Cystoscopy under GA vs In office procedure ??

Posted , 6 users are following.

Is the cystoscopy procedure that is done under general anesthesia more thorough than the in office method? I had it done in office and it seemed like the urologist just took a quick cursory look and was done in less than 30 seconds.

This was done about 9 months after he performed a bladder neck incision and 2nd turp. due to urine retention problems that are now gradually getting worse. It is now 18 months post surgery and I would like him to take another look to check for scarring, strictures or other bladder issues.

He seems to prefer doing it in office.

I have had several cystoscopy done some ago with a different urology group that were done under GA.

Thanks for any feedback.

0 likes, 4 replies

4 Replies

  • Posted

    No, George. The procedure is essentially the same. However, the patient is different and how he or she reacts might affect the procedure, particularly in how much they might tense up causing sphincters to close up tightly or patient stress leading to gasping, etc.

    For example, in my own case I'm a sucker for not feeling pain or discomfort so I like to see what is going on. I therefor request no lidocaine or other analgesic, please, but oodles of lubricant, yes. Most urologists will try and keep off GAs just on the grounds of higher risks.

    I hope this answers your questions. My best wishes for your cystoscopy being a tolerable event, Alan86734.

    • Posted

      Thanks Alan,

      Cystoscopy scheduled for next Tue. Doc. refused to do it under GA citing risk factor as you stated above.

      He also wants to do urodynamics test due to ongoing urine retention problems now almost 2 yrs. after bladder neck incision and 2nd turp. I have resisted doing this test for some time due to anxiety or fear of the lengthy procedure.

      My symptoms are involuntary bladder contractions during urination which shuts off flow mid stream, then hard to restart leaving residule urine and feeling of never emptying bladder.

      He insists I have urodynamics test. I don't want to but seemingly have no other options.

      Would like to know if anyone has any suggestions or remedy to stop these contractions.

      I believe this condition is called "DETURSOR-SPHINHCTER DYSSYNERGIA".

      Not sure if I should post this in a different section of forum?

      Thanks Again for feedback.

    • Posted

      Hi, George,

      First and foremost I am not a doctor; my background is mechanical engineering from which I am retired. So what follows are my opinions based upon my own urinary experiences which happen to include urinary retention.

      What you describe seems more like urinary spams occurring during your voiding process. Bladder spasms (involuntary bladder contractions?) can cause the inner (bladder) sphincter to close, thus stopping the midstream flow of urine. If it becomes difficult for you to restart urination fairly soon after, you run the risk of urinary retention, and possibly heading for a potential urinary tract infection (UTI) as a result.

      I don't understand your concerns over urodynamics testing being a lengthy procedure. As far as I am aware urodynamics embraces a number of tests from which they choose only a few to satisfy each particular case being examined. I also suggest you double check the source of your information: "....or fear of the lengthy procedure."

      I personally think that your most urgent goal right now is to get any retained urine out of your bladder by means of a urinary catheter, which would be the quickest action. Go to an Emergency Room?. A hospital, perhaps? A Urology Clinic who would have the urinary catheters needed and the expertise to use them properly?

      Not knowing even what country you are in I cannot offer you any other meaningful suggestions beyond the lame ones I'm putting forth here.

      Finally, I wish you luck with your cystoscopy next Tuesday. If I may offer one of my pet techniques: Throughout the insertion phase of the procedure, bear down firmly as though to urinate.

      All the best! alan86734.

    • Posted

      Hi George

      How you feeling now. My position is same as yours.

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