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Cystoscopy Anxiety: What to Expect

I've been having pelvic pain for about a year and my Uro suspects varecoceles. To rule out other issues I had a cystoscopy done. It wasn't as bad as I had worked myself up for. I went through the procedure without any sedation. The doc used a flexible scope and had a monitor I could watch if I wanted.

Prep:
The nurse had me strip my bottom clothes off and I laid down on a small declined table. I had a gown on top and she cleaned me up with iodine and put sterile leggings on me. Personally, I think the cleaning was the worst part because it was a bit embarrassing. She injected lidocaine gel which did burn for about 10 seconds and put a clamp on. The clamp did not hurt. I waited maybe 10 minutes for the doctor.

Procedure:
The doc came in and explained what he was going to do and that I should feel only pressure and maybe some pain when he went through my prostate. He squirted some water and guided the scope down my urethra and took a picture of my prostate. I hadn't really felt much up to this point. When he went through the prostate it did hurt. It was a burning sensation I've experienced a few times when urinating after ejaculation so it makes sense. It was no worse than that. Once he was through i could feel a little but of the movement. He gave me a tour of my bladder and then removed the scope. He was in and out in not much more than a minute.

Post Procedure:
I had to pee really bad because of the water he injected. I also had a CT scan where I had to drink lots of water beforehand so my bladder was filling quickly from that as well. We could see it on camera.

Nurse and doc left the room and I was allowed to clean myself with soap and a washcloth and towel. I emptied my bladder in the bathroom with no discomfort. I haven't experienced any discomfort like other people have said they had after the procedure. I was even able to leave a semen sample for analysis after the test. My doc and I met in a separate room to go over his findings from my tests.

Final thoughts:
Like everyone else has said the anxiety is the worst part. The procedure was relatively noninvasive just embarrassing. Even that wasn't so bad because the staff and doctor were very professional and attentive. The peace of mind was well worth the 11-12 minutes of being uncomfortable. The only cautionary statement I'd like to make is to point out the fact that it will probably hurt worse if your prostate is already irritated or inflamed. One way to avoid that would be abstinence from ejaculation for a couple days before the procedure. The scope is through the prostate pretty quickly so it should subside quickly once it is on the other side. Thanks for all of this info. It was very empowering to have this knowledge before my procedure.

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I recently had a cystoscopy, with a flexible scope. I want to share my experience for all those who may be facing this and feel understandable anxiety. I have BPH and occasional bouts of prostatitis.

First, I've had two of these procedures 12 years apart; the first under general anesthesia with a non-flexible scope, the second, very recently with a local anesthetic. This account concerns the second procedure, which was for examination purposes, not surgery.

Most patients will undergo a cystoscopy with local anesthetic in your doctor's office. Like me, you will be nervous about this prospect. Indeed, I lost a lot of sleep for a couple of weeks beforehand, imagining the worst. Here is what you need to know, from someone who just underwent this procedure.

First, the local anaesthetic (usually Lidocaine) is very effective. So effective, you will experience little at all through most of it, certainly no pain. Your doctor may (as mine did) administer a calming drug, Valium (10 mg), about 20-30 minutes before the procedure. This helps. If he doesn't offer it, ask him for it. It doesn't make the experience more painless, it just reduces the anxiety.

If you are extremely anxious, you can ask for a shot of Demerol as well. I did, but in retrospect I don't think it was necessary. Mostly the Demerol made me feel a bit woozy after the procedure. In any case, if you have Valium or Demerol, somebody will have to drive you home after the procedure.

Once the Valium has taken effect, the doctor will inject a Lidocaine gel into your urethra. This is not as bad as it sounds. The doctor does not use a needle. The syringe is just that, a plastic tube without a needle. Pressure alone suffices to get the stuff in. You will hardly feel anything at all as this happens. He will probably inject it twice to get the full dose. Don't worry about this part, you will hardly feel anything.

The Lidocaine works fast, in about 20 seconds. They doctor will then proceed with the cystoscopy. I used a sheet so I didn't look, to reduce anxiety. I didn't feel much at all. Only a vague sensation that something was happening.

Reading these forums, I expected some discomfort when the tube reached the prostate (I have BPH). To my surprise, I didn't feel anything. (I did keep up a dialogue with the doctor during all this, a technique I have long used during any mildly uncomfortable medical procedures to distract attention: I recommend this in any case.). The next thing I knew, the doctor told me he was looking inside the bladder. I was surprised a bit, because I hadn't felt the scope enough to know where it was.

I did feel a twinge or two during this phase, which lasted about a minute, maybe a bit more. I seemed to feel these twinges when he moved the cystoscope around to inspect the bladder. They were twinges, not painful, just a little unfamiliar. Believe, nothing to worry about.

I had also read and worried a bit about the part of the procedure when the doctor injects water into the bladder to make it more accessible and visible for his inspection. I had expected to get an urgent feeling of needing to urinate.

To my surprise, this did not happen. While he injected water, I hardly felt a thing. Only the mildest feeling of fullness, well within easy tolerance.

When he was finished his examination, he slowly pulled the instrument out. I could hardly feel this until I felt a gush of water on my pelvis, after withdrawing the instrument. It was all over, having taken at most 2 or 3 minutes, probably less.

Bottom line: this procedure is a lot less uncomfortable, let alone painful, then is the worry and anticipation leading up to it.

Now for the bad news.

After the procedure the local anesthetic wears off very quickly, within three or four minutes, When it does, your bladder and urethra will feel sore. Urinating will be painful: a burning sensation. It will take a long time to begin to urinate, with a thin stream, and be quite uncomfortable for the first 12 hours. The second 12 hours it will be a bit better, but only a bit. After 24 hours it will still be burning, but not nearly as bad. After 48 hours you will feel almost normal. Complete normality, in terms of urination and ejaculation may take a few more days, but this period is without any real discomfort at all, only the realization that you are not completely back to normal.

I'm 59 years old and had my first cystoscopy today. Mine was a routine follow-up visit to the urologist. I'd been having discomfort in the bladder area and having a need to get up at night to urinate for quite some time. Long story short, the cystoscopy was no "garden party," so to speak, but it certainly wasn't as bad as I thought it might be. I was surprised it could be done right there in the doctor's office. I had the local anesthetic. Yes, the procedure is a little uncomfortable, but not bad. Mostly just a feeling of pressure in the area. It was all over in about 5 minutes. It's reassuring to know he found nothing except some enlargement of the prostate typical for a man my age. Hope this report helps anyone who's apprehensive about the test.
Howard in Missouri

I recently had a cystoscopy and I must say the pain was not that bad. I was put under general anesthesia and the procedure lasted about 20 minutes. I woke up, felt completely fine and went home without incident. I spent the rest of the day relaxing and drinking many Arnold Palmers. My doctors and nurses said that the more I drink, the more I will urinate (obviously). the more I urinate will make the pain less severe and would cause the pain to stop sooner. It did hurt a bit to urinate the first couple of times, but only just before you go. Over the course of two days, the pain subsided and by the third day, I was in no pain at all.

In terms of side effects, I really suffered from none. I was not groggy or woozy at all immediately following the procedure. I was alert and surprisingly, very hungry (my procedure was in the early afternoon and by the end of it, hadn't eaten in more than 15 hours!). Additionally, I was given pyridium to combat any pain when I urinated; I was given this immediately after I woke up and forgot I took it...until I saw my urine (this makes your urine a orange color).

Overall, the procedure can cause a lot of anxiety and worrying, but I am here to say that is all unnecessary. Having piece of mind is worth a couple of days of discomfort (and because it only hurts just before you urinate, it is actually only a couple of minutes). Good health to everyone!
Jay

 

 

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