Are cystoscopies always painful, or do they only hurt if you have cancer?

Usually uncomfortabl. Performing a cystoscopy is an office procedure done with local anesthesia only. It is usually a little uncomfortable but not very painful. Having cancer does not make the procedure any more or less painful.
Discomfort for all! Cystoscopies are somewhat painful. The doctor performing the procedure will use numbing medication to reduce the pain, and might give you some sedation to relax you, but it's an uncomfortable procedure. Discomfort during cystoscopy does not mean you have cancer!