Had a flexible cystoscopy on Thursday, my second one in 3 months, and actually my third in total (the first being during original prostate cancer diagnosis nearly 6 years ago).
This was kicked off by peeing blood at Christmas. Actually, the blood was immediately after peeing - it didn't seem to be in my urine. Then it was in semen too. Being around Christmas/new year, I was wondering what to do about it. Then bizarrely, I got a call out of the blue from a urology consultant who asked me how I was doing. I'm under oncology, not urology, so this surprised me on many counts. Someone jokingly suggested my toilet must be connected via the Internet back to the hospital! He said he'd bring me in for ultrasound scan of upper urinary tract (I know that's to check for any cancer or other problem with kidneys/upper urinary tract) and a flexible cystoscopy (that's to check bladder/lower urinary tract). I wasn't referred on a 2WW, but did get the ultrasound quite quickly, which was all clear.
Then I got a UTI, although it took me a while to realise the increasing pain and urgency might be that. I do have a tub of the Multistix dip tests at home which would have told me instantly, but I was not at home for a week when it happened. Got a GP nurse appointment last thing on a Friday which I rushed back for, which showed a UTI, and immediate antibiotics prescribed, which fixed it, although it did turn in to prostatitis for a couple of days before it completely went. A UTI causes positive leukocyte/nitrite dip test results, but usually also causes positive blood and protein in urine by the time it's bad enough to notice you have it, which indeed mine was. I monitored this with periodic tests, and the leukocyte/nitrite test went negative quickly showing the infection had gone, but the blood and protein took a month to clear as tissue damage heals more slowly.
My flexible cystoscopy came through the day the protein level went negative and blood level was down to the lowest detectable on the dip test. The cystoscopy showed my bladder was quite a mess with loads of large red blotches (which definitely weren't there nearly 6 years ago). The urologist was clearly thinking bladder cancer and said it looked worse than is typical for radiation cystitis (which I also guessed wouldn't be all around the bladder), but I was thinking scarring from the recent UTI. Urologist wanted to book me straight in for a rigid cystoscopy under general anesthetic to take biopsy samples. I wanted to wait a bit longer for the UTI scars to heal if that's what it was, so he agreed to do another flexible cystoscopy in 4-6 weeks. The followup letter suggested the MDT (who I presume must have watched the video later) didn't think it looked like bladder cancer.
The 4-6 weeks became 3 months, and a different registrar did it on Thursday. Getting rather used to these now, I asked if she could give a commentary on where we were looking, which she did. Bladder was now completely clear of the red blotches, and looked fine. There wasn't even any sign of radiation cystitis in it (and I've never had any symptoms of that). I think she took me on more of a tour around because I asked for a commentary, which was very interesting, pointing out the bladder neck looking back from inside the bladder, the ureters, the inside of the prostate, etc. Although I have a large prostate (it was 93cc and 97cc on a couple of the early scans), the urethra through it isn't occluded, but does have lots of exposed blood vessels. I think this is where the bleeding was coming from, in which case it's of no significance (or surprise) after radiotherapy. My urethra is narrowed in the penile bulb where the HDR brachytherapy catheters passed through, but no scarring, so it might not be an active stricture, but something to keep an eye on if my flow rate reduces. She had to dilate it a bit to get the camera through. That stricture was probably caused by the HDR brachy, because that wasn't there before treatment.
Anyway, no further followup required, unless I notice my flow rate reduce.