any problems. Talk to the team looking after you if you have any questions about any of these risks.
Bruising and swelling
You may have some bruising and swelling around the urethra from the cystoscope being inserted. This should clear up after a few days. If it does not, please contact us or your GP as you may temporarily need a catheter (narrow tube) placed in your bladder to help drain your wee until the bruising and swelling goes down.
Damage to the bladder
It is possible to damage the bladder with the cystoscope or when taking a biopsy. This can lead to bleeding and infection, which may need treatment with medicines or surgery.
Bleeding when you pass urine
You may have a small amount of bleeding from the cystoscope being passed up the urethra, or from any biopsies taken. Some patients do not have any bleeding at all, but some find their wee is slightly pink for a few days after this procedure. Drinking plenty of water (about 3 litres over 24 hours) can help. If your wee remains pink after a few days, contact your GP.
Bleeding from the vagina
Do not use internal contraceptives or tampons. Instead you can use a sanitary towel after the procedure. You might notice some small blood spots on your sanitary pad or panty liner for a few days after the procedure. This is quite normal. If you have had a biopsy taken you may find this bleeding does not stop after a few days or becomes heavier. If this happens please contact your doctor, as sometimes an infection can cause prolonged bleeding and antibiotics may help. In a small number of cases the bleeding may be related to the cancer.
If you notice any symptoms of infection such as redness, swelling, heat around the area, discomfort when having a wee, a new vaginal discharge which smells strongly and/or is green or yellow please inform your doctor. You may need a treatment of antibiotics.
- Urine infection. There is also a risk that you will develop a urine infection after your cystoscopy, which could result in a fever and pain when you have a wee. Drink plenty of water to reduce the likelihood of this.
- Chest infection. Occasionally, a chest infection may develop as a result of having a general anaesthetic. You should let your doctor know if you develop a cough with yellow or green coloured spit.
Before the procedure
Before this procedure we will arrange for you to have an MRI scan so that your doctors can look at pictures of the inside of your body. This will help with their assessment of your cancer by EUA and cystoscopy.
You will need a responsible adult to come with you for the appointment or be contactable by phone when you are ready to leave.
If you do not have an escort, or have not arranged to be collected by someone, your procedure will have to be cancelled.
If you cannot arrange this, then please call us on 020 7188 1729 and speak to one of the pre-assessment nurses so we can help to make alternative arrangements.
At your appointment, we ask you to remove all your clothing and change in to a hospital theatre gown.
You are welcome to bring your own slippers and dressing gown with you to wear over the theatre gown if you wish.
A nurse will ask you some questions about your medical history, and then take your blood pressure to make sure you are properly prepared for the procedure.
An anaesthetist will talk to you before the procedure. The anaesthetist puts a thin plastic tube (cannula) into a vein in your arm, often in the back of the hand. We inject medicine through the cannula and you will quickly drift off to sleep.
You can read more about having an anaesthetic.
During the procedure
While you are asleep your doctor uses a speculum (the same as the instrument used to do a cervical screen or smear test) to see your cervix clearly.
Using sterile gloves, the doctor examines your cervix with a finger for any abnormalities to help decide where the cancer is and how big it is.
The doctor also feels for any abnormalities behind the cervix by inserting a finger in to your bottom (rectum).
We may give you an antibiotic to lower the risk of urinary infection.
After the procedure
The procedure usually takes 20 to 30 minutes. When the doctor has finished the examination, the camera is gently removed.
We take you to the recovery unit, where you stay until you wake up. You may have an urge to have a wee (urinate) when you wake up but you may find this difficult as your bladder will be emptied at the end of the procedure.
Before you leave hospital your doctor prescribes painkillers if you need them.
You must have someone to escort you home and stay with you for 24 hours after the procedure. Having someone at home to care for you will give you time to recover from the anaesthetic and also help you in case you have any problems after the procedure.
You might feel light-headed and tired so get plenty of rest for the remainder of the day and the following day. The anaesthetic will take 24 to 48 hours to fully wear off but you do not need to stay in bed for this time. Gently moving around will help.
You may feel a stinging sensation or have difficulty having a wee for the first day or two. Drink extra fluid for the first 24 hours to help improve this. If the pain is severe and lasts for more than couple of days, please contact your GP.
You may need to wear sanitary pads or panty liners for a couple of days to protect your clothing from the small amount of bleeding you may have.
To reduce the risk of infection, please do not have sexual intercourse until any swelling or bleeding has cleared.
We might prescribe antibiotics to reduce the risk of infection if we think it’s necessary. If you have antibiotics it's important you complete the whole course. Do not drink alcohol until you have finished the antibiotics and your symptoms have completely cleared.
You should be given a follow-up appointment, usually for within 2 weeks to discuss the findings and your cancer treatment plan. Contact your clinical nurse specialist (CNS) if you have not received an appointment within a week of your procedure.
Problems or concerns
If you have any concerns, please contact your GP, call the gynaecology ward or call NHS 111.
Contact the day surgery unit if you still have any of the following symptoms 2 days after the procedure:
- extreme pain
- continuous or excessive bleeding
- passing blood clots
- a raised temperature of 38ºC (100.4F) or greater
- excessive swelling
- difficulty having a wee
Phone 020 7188 1734 Monday to Friday, 8.30am to 5.30pm.
Go to your nearest emergency department (A&E) or call 999 in an emergency.
Talk to your clinical nurse specialist (CNS)
Your CNS can provide additional support and information about your cancer, investigations and treatments. They can also provide emotional support during this challenging time and practical advice on concerns you may have, for example with finances or benefits, recovering from procedures or symptoms.
The Department for Work and Pensions can help with enquiries about benefits
Jo's Trust – for those affected by cervical cancer
Resource number 2825/VER4
Date published: April 2023
Review date: April 2026