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Telecystoscopy can lower the barrier to access critical urologic diagnostics for patients around the world. A major challenge for robotic control of flexible cystoscopes and intuitive teleoperation is the pose estimation of the scope tip. We propose a novel real-time camera localization method using video recordings from a prior cystoscopy and 3D bladder reconstruction to estimate cystoscope pose within the bladder during follow-up telecystoscopy. We map prior video frames into a low-dimensional space as a dictionary so that a new image can be likewise mapped to efficiently retrieve its nearest neighbor among the dictionary images. The cystoscope pose is then estimated by the correspondence among the new image, its nearest dictionary image, and the prior model from 3D reconstruction. We demonstrate performance of our methods using bladder phantoms with varying fidelity and a servo-controlled cystoscope to simulate the use case of bladder surveillance through telecystoscopy. The servo-controlled cystoscope with 3 degrees of freedom (angulation, roll, and insertion axes) was developed for collecting cystoscope videos from bladder phantoms. Cystoscope videos were acquired in a 2.5D bladder phantom (bladder-shape cross-section plus height) with a panorama of a urothelium attached to the inner surface. Scans of the 2.5D phantom were performed in separate arc trajectories each of which is generated by actuation on the angulation with a fixed roll and insertion length. We further included variance in moving speed, imaging distance and existence of bladder tumors. Cystoscope videos were also acquired in a water-filled 3D silicone bladder phantom with hand-painted vasculature. Scans of the 3D phantom were performed in separate circle trajectories each of which is generated by actuation on the roll axis under a fixed angulation and insertion length. These videos were used to create 3D reconstructions, dictionary sets, and test data sets for evaluating the computational efficiency and accuracy of our proposed method in comparison with a method based on global Scale-Invariant Feature Transform (SIFT) features, named SIFT-only. Our method can retrieve the nearest dictionary image for 94–100% of test frames in under 55[Formula: see text]ms per image, whereas the SIFT-only method can only find the image match for 56–100% of test frames in 6000–40000[Formula: see text]ms per image depending on size of the dictionary set and richness of SIFT features in the images. Our method, with a speed of around 20 Hz for the retrieval stage, is a promising tool for real-time image-based scope localization in robotic cystoscopy when prior cystoscopy images are available.