23 yrs old male. my urologist thinks i have hypertonic pf but only assuming says he wants to do a cycstoscopy. is this a good way to go? i have painful urgency to urinate been going on for 3 years is there any long term negatives to cycstoscopy?

In a cystoscopy, a scope is placed into the bladder so it can be directly examined. If your urologist is recommending this, then it is the next step in your diagnosis and treatment. There would be no long-term effect from looking into the bladder. Your doctor can explain the potential short term side effects but they are short-lived. Good luck to you!