Flexible cystoscopy and Urodynamic testing.

Posted , 20 users are following.

Hi all,

I went to the hospital on Friday to see the urologist regarding my urinary symptoms which started several years ago and led to a diagnosis of BPH.

He has requested that I undergo a flexible cystoscopy and also Urodynamic testing.

I was just wondering whether any of you have had either of these tests and, if so, what your experience was like and also the outcome.

Also I would like to ask any of you whether you find that your flowrate varies from day to day or whether it remains slow. Mine varies, sometime extremely slow to the point of hardly being able to go at all, whilst other times it is, to me, almost 'normal'. When tested I am told it is slow.

Thanks for reading,

Best wishes to everyone suffering with similar symptoms.


0 likes, 22 replies

22 Replies

  • Posted

    Hi Steve

    I've no idea what Urodynamic testing is i'm afraid. But flexible cystoscopy I do know - I've had several. Usually, it's OK; but if the surgeon is new to this, it can be painful. There's usually a 'bump' as the tube goes past the prostate restriction - uncomfortable, but generally not too painful.

    As to the outcome, for me it was to check on my bladder cancer - to see whether it was there/returned (I've had it all, from a big tumour initially, and then much less so over the years as it returned in lessening size).

  • Posted

    Hi Stephen. I have had bph for about 18months.  The urodynamic test is to test your bladder, I was crapping myself when I went to have this done, but it wasn't that bad in the end. It's very uncomfortable and a little degrading but you know what, in the big picture it a test that has to be done to make sure it's not your bladder giving you problems. It's does sound like a prostate problem. Yes I have good days and bad days, the last few nights have been bad and other nights and days have been fine. I asked my urologist this why does I have good days and bad days. His honest answer is there's no answer, it's like anything some days you have aches and pains other days you are fine. Some people say it could be certain foods, alcohol, caffeine, smoking that inflames the prostate. Good luck with your tests. 

  • Posted

    Hi Steve, I had a flexible a few years gone by now. It's fast as far as I remember.

    Mine only took a few minutes. I did find it pretty painful, other people do not have 

    a problem. It was over in no time though so I wouldn't loose any sleep over it.

    My friend has had the dynamics test though but I can't comment on it.

    You can find how it's performed by google, or on this discussion platform.

    Its to test the bladder, to see if it's doing its job. All the best.

  • Posted

    Hi Steve, As others say Cystoscopy not too bad, but worse if Prostate is swollen. I am booked in for Urodynamic test at end of this month, and not sure about it.  Regarding flow I can be very fast and very slow, and night time and evening are worse. I have been advised to self cath at night when slow to ensure no urine left as this makes infections worse.                 David
  • Posted

    The inconsistency of flow rates is something I found and still find since my PAE, to be the most frustrating thing. Night time is always the most annoying, the one time you want your bladder to be quiet. I'm now down to an average of once per night from 4 pre PAE. During the day I find I can pee like a horse or relatively slowly without understanding why there is such a difference. I only drink one coffee a day so can't say whether this affects me, I suspect not. One thing that definitely does is alcohol, particularly beer but mainly because of the volumes. The affect alcohol has is to  enlarge the prostate and make the flow more restricted. This is something I can live fairly easily with post PAE, but pre PAE was really debilitating, so you could try abstinence, if you drink of course, and see how that goes.

  • Posted

    Hi, Stephen. We are very  much on the same page! I will give you a brief outline of my experiences here but if the discussion expands into greater detail then we can complete any exchanges using the Private Message (PM). This is how 'Patient' wants it done and I am happy to adhere to their wishes. So, to business.

    I am an 88 year old male mechanical engineer, retired, living in the northeastern part of the USA. I suffer from moderate urine retention and ED. As of the beginning of this year my suffering has extended to include the ravages of Fluoroquinolone Toxicity Syndrome, their forum also run under the auspices of 'Patient'.

    I have undergone one Office Flexible Systoscopy and one Urodynamic Study. For urinary treatment I follow Clean Intermittent Catheterization (CIC) only (no other major urinary medications).

    Drop me a response lets see if we can help each other out.

    Warm regards, Alan


  • Posted

    I've found flow rates do vary substantially, particularly between day and night. Sometimes nighttime urination is slow and difficult compared to day time when it's usually much easier. It may have something to do with the muscles used in urination because they may really clamp down while you're sleeping so you don't pee the bed.  

  • Posted

    Hi Steve

    I've had 2 cystoscopy sand both were about the same- very tolerable. I too worried myself sick beforehand. Both were very quick. First was done in about

    A minute or so and second in about 45

    Seconds. They squirt in a local anesthetic gel which seems to work pretty well. 

    All the best


  • Posted

    Cystoscopy is no problem depending on who is doing it, but to increase urination look into diuretic pills. Any other medication will cause side effects but will not correct the problem
  • Posted

    Had both done. Nothing to worry about. You can look both up on YouTube if you want to see what they do. Gives them a general idea of bladder size, flowrate, retention. Not knowing what there going to do makes anyone nervous. But not knowing why you can't pee is worse.

  • Posted

    Your Urologist did the right thing in ordering those tests. Some...actually many will have you on the table for a full on and outdated surgery with all of the attendant risks (anesthesia and considerable side effects) without anything more than a symptom description.

    The scope can be painful, but its quick and necessary to determine if your prostate is part of the problem. As for changes in flow day to night, that can mean that there is bladder involvement. Often long term BPH can lead to it.

    Get your tests and see what the diagnosis and recommendations are and post those. Good luck!

  • Posted

    These are both standard tests and often required for a better bph diagnosis. They are generally done with a local anethestic (numbing agent) although you can be put to sleep if you request. You should also have a bladder/kidney ultrasound study to check both the condition of your bladder and kidneys, as well as bloodwork for kidney function tests. The bladder/kidney scan is non evasive. Have they done an office bladder scan to check for your residual? This, a DRE, and Uroflow are usually first steps before any of the other tests mentioned. 

    The important thing is that after you get all the test results is for you to understand that there are many options available these days to treat BPH, some of them new. Unfortunately, in most cases your urologist will only tell you what procedures or surgeries his particular office does, as opposed to laying out all the options. So please report back after you get the test results and do not rush into any decision until looking at all your options, not just the ones presented by your doctor. 


    • Posted

      Hi Jimjames,

      Thank for your reply.

      Yes they have done a bladder scan to check my residual, on all three visits to the hospital. The second one showed 24ml and the third 70ml. But on both the last scans the nurse commented on how my prostate was protruding up into my bladder and she showed me this on the monitor. I have also had several DREs and Uroflow tests. My flow is 'very slow' apparently. The doctor also requested I have another PSA test before I see him again, I had the last one in March.

    • Posted

      Your residual is normal. Keep in mind that BPH only means an enlarged prostate that is not malignant. So BPH in and of itself does not need treating unless symptomatic when it's called BPH/LUTS. LUTS=lower urinary tract symptons. 

      I mention this because regardless of whether or not your prostate protrudes into your bladder, your symptons (sporadic weak flow) seem to me fairly mild, in the context of no residual. (You might want to google "IPSS test", take the 5 minute test, and rank your symptons).

      So, given this, I question whether either urodynamics or a cystoscopy is warranted now. What it sounds like to me is that they are qualifying you for some sort of prostate reduction surgery or procedure which again, you probably don't need now. 

      Watchful Waiting sounds more appropriate in your case, with both periodic bladder scans as well as periodic ultrasound studies of bladder and kidney. The latter, along with kidney function tests (bloodwork) will monitor any changes to your bladder and kidneys that your obstruction may be causing, although given your residual I doubt if anything is going on. This (ultrasound study of bladder/kidneys) IMO is more important at this stage than either urodynamics and/or a cystoscopy. 

      My advice is to step back a bit, get that ultrasound bladder/kidney study first, and then sit down with your uroloigst and question him on the reasons he wants to go forward with the cystoscopy and urodynamics. 

      As to weak flow, again not really harmful as long as you empty well as you are doing. If it bothers you, a reasonable approach is to do a trial on tamsolusin or preferably daily 5mg Cialis, or just live with it for now. It's possible you may be many years away from needing any type of procedure or surgery, so why fix it, if it ain't really broke!  

      There are a number of new procedures for BPH/LUTS out now, and no doubt more on the way. Therefore there has never been a better time for watchful waiting, if you can afford to. Sounds like you probably can.


    • Posted

      Thanks for sharing your thoughts.

      I have been taking Tamsulosin now for about five years and they made a great difference to my flow and the difficulty in getting going during the first year or so but, as their eficacy apeared to wane, I was also put on Finasteride almost three years ago now. I then started suffering with a lot of discomfort after urinating in the form of burning/stinging sensations (no infection)  which last for hours. My frequency got to the point that I was 'going' every 40 minutes, that is when my GP reffered me to the hospital. I was then placed on Vesicare but, after only three tablets, I found they made urination even more difficult so was placed on Mirabegron which have helped with the frequency but I still suffer with the discomfort which varies from mild to very 'distracting'. 

      I did have a cystoscopy, under general anaesthetic, about 30 years ago, when in my thirties, because I was suffering similar symptoms to those I am now the outcome of which was I was informed that the lining of my bladder appeared very 'red'. I was given a protracted, low dose, antibiotic which appeared to settle things down and it hasn't bothered me again until now.

      That's a brief outline of how I have got to this point and I am feeling very confused as to just what is wrong with me. I am in no hurry to undergo any sort of surgery in that area and shall think long and hard before agreeing to any which may be recommended. My brother, who is six years older than I, was diagnosed with prostate cancer two years ago and has had the gland removed, he now suffers what he calls 'leakage'.


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