Posted , 14 users are following.
I've been told that my major urinary problem is BPH. I have never had the scope up the urethra done; wasn't even offered to me but they had me scheduled for pre-op for G.L. The last time I went to my Uro's office I requested & scheduled an appointment in Jan. to have it done. I've been doing CIC for about 5 months and that is going as well as can be expected. Actually I'm pretty happy about it. 3-5 CICs a day and I don't have to worry.
I just dont want to do anything that will cause my insides more trauma. I don't intend to have surgery until they come up with something that can shrink the prostate without trauma. I may be waiting until my end; but then so-be-it. So I guess having the cystoscopy is really kind of unnecessary. I just read a lot on here about "oh, my prostate is 65 grams" or "I have mainly a medium lobe enlargement" etc. and I just kind of wonder what is going on with me. The glove inspection with the finger up the anus was done twice. The last time the doc said will its definitely enlarged but it feels smooth. He seemed to think that is good; but thats about all I know about it. He seemed to have decided on GL laser surgery just from that but I didn't allow things to go that course. Hate to keep cancelling appointments; I give them plenty of notice ahead of time though. Anybody have bad experiences with the cystoscope? I understand the the newer flexible ones are preferable.
0 likes, 32 replies
keith42667
Posted
Thats as much (maybe more) than I wanted to know. Thanks Gentlemens. Probably should have had it done first thing but like Jim says, since I've decided not to have the operation any time soon, it seems almost unnecessary. My Urologist PA seemed quite OK with me cathing. They even had Coloplast send me 30 samples. They knew I used Speedicath. I took one in with me because I thought they might need a urine sample. The nurse came in and wanted to see it and then went out to the work area and was showing some people. I was actually in there to have my prescription raised to 150 a month from 120. So thats probably why they were checking it out. But the point is that; they ordered me 30 speedicath. It wasn't until I used 3 of them before I reallized they were coude tip. They look just like the others if you don't look close and my eyes aren't too good up close. One of them sort of cut me, or made my urethra more sensitive and I thought "I wonder..." and sure enough they were curved tip. I'm glad I have a habit of sort of turning even the straight tip so it lines up with my navel and my thumb routinely. But not that carefully as I would if I knew. Anyway, I don't think the Urologist of Idaho knew the difference.
jimjames keith42667
Posted
Keith,
The orientation of the coude tip is very important. Note the guide bump on the plastic funnel. If you're cathing standing up, and if you gently pull your penis toward the ceiling, the guide bump should be facing your stomach. I will send you a private message with a diagram in a few minutes.
As to frequency of CIC, the rule of thumb is to try and keep total bladder volume around 400ml or under. That would be the volume of what comes out of the catheter plus the natural void just preceding it, assuming you have a natural void.
Jim
jwrhn1951 keith42667
Posted
I found urodynamic testing to be much more informative, it takes a lot longer (an hour or more) and can be mildly uncomfortable at times during the procedure when the bladder is filled to near capacity, but I got a lot of good information from mine and it helped me come to terms with the fact that I will likely be doing CIC for the rest of my life...
It might be something you should consider doing in addition to the cystoscopy..
arlington keith42667
Posted
It was painful/uncomfortable; however, I don't think it's dangerous.
paul96555 keith42667
Posted
I felt queasy watching the scope, because I was nervous and rather fearful that it might hurt. The first bit was painless. Flexible one of course. I did yelp a little as he got to the prostate area, as the gell he embarrassingly squeezed in hadn't got that far I think (tight up there) but it wasn't that bad and I certainly wasn't wimping out having gone that far. I said to carry on, the third go it went through (no doubt smearing the prostatic urethra with lidocaine that hadn't got pumped that far up....) and no further discomfort. Nothing like the yelp I did when they pulled out the catheter post holep by the way, that hurt a fair bit more, but still only for 30 seconds. The scoping seemed to take only a further 35 seconds before he was removing it (painlessly). I kind of semi fainted after getting off the couch, what a pillock (I hadn't eaten much before, for no sensible reason, and was on mainly vegetables as PSA=16.92 and MRI=4, free PSA 4% meant I was in the middle of a prostate cancer scare, so .... salt-less diet had pushed my blood pressure down to 160/57, which doesn't help). Anyway, recovering quickly after snacking on a few biscuits, I was delighted to find my first post-cystoscopic pee was painless. That's because you're full of lidocaine - you just pee'd it out. See, he said at the appointment right after, told you so. I had a hunch about this. On the way home, as I'd drunk tonnes of water as instructed and still had an inflamed prostate=>frequency, I badly needed to pee. As I begun to pee, nothwithstanding that I had stuffed some weird painkilling pill up my rectum as instructed beforehand, it really hurt at the meatus, so I stopped at once (only a few drops out), almost hollering in pain, paused and started again. 10 times over. And I thought, stuff it I'll carry on next time, before I pass out. And you know what, once you've been peeing for 1 to 2 seconds the pain goes almost entirely. You just have to "pee through the pain". How I wish someone had told me that. Of course, the next pee was easier, and by the morning it was gone. So, if the second post-cystoscopic pee hurts for the first second, my advice is DO NOT STOP the pain is (mostly) all gone within 1 to 2 seconds. Post-holep pee pain is deeper and longer-lived (it endures throughout each act of peeing, and for up to 30 seconds thereafter), but with a lesser peak. I think post-cystoscopic pee pain is better due to being so short-lived, but neither are too bad really. Always, weak pee (drink a lot) is good to minimise it. I wouldn't even blink now at having a second cystoscopy, as I know what to expect and although it isn't "nothing", it's not too bad. How stupid I was to be that worried. Risks are very low, utterly minimal. And how strange that no-one gave the above vital tip (I have checked since with other men, it is universal). I told the uro, so that he might tell future patients.
kenneth1955 paul96555
Posted
paul96555 kenneth1955
Posted
Oh, I wouldn't even blink at cystoscopy if I had to have it again. Half the problem is you read the internet, and of course you can find at least one person that had a bad time with that procedure; but it wasn't that much more bother than a filling, or having a tooth out. I used to dislike them taking a blood sample too, but by the fourth or so time oh, shrug, I knew which arm was best, to drink plenty beforehand (I once misunderstood the instructions for a company medical and didn't drink for 7 hours beforehand, of course that made it a proper swine when they tried to take blood - had to give up, make me drink 1.5 litres then try again an hour later...) and to bend it right back (it broke once so I can bend it a little beyond straight) then you hardly feel it (in the other arm, they'd have poke about for ages unable to find a vein, and it was a little bother). I've gotten used to the canula in the hand before being knocked out, too. Strangely I was relatively speaking without fear by the time I had the holep, although I'd pestered the poor uro' plenty at sessions somehow beforehand with questions about pee pain ("I wouldn't do it if it hurt much" - and it wasn't that bad, either). You get so you've been mussed about with so much, you kind of trust them.
?Keith, to decide how to treat your enlarged prostate (and to be sure it is that, and not a bladder issue) they do need to 'scope you - e.g. that would show if it was pushing up at all on the bladder neck (which I believe is quite common) and if you have a significant "median lobe" (makes urolift unlikely to work). Rules out (or identifies) bladder issues (as an explanator for LUTS instead of prostate issues, which is more common), and as a bonus if there are bladder stones, or bladder cancer (VERY unlikely), it would be seen. Trebeculation in bladder would show too. They may fill your bladder with a little water; mine didn't do that. Look on it as a positive step to ID-ing your issue and selecting the best treatment.
kenneth1955 paul96555
Posted
Even man has to decide for him self what procedure he want to have. The best thing any man can do is research the pros and cons of every procedure he is thinking of having. The procedure the side effects and the healing time. You have to look at what he can deal with and what you can't. Ask question . Your doctor should be able to tell you everything about the procedure. and he should be concerned with the side effect that your concerned with. If the doctor does not do that you should get another doctor. Also you should never pick a procedure just because you are having problem. There are to many procedure that will help and do the same thing. All procedure do do the same they make a tunnel. With a knife, a laser, steam or clips they all do the same. Then life goes on..Ken
keith42667 paul96555
Posted
Thanks Paul. So, would you assume if you were me that they were going to do the cystoscopy at my pre-op appointment? Is that pretty standard procedure, do you know. The first time I ever had an appointment with this Dr. was last summer. He did the glove up the anus thing, told me I had an enlarged prostate, and scheduled me for surgery in 3 weeks, the next week after the preop appointment in 2 weeks. He also gave me a DVD & a pamphlet advertising GL surgery. Wouldn't one assume that he had planned on doing this w/o the cystoscopy & the urodynamics or was this exactly what the preoperation appointment is for? I'll never know because doing CIC was working so well for me that I wanted to just hold off awhile and cancelled. Now they seem quite happy sort of following me while I self-cath. The PA said that if thats what I want to do thats fine. They're fine with that.
kenneth1955 keith42667
Posted
Keith you did the right thing. Just because you have a large prostate from the anus finger test. Does not mean anything and to schedule you for a GL is a little rushed My doctor just did that a few month's ago because by PSA was a little higher then normal . He said mine was a little bigger but smooth so don't worry about it. Some doctor I think like to force patients into surgery and then deal with the after math. Just do what you want. If CIC is working stay with it Ken
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