Introduction: There has been considerable expansion in the use of flexible cystoscopy (FC) and people who can perform the procedure. Hence, there is a criticism that this procedure is being overused with no management benefit. Materials and Methods: We audited the use of FC in a district hospital for a period of 1 year. The results of FC for non-standard indications (other than haematuria and check cystoscopy) were analysed for their diagnostic yield. Results: Of the 1,390 FCs performed, 295 were done for non-standard indications. 46.14% of these cystoscopies had positive findings. Cancer detection rate was 6.10%. Cystoscopy altered the management in 14.08% of patients and was supportive to diagnosis and management in 32.06%. Conclusion: This procedure is certainly not overused and the ever-increasing requirement of this simple procedure has serious resource implications for the National Health Service.

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Hiatus hernia refers to upward displacement of the stomach through the diaphragmatic esophageal hiatus into the thoracic cavity. It is rare in children and may be asymptomatic or may present with various symptoms. We are reporting a case of sliding hiatus hernia detected incidentally in a 6 year old boy.

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