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Hi again, I have a cystoscopy scheduled this week to investigate why I had blood in my urine, am experiencing frequency and urgency, incontinece at night, and pretty high residual urine after peeing.

The doctor says it happens in his regular office down the hall - and it sounds like he’s the one that does it. From what I’ve read through, others have been knocked out with anesthesia for this - like they do for colonoscopy or something.

Can you tell me more about the test? Should I be worried about the pain given that It does not appear there will be any anesthesia or drugs for my test? Is it not as big of Deal as some make it out to be?

Of course my greatest concern is that I have cancer or something really bad - hopefully he’ll find something minor that explains my symptoms or, I guess, nothing at all...although that prospect feels unaffirming... The doc said that he may do urodynamics testing on me after this depending on the result.

Thanks for your advice and explanations.

I have had several cystoscopies in the past. It was done in my doctor's office. You do not need to be asleep. It is almost like having a catheter inserted. The doc will insert some lidocane jelly first then insert the prob/camera. He/she can then see all the way up and into the bladder. Tissue samples can be taken so a biopsy can be done. It only take a few minutes. This is a minimal invasive test and a lot of information can be obtained. If you ask he/she might give you a picture.

By the way I like my urologist. When I saw him he wanted to prescribe medications for my incontinence, I told him I would rather wear an adult diaper as I am not bothered wearing one. And that pills do not always work and have side effects. He told me that was fine with him

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RetiredRN

I’ve had a few cystourethroscopies myself as part of a standard uro workup. The test is fairly easy and is mildly uncomfortable. Takes about 5 mins. You’ll go in an exam room. They’ll have you lay on your back and will put your feet in stirrups. You will have a gown on most likely. Don’t be embarrassed. They do this a lot. The nurse will prep and clean you. They should explain everything they’re doing as they go along. It’ll just be you and the nurse. The nurse will then take a syringe of numbing gel and insert it into your urethra. It will numb everything and make the test a lot more comfortable. The gel should be warm. This does not hurt. Weird, but painless. The nurse will then step out and give you a few while the numbing agent takes effect. Once this is done, your doctor will come in. He will have a small cystoscope. It’s a long thin tube with a camera on one end. He will then insert the scope into your urethra. The most uncomfortable part is when the scope goes past the prostate. This part is uncomfortable no way around it. But it’s not unbearable. That’s what the gel is for. As far as the scope, it’s not scary looking. When I had this done, the doctor was able to evaluate sphincter function and I could see everything he was doing on a tv monitor. With the scope, your physician can take tissue samples. It gives him a clear picture inside your urethra all the way to your bladder. I think having a catheter inserted is worse. Every time I’ve been cath’d, it’s been very painful. My cystos weren’t like that. In and out, 10 minutes. Your doc may give you an antibiotic like Cipro just to prevent infection. I’ve had this done twice. One doc gave me a Med and one didn’t. I’ve had numerous bladder tests though and have never had infection. It’s really easy...don’t sweat it. It gives your urologist a lot of valuable data. Do discuss treatment options with your doctor. Just because something didn’t work for one person does not mean it won’t work for another. Everybody is different. Seeing your doc has been a very positive step.

Thank you so much for your reply. I was really worried about this but you have helped me feel more calm, it doesn’t sound like nearly as big of a deal as I had in my mind.

So I had my test and like you said, it was nothing.
I realize some people have found it painful a but to me literally, it was hardly uncomfortable let alone painful. It was quick, easy, relatively interesting because I got to see the video, and has had no lingering side effects.
I will admit that it was embarrassing and uncomfortable in a personal sense. But that’s really it.

Happily the doctor didn’t find cancer or any other underlying disease in my bladder or urinary tract. That’s a huge relief. At the same time however it also feels a little bit frustrating or even demeaning because apparently then my issue is unexplainable, in my head, or easily treatable with behavior changes. I was kind of shocked by that and didn’t process my feelings quickly. Still reeling a bit actually.

Doc wants me to try a drug for OAB for a month and then see me again to re-evaluate.

wwboy, you are not alone in this as many of us in the past have noted the same, i.e., that our physicians were scratching their heads, unable to identify a single cause for our incontinence. That does not mean that there is not a cause, just that they could not identify it. For example, in my medical records the cause of my incontinence is noted as "idiopathic," a fancy word to say that they don't know. Actually, I had several causes contributing to nerve damage that, collectively, could be responsible. It does not mean that the problem is in your head. Most importantly, don't worry about it.

The medications are worth trying, but you may find it helpful to search for them in the archives as there have been substantial discussions in the past. Most medications for urinary incontinence have such adverse side effects that they are not tolerated well by most users and also are not 100% effective. Some have noted that, if the medication is only partially effective, they still have to wear diapers. However, for a minority of users they are very effective and you may be one of those.

--John

I just had a cystoscopy done on Friday to check why my flow is so limited. In my case they had me lie on a bed and lower my pants to the ankles, with a towel over the groin. I wore a pull-up to the appointment but no issue made of that. I was able to watch the scope on a monitor. During the painful parts (incisions) I didn't watch. It took three tries to poke the camera through the prostate but by then there wasn't much to see because of the blood.

After all that they left me with a catheter in, which was painful getting past the prostate. I am stuck with this for a week now to help expand areas that need a stretching. He has also put me on two drugs + antibiotic -- one to relax the prostate and the other to shrink it. I can feel its effects today as I now have the dull headache. I sure hope that that side-effect goes away with time. I hate the dull headache.

One thing did surprise me. After I got home, and even though I am draining into my bag ok, I still sometimes get the "urges". These are painful because of the bothered prostate + catheter.

Now I need to endure getting through the night lying on my back. I did manage to lie on my side for a spell. Oh, this is oh so much fun.. ug.

Tomorrow morning I am finally going to have this freeking catheter removed! I can't wait! It's been strange not having to worry about running to the toilet, except for the when the leg bag gets heavy.

In bed it has been ok, as long as I keep still and lie on my back or carefully on a side. Thankfully the cats didn't need to play with the bag hanging from the bedside. But during a normal day the movement really aggravates. Even sitting at the computer is trying at the moment. Just 18 hours to go!

How people self catheter and tolerate this is beyond me!

Update:
Yea, it's out. Feeling much better now and the flow is ok too.

did you get a fixation device for it?
big fan of the DALE when cathed ..does away with the tugging issue
https://www.amazon.com/Special-Pack-Foley-Catheter-Holder/dp/B0064Q4G68/

I did indeed get a patch that was glued to my leg for fixing the catheter. It was a major pain to remove with abundant amounts of rubbing alcohol (the patch indicated to remove it with alcohol). It was a great help while cathed though.

Most of my discomfort was at the urinary sphincter valve (at the bottom of the prostate) where there were incisions made to widen the passage. Tissue had grown in at the sides of the sphincter restricting the flow. I was able to watch the monitor when not wincing from pain. After the incisions were made, the catheter was inserted to help stretch things out. I had to endure this for a week. With the catheter out and taking two BPH meds, I am now peeing like a racehorse.