Anxious about Cystoscopy

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I had a TURP and bladder neck opening operation in March 2016. I currently have to drain my bladder once a day to drain the excess void of urine to help retrain the bladder muscles. All was fine self catherterising to begin with using a size 12 Coloplast straight tip catheter, a 14 was uncomfortable. However, lately it has become more and more difficult and very uncomfortable to get the catheter into the bladder to the point that I can only catherterise randomly, a bit hit and miss if it goes in or not. And I have tried just about every catheter and tip going. I spoke to my specialist nurse today who is going to arrange for a Cystoscopy to find out what's going on.

My concern about the Cystoscopy is not so much about the procedure but the discomfort/pain it will cause as it is inserted. If I am finding it uncomfortable inserting a size 12 catheter what's it going to be like having a Cystoscopy camera that is probably 3-4 time bigger (Ouch).

I've also had the local aneasethic gel before, and it stings like hell. Not sure which is worse!

Not looking forward to it, at all. 

1 like, 16 replies

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16 Replies

  • Posted

    Cat Man I am sorry that your having a problem  But I throught having a Turp was going to solve your problem instead of causing more.   It seam like you have some scare tissue maybe from the catheters or the procedure glad your having it checked  Also the camera is smaller then the 12fr catheter.  Don't like them and any size catheter hurts when it going in.  Had 3 done this year.   I will keep you in my prayers.  Good luck  Ken
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    • Posted

      Thanks Ken.

      Are you sure about the camera size, they look pretty big to me. My specialist nurse thinks it might be a stricture causing the problem.

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    • Posted

      Yes that is what I think.  I have one from kidney stones surgery.  It's getting bad when you have something to help you and it causes more problems  Good luck  Ken
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    • Posted

      The  reason for the turp was because of the enlarged prostate and to help better flow by opening up the bladder neck a bit more. The catheter is to drain the retained urine and to help retrain the bladder muscles. Starting to get a bit fed up with it all now, especially as I cannot get a catheter to go into the bladder. 
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    • Posted

      I know it been a problem.  Just go to your doctor and see what the problem is.  Try to rrelax  If it is a stricture that have to use a coude catheter on me Ken
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  • Posted

    Speaking from a female point of experience, lve had catheters in just a couple of times really, after ops, l hate them and always got discomfort with them, and sometimes infection, my experience, lve had 2 cystoscopy,s, lst with a  g and a, they usually give you a choice, just a bit sore after, but was sore when having it anyway,  had a flexible with local anascetic and had no probs, much to my amazement, expecting discomfort and embarressment, but it was done very quickly  without anyprobs, theyre good at what they do, only thing l felt was the chill of the anascetc cream;   mine was found to have narrowing urethra, so we need to know, and sounds like your having a lot of probs,hope they find cause and solution for you, best wishes
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  • Posted

    Do you feel resistance at the bladder spincter (2nd resistance point) or when the catheter has to go around the prostate (first resistance point)?

    I understand you had issues with FR14, but sometimes going up a size helps. So, if you haven't tried a 14 in some time, you may find it easier to get around the prostate because the 12 is very flexible and therefore tends to bend which can make insertion more difficult.

    The other thing is to try the Coude tip, which is what I use. Lastly, jand perhaps most importantly, which Coloplast catheter are you using? If you're not using the Speedicath with Hydrophillic coating, I would switch at once. From someone who has tried just about every catheter on the market, Speedicath makes for the easiest insertion and no external lubricant is needed. If you go the Speedicath route, I would order some samples in both 12 and 14 but start with the 14 because they are easier to manage at least initially. 

    Would not worry much about the Cystoscopy. Yes, it's a bigger bore, but once the gel sets in I doubt you will be in much discomfort, assuming they are doing a flexible Cystoscopy which most of them are. That said, if you are really uncomfortable you can ask for sedation. Some doctors are set up for this in the office and but many will perform the Cystocopy under sedation in the hospital with outpatient status. 

    Jim

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    • Posted

      Thanks for the reply Jim

      To answer your questions.

      1. The 2nd resistance point

      2. Have tried a selection of size 14's

      3. I assume you mean the small bend on the end when you say 'Coude' tip which if correct is what I am using. I was using the Coloplasr speed agh size 12 straight tip and was getting on well with it to start with but after a few weeks it was slowly becoming more difficult to insert into the bladder. I then tried a 12 with the small bend on the end of the same make which worked for a short while but the again became difficult to get in. I then tried a selection of other makes and sizes, 12 but mainly 14's. The only one on two occasions that would go in was a LoFric size 12, although it worked it was uncomfortable and fiddly to use. I agree, Coloplast are the best, I just need to be able to use them again.

      4. Think I will make Enquiries about either a G&E or sedation. I did ask my GP recently if I could request a G&A for this and he said yes. After having a recent TURP and bladder neck operation with all the tests before and problems afterwards I've had enough of pain and discomfort. 

       

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    • Posted

      The second point of resistance would most probably be the sphincter muscle. This muscle can sometimes be very tight and difficult to penetrate especially when working with a flexible catheter such as a Speedicath FR12. (Unclear from your post if you ever tried the Speedicath FR14 with Coude tip which would be my suggestion as a starter.) 

      In the beginning the tendency is to tighten the already tight sphicter muscle because of the cathing process, but over time I have found I could relax the muscle by focusing on it.  I also sometimes wait a second or so when I hit resistance and then give it a quick but gentle twist back and forth a few times as it slides in. Just from 11 to 1 O'Clock, very subttle. Some people just hold the position with just slight pressure (without trying to penetrate) and wait for the sphincter to relax by itself and let the catheter in. Others cough to relax it at that point. The idea is never to force it. If none of these techniques work, you should try some sort of muscle relaxant if you haven't already. Tamusulin is one possiblity but also something like valium might help. Daily Cialis another possiblity.

      Technique wise, I cath standing up and pull the penis gently upward toward the ceiling (with left hand) to straighten out the canal and "drop" the Speedicath into the meatus holding the catheter only by the plastic funnel with the right hand. I never touch any other part of the catheter other than the funnel. In this position, the "notch" on the funnel would be facing my belly so that the bend in the coude tip would be up. I keep the stretch all throughout the whole process. 

      If nothing works,  you might consider temporarily using a  suprapubic catheter which should be able to rehab you bladder in similar fashion to CIC, especially if you get it with a valve which I believe would allow you to use your detrussor muscles to empty it. The subpraubic drains your bladder thorugh a small hole in the belly so the urethra, prostate and sphincter are bypassed completely. 

      Jim

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    • Posted

      Hello Jim

      Yes I have tried a speedicath fr14 with a coude tip and couldn't get it in. I wonder if catheterising every day is making the bladder opening swollen and causing an even tighter muscle, especially if I am trying two catheters at a time.

      As for tecnique wise i pretty well do the same as you.

      As for the last option.....no thanks.

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    • Posted

      Assuming the uro has taken a good look via imaging to check for any abnormalities, I would then try various muscle relaxant drugs if you haven't already. Swollen or not, a tight muscle can be hard to penetrate, especially with the stress of the procedure. Stress causes more tightness which causes more pain which causes more tightness etc. I can understand the reluctance for subrapbubic but on a temporary basis I think I would prefer it to a Foley if I could not CIC. And if your bladder needs rehab at some point you will need to do one of the three (CIC, Foley, Subrapubic) to empty out your bladder on a regular basis to give it time to decompress.

      Jim

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    • Posted

      Your well up on all this Jim. At the moment I'm just trying to get my head around the thought of having this Cystoscopy. I only had the TURP and bladder neck widening operation mid March of this year so would have thought everything would have been inspected at the time.
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    • Posted

      It's a flexible (not rigid) cystoscopy, right? Don't know where you're located, but here in the states anasthesia is offered with both general and epidural anathesia. The one i was offered (for a rigid) was a very quick acting sedation similar to the one given for colonscopies. I ended up getting a flexible with only a numbing agent but could have opted for sedation if I wanted. Given what you've gone through, some sort of anathesia/sedation seems the best route. Why put yourself through any more. 

      Jim

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    • Posted

      Typo: Meant to say in second sentence: "here in the states Cystoscopy is  offered with both general and epidural anathesia. 
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    • Posted

      Forgot to add, i'm in the UK. Could really do with an editing tab on here for after posting.
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