cystoscopy - eep
May 27, 2009 8:42 AM   Subscribe

Cystoscopy - have you had one? Do I need one?

I've been recommended to have a Cystoscopy because of Interstitial Cystitis. Apparently it will tell me whether there is any damage to the inside of my bladder which needs a long course of antibiotics.

I don't really want to take antibiotics if I can help it. And from what I read online this is an uncomfortable procedure which leaves you in discomfort for at least 24 hours. I wonder if i might be left wondering after why i put myself through it.

Have you had one, how bad was it, and was there anything worthwhile about having it?

short version: would i be avoiding a damned nuisance and waste of time, or just being a pussy, if i cancel?
posted by anonymous to Health & Fitness (8 answers total)
I've never had cystoscopy, but I've observed several (while in medical school). My impression from patients was that, while not a fun time, it was not a significantly painful/awful procedure. Patients who chose spinal anesthesia for the procedure were able to carry on a conversation during the process. You may have the option of general anesthesia, if you're really concerned about discomfort?
posted by BundleOfHers at 8:52 AM on May 27, 2009

I had one for IC. It really wasn't bad, and I have a particularly hard time with medical procedures. I was under general anesthesia for the whole thing. The only thing that was frustrating was that it was inconclusive, so I didn't really gain anything from the procedure.

You might want to look on one of the several IC support forums to hear more about other people's experiences.

Good luck!
posted by emilyd22222 at 9:01 AM on May 27, 2009

You don't say if you are male or female... I think that makes a big difference when you're talking cystoscopy.

I was scheduled to have one plus have a CT scan to look at everything, too. I am a female. I was not going to have any anesthesia except local for insertion. (Fortunately, for me, the issue was not in my bladder so I don't have to have these tests after all.)

As a female who has had a Foley catheter before, I was not really concerned about it. I was just going to ibuprofen up before and after the procedure. I also think anti-anxiety meds like Ativan or Valium are good in these situations, too. You just take it before the procedure and it mellows you out--not that you're rendered totally incapable of doing anything, but so that you are not freaking out about things.

I can't imagine that a cystoscopy on a man is carried out without some type of more serious anesthesia like twilight or spinal. If your doctor hasn't been clear about your options with you, ask about them. There are some wonderful drugs out there specifically for these purposes!

Bonus: if you do it, you get to see the inside of your bladder! I would insist on seeing the screen during the procedure. I remember seeing the screen during my endoscopy and that was cool.

Good luck!
posted by FergieBelle at 10:10 AM on May 27, 2009

I hate to break this to you but I had one and almost sixteen years later, I remember the discomfort. YMMV. It did help in that I had some chronic pain that went away after the doctor said, "Aha," and prescribed the correct course of antibiotics for me. For that reason, it was worth it.
posted by notjustfoxybrown at 10:26 AM on May 27, 2009

I've had one (female). I was terrified beforehand, but during and after really was not that bad. I took valium before the appointment in order to not bolt from the exam room (as I had done the first time it was scheduled . . .).

The whole thing was uncomfortable, but not painful. After it was all over, I was perfectly fine.
posted by ainsley at 11:05 AM on May 27, 2009

I had this done a year ago because of Interstitial Cystitis and it was indeed painful. I had no anesthesia, no valium. I'm not a wimp when it comes to pain, but couldn't help but cuss my doctor out as it was inserted. Maybe it's because I'm a small woman and one size does not fit all.

If you go through with it, insist on some sort of pain killer and have someone go with you.
posted by WWJB at 12:03 PM on May 27, 2009

There are two kinds of cystoscopy rigid and flexible. The pain and discomfort are not the same. Flexible cystoscopy is usually performed with local anaesthetic gel only, whereas rigid cystoscopy is usually done with a general anaesthetic. The wikipedia article is a surprisingly good summary.

There are no universally agreed diagnostic criteria for IC, but it does need a cystoscopy for diagnosis. If the problem is something else, like recurrent or chronic bacterial infection, or overactive bladder, the appearance down the cystoscope and the biopsy results will still help your urologist/gynaecologist decide on treatment.
posted by roofus at 12:06 PM on May 27, 2009

I underwent both the flexible and rigid cystoscopy procedures because of a large kidney stone. The CAT scan showed the stone to be 5mm in diameter but the doctor later said that the scan caught the small end, it was really more like 7mm to 8mm.
The rigid procedure was performed under a general anesthetic and the outcome was very painful; that was mostly due to the removal of the stone. It was blasted by a laser and the resulting pieces removed. (In the doctor's words: "I had to yank pretty hard to get them out.")
They left a stent in the ureter for healing and I had to return to the office two weeks later to have it removed.
Now, I was REALLY scared!
Some prescribed vicodin and a little lidocane gel and it was all better, quick and easy, all that worry was for nothing.
Interesting addition: the procedure added some air into my bladder and the resulting "penis farts" were very entertaining.

posted by Drasher at 2:57 PM on May 28, 2009

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