Cystoscopy is the primary diagnostic modality for the diagnosis of bladder carcinoma because it confers low risk and allows the urologist to take biopsy specimens and resect papillary tumors during the same procedure. Cystoscopy with bladder biopsies is generally performed as an outpatient procedure with the patient under general anesthesia. On occasion, it can be performed in the urologist's office, with local anesthesia obtained by instilling anesthetic agents into the bladder. ^{[1, 2, 3]}

Patient comfort with cystoscopy should be paramount. Viscous lidocaine may somewhat decrease the discomfort for men, but lubrication appears to be more important for patient tolerance. The use of lidocaine has shown little benefit in women in randomized controlled trials. Adequate lubrication, gentle technique, and facilitation of patient relaxation are the most effective measures to allow tolerance of the procedure.

Cystoscopy may be an embarrassing procedure for the patient. Exposure and handling of the genitalia must be performed with respect. The patient remains exposed only as long as is necessary to complete the evaluation.