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Advice? Cystoscopy scheduled for Dec 11

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Posted 12/3/2014 4:01 PM (GMT 0)
After a brief altercation with scheduling through the urologist's office, I'm on now for Dec 11. This is to look for causes of blood in urine, probably related to my radiation therapy. It's not too worrisome, the symptoms weren't real severe, visible but not dramatically so. I haven't had any more incidents in almost a month.

Many here have surely had a cystoscopy, so I'm looking for any suggestions about it. Should I push for any specifics with anesthesia, local, etc.? Is it likely I can go right back to my office afterward, or should I plan to take the rest of the day off?

Thanks in advance for any advice you may offer!
Posted 12/3/2014 4:42 PM (GMT 0)
I had mine without anesthetic. Not pleasant but not overly terrible either. Does not take very long (at least for those of us on Lupron with such a short distance to traverse).

Not sure if you hae ever had gold fiducials placed, but I thought thaat preocedure was worse

LupronJim
Posted 12/3/2014 7:07 PM (GMT 0)
I have had several cystoscopies under 2 different Uro's.

Both used light anaesthetic, which although very mild, meant no driving for 24 hours. Also meant pain free.

Unfortunately I also have strictures and after each cystoscopy, I ended up in urinary retention, requiring catheterisation. Shouldn't be an issue for you.

One of the Uro's made the point that he uses the smallest scope possible (14Fr I think). That should also minimise discomfort.

Good luck

Chas
Posted 12/3/2014 7:42 PM (GMT 0)
Mine was done without any anesthetic; tolerable and much less discomfort than the biopsy. I was readied for the procedure (i.e. stripped with towel across my lap) at least 25 minutes before the urologist came in. A bit chilly. This resulted in my bladder started filling up and the doctor remarked he couldn't examine the bladder wall completely. I had drank a bunch of water before going into the office because they seem always want an urine sample starting off. All to say, I would recommend draining the bladder as close to the procedure as possible, don't over-hydrate and speak up if they keep you freezing on the exam table for 30 minutes before starting.

Mine was done due to a couple episodes of blood two years after SRT. Nothing discovered and attributed to a bit of radiation burn. The blood has not been visible for over a year.

Our best,
Jake
Posted 12/3/2014 7:49 PM (GMT 0)
Mine was a lot like Jake described except that before she handed me the towel the nurse gave Mr Unrelable a squirt of drippy goo. (I briefly considered a "turn about is fair play" joke here but decided to stay classy, so we'll have none of that...) My wait wasn't 30 minutes -- more like 15 -- and was intended to give the goo a chance to numb me up. The actual procedure was something of a non-event for me. I drove myself back to work and didn't notice any after effects.
Posted 12/3/2014 8:41 PM (GMT 0)
Ditto to the last two posts-> "Done without any anesthetic; tolerable and much less discomfort than the biopsy."

I won't mention the part about finding a staple that was being rejected by my body and how the URO tried to yank it out. I think we both almost cried... Went back for day surgery.
Posted 12/4/2014 3:33 AM (GMT 0)
They actuallydo use a topical anesthetic, usually Lidocaine, which numbs things up. I would say no general anesthetic is necessary, but may not want to listen to me. I do teeth fillings, colonoscopies, and uteroscopies without anesthetics.

Goodlife
Posted 12/4/2014 3:55 AM (GMT 0)
Lidocaine (also known as Lignocaine) is also used for catheter insertion.

I have had many catheters inserted, often quite painful.

Unfortunately, many practitioners give a squirt of Lidocaine then immedietly ram the catheter in, before the gel has had time to have an anaesthetic effect.

I always insist that they inject the lidocaine then wait at least 2 minutes, preferably 3, before inserting the catheter, or in this case the cystoscope. Is usually then much more comfortable. I also had one Dr who, off his own bat, used 3 doses to ensure the full length of the urethra was desensitised.

He was my hero.

Chas
Posted 12/4/2014 4:01 AM (GMT 0)
the key is to relax and let the uro do what he does. I felt no pain and it was in the bladder checking around, again no pain. Coming out the same. Its the fear thing again, which really doesn't help, I know. but none the less true. This, if your urethra is medically sound. All bets are off if the previous is not true.
Posted 12/4/2014 12:25 PM (GMT 0)
Thanks, guys! There's sure a wealth of experience here.

The lidocaine with a pause sounds like a good idea. I respond slowly to novocaine, often the dentist and hygienist are standing there, tapping their feet, repeatedly asking if I'm numb yet. Sorry! It's biological and it's slower than normal. Maybe the same with lidocaine.

I'm not fearful about this, and it's not likely extra "chemical help" will be necessary. I'm a little concerned about what happens when they slide that rascal through my thoroughly cooked little prostate. Hopefully things in there are tolerant of such violation!

Thanks again, and I'll post when I get the results for sure.

Jerry
Posted 12/4/2014 12:40 PM (GMT 0)
Jerry,

Sometimes we envy one another's problems here. With my post-RP leak, I am convinced that a skilled urologist could navigate a broom handle through my urinary sphincter without touching the sides.
Posted 12/4/2014 2:15 PM (GMT 0)
My first cysto was done with a squirt of Lidocaine then immediately the catheter was inserted without allowing the the gel to soak in and achieve its anesthetic effect. If I wasn't in such shock after I would have hurt someone. DONT LET THEM DO THIS TO YOU.

Now I insist that the give me a squirt, wait 5 minutes and then return and give me a second squirt. Yes it slows them down, but I refuse to suffer when it's completely avoidable.

Cystos are almost non events if done properly, but I still take 10 mgs of valium to help me relax.
Posted 12/4/2014 3:34 PM (GMT 0)
Redwing57 -

Accurate accounts above, all of them.

I had to go the cystoscopy route myself back in my TURP days, as part of the investigatory prep for that surgery. No pain, just rather uncomfortable.

In my case most of the time was actually spent with the nurse getting me ready, as the doc was in, did the procedure, and was out pretty quick (but he did say things looked OK as he was out the door). I think the nurse had a lot of experience with these, as she said after applying the numbing gel that "we need to wait at least a few minutes" for it to take effect.

That's the point I am posting to emphasize. INSIST that it has been "at least a few minutes" before the procedure starts, even if everyone else is in a hurry. You won't regret it.
Posted 12/4/2014 3:57 PM (GMT 0)
Peter, you crack me up man! A broom handle....

Thanks for the laugh!
Posted 12/7/2014 7:13 AM (GMT 0)
As the others have said with the lidocaine there is no real pain just a bit of discomfort and a little embarrassment with a team of females looking on. But make sure they wait a bit for the lidocaine to kick in. Id rove home after the test and went to work the next day.
All the best.
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