Cystoscopy questions

August 11, 2012 11:38 AM

Cystoscopy questions - likelihood of procedure on first visit, pain etc.

I've got an appointment with a Consultant Urologist on Tuesday, having been referred by my GP due to the sensation of a bit of a 'blockage' when urinating, some pain at times, terminal dribbling and needing to urinate frequently.

When I received the confirmation letter from the clinic they said that they like to do all investigations that they might need while you're there for your first appointment, to save you having to arrange appoints to come back and see them later etc. Apparently I see the consultant first and then may have various investigations performed

My question is: are they likely to do a cystoscopy during this first appointment? Looking at information on the internet suggests that they may do urine flow tests and radiography etc, and I don't mind about those (no pain!) - but I'm really rather concerned about a cystoscopy.

Again, from reading online, it seems that rigid cystoscopies require general anesthesia (for men at least - and I'm male) so I'm pretty sure I wouldn't be having one of those in my first appointment, but my GP said it was likely to be a flexible cystoscopy - which it seems can be done with a local numbing gel.

Has anyone had one of these done with no prior notice - in an appointment like this, for example? And if anyone has had one done - was it painful? I can imagine them covering my penis in numbing gel, but given that it's going down the middle of the penis that bit won't be numbed! I mean, can you feel it moving down the penis? I guess the bit I'm most worried about is the insertion at the end - my glans is incredibly sensitive and I can imagine that would hurt a lot.

Any views or past experiences would be most welcome

posted by robintw to health & fitness (3 answers total)

I don't know about the likelihood of them doing a flexible cystoscopy during the appointment (I knew I was going in for it), but I can describe what it's like to have one. I'm also a guy.

In my case, the consultant put some stuff on the head of my penis, but I'm not sure if that was an anaesthetic of some sort or an antiseptic. It didn't hurt. Then he used a syringe (note: JUST a syringe, not the needle!) to put some numbing gel down my urethra. That part didn't hurt, just felt a bit weird.

At that point, he told me to look away and brought out the scope itself. It hurt going in, but it wasn't agonising or anything. Imagine a brief stinging sensation every time he pushes it further - the pain goes away completely when it's stationary.

Once it gets all the way down, so that it's no longer going along the length of your penis, the pain becomes a LOT easier to handle. The only really painful moment after that was when he turned the whole thing sharply at one point to investigate something, which kind of hurt.

Overall, the pain was genuinely unpleasant, but not anywhere near being unbearable. Apart from the pain, there's also the sensation of them pumping saline solution into your bladder. A lot, er, comes back out, but it's not as weird as you'd think.

My advice would be to relax and not freak out over it. It's all over in a matter of minutes. Peeing will sting quite a bit for a day or two afterwards, which is annoying but easy to cope with.

Good luck!
posted by anaximander at 1:06 PM on August 11, 2012

I can't imagine they would do a regular cystoscopy under general anesthesia during that 1st visit. When I had mine done there were specific instructions as far as what I could or could not drink the night before and I had to formerly arrange for transport after the procedure (I couldn't drive myself home after coming out of the anesthesia). So I think you would have been informed about those things if that was part of the plan.
posted by Seymour Zamboni at 2:23 PM on August 11, 2012

I agree that they are unlikely to spring the rigid version, with full anesthesia, on you as a surprise.

The flexible one, though, could be dropped in your lap, so to speak. It happened to me unannounced on my first appointment at the urologist; I'd never even heard the word "cystoscopy" before that moment, and thirty seconds later my pants were down and this cute nurse was prepping me. They brought the apparatus out and I'm all, "You want to put that WHERE???"

But shock value aside, it really wasn't a big deal. Anaximander's description pretty much matches mine, but I had fewer ouchy moments from the sound of things. It definitely felt weird during the procedure, and the first pee afterwards was super weird (it didn't hurt, but you know how they put in numbing gel and lube at the beginning? That stuff has to come back out...).

They didn't have me look away, but it would probably be a good idea if you get weirded out by medical stuff. If anything, it was like one of those scenes in whatever Alien movie it is where the tentacles are going into the guy's nose -- not a sight one sees often in one's penis.

So seriously, not a big deal, not painful, and not worth worrying about. Honestly, I found it less painful and more dignified than when they stick their finger up your bum and poke at your prostate, if that gives you a point of comparison.
posted by Forktine at 4:03 PM on August 11, 2012