“Do they put you to sleep for a cystoscopy?”

That is the most common way of doing a cystoscopy

In general, the answer is "no," urologists do not use general anesthesia or intravenous sedation to perform diagnostic cystoscopy. Urologists usually use a lubricating jelly (similar to "KY Jelly") containing the local anesthetic lidocaine to lubricate the urethra and the shaft of the cystoscope. The most common patient response to cystoscope insertion (both females and males) is a sense of needing to urinate; most patients describe the procedure as mildly uncomfortable (at worst). The procedure is usually done in the urologist's office. Rarely, urologists will have an anesthesia professional provide sedation, regional anesthesia (e.g., "spinal block") or general anesthesia for a cystoscopy, usually in a situation where it is deemed "medically necessary." An example would be a patient with complicated urethral/bladder anatomy (perhaps caused by prior trauma, prior surgery, or radiation for cancer) or an unusual medical condition. For example, despite apparently lacking skin sensation below the umbilicus, a patient with paraplegia or quadriplegia due to a spinal cord injury can develop potentially life-threatening problems with blood pressure and heart rate during cystoscopy and bladder irrigation; such patients would typically receive care from an anesthesia professional in a hospital or an outpatient surgery center.

Jeffrey Anderson, MD