ObjectiveTo access the feasibility of using “flexible ultrasonic cystoscopy (FUCS)” (ultrasonic bronchoscope Olympus BF-UC260F-OL8 as a substitute) for staging of bladder cancer. MethodsFrom Jun. 2010 to Nov. 2010,36 patients with primary bladder urothelial carcinoma were examined by “FUCS” before operation and were staged by “FUCS” findings. All patients received IVP and enhanced pelvic CT. Non-muscle-invasive bladder cancer patients received TURBT,and the tumor base was routinely biopsied for pathology.Pathological results,traditional imaging evaluation, and “FUCS” evaluation were compared. Visual analog scores (VAS) were also compared between patients receiving “FUCS” and routine cystoscopy. ResultsCompared with conventional cystoscopy,the VAS of patients receiving intraoperative “FUCS” was significantly lower (1.3±0.5 vs 4.3±0.9, P<0.01). Of the 36 patients,28 were diagnosed as non-muscle-invasive bladder cancer (Ta+T1) and 8 were diagnosed as muscle-invasive bladder cancer (T2+T3). Based on the postoperative pathologic results,“FUCS” had a 100% accuracy in diagnosing non-muscle-invasive and muscle-invasive bladder cancer. Conclusion“FUCS” is painless and feasible in clinical practice; it can display the depth of bladder wall invaded by tumor, and can be used for preoperative staging of primary bladder tumor.