Flexible cystoscopy (male)

hello ian and all, i am not a patient but have come to this site to hopefully get some real info from people who have 'been there'.

i visited my father this weekend who has undergone surgery to open a stricture into his bladder, to enable routine checks after going into remission from bladder cancer.

he has to self cathertate daily to prevent the stricture forming again and invited me in to watch him do it. this may sound weird but his reason was to assure me that if i ever have to that it is, although uncomfortable, qite simple.

the cathater was 16" long and at one point he wasnt sure if he had gone in far enough.

my question is how far does he need to insert and can he cause any damage by going to far??

any advise or help would be appeciated and good luck with your treatments.

bob

You describe the procedure very well. I've had it three times, with differing outcomes in terms of pain - the last time was today.

To be honest, the procedure itself hasn't ever hurt a great deal, at best it just felt a bit uncomfortable, at worst it was like a couple of bad-ish injections: once as the scope went in, once when it passed the prostate. One important tip is to relax as far as possible.

Where my experiences differed were the after effects which ranged from ok to fairly distressing. It seems I'm very atypical-though most people seem to get mild after-effects, a bit of burning when peeing etc. I'm posting as a warning as on two occasions it was difficult for me to drive home as I intended. One man I met the first time obviously had the same experience as me, so although atypical I am not alone. The worse after effects both happened when the cystoscopy hurt more. In both cases I was fine for about 20 mins after, just some discomfort. Then I felt the urge to pee. When I did pee, the burning sensation was more than mild, equivalent to cutting a finger with a razor blade I suppose, nothing unhandleable. What really distressed me was the strong feeling of needing to pee would't go away- today I just stayed in the cubicle for 45 mins until I felt confident I could leave. So if you are going to go through this procedure, consider taking someone to get you home. That said, pretty much everyone in the board hasn't had that level of problem, one time I came away with mild discomfort and the urologist said my bad experience is very unusual. Just lucky I guess .

Thanks for this info guys sure helps except the part where some nurse has to find my penis I haven't been able to find it since my wife died ,oh well that's what microscopes are for

I had mine too , almost similar experience. Question- have you been experiencing any pain in the urethra? Any discomfort perhaps? thanks!

Hello my friend. I'm 60 year old and never had a problem that needed that procedure until last year.  I ended up in the hospital last year and had sepsis.  They tried to catheter me and after 5 trys they stopped.  That was a ordeal. Never again. It was the most painfel thing I ever went through. ( never ask or told me anything just came in and did it and left ) I went to see my urologist and he did the cystoscopy in the office.  The nurse did the first part with the cleaning and the gel.  The doctor did it and found a stricture just before the prostate.  It was no big deal I watched the whole thing.  All was fine for a while.  Had to have another.  This time it hurt. He weny through the stricture and they tried to go through the prostate.  He could not get it in it was so tight on the urethra that is the part that hurt I could have jump off the table.  I kept ask him how much longer.  I ended up having a Uro-lift done much better now.  We have to do anything to make our life better   Take care       

I am 24 and had to get a flexible cystoscopy done cause I was peeing blood for a month, I found it very painful, but I gritted my teeth and just got through it. Maybe because older guys are all loose and old it is easier for them, compared to a young mans tight urethra, it felt like a man trying to squeeze his foot into a baby sized sock, except the sock was my urethra and the foot was a metal probe.

One of the great conspiracies of the Millenium - the myth that Flexible Cystoscopy is NOT painful! ;-)

Urology must be the ONLY medical specialism where EVERYTHING they do is painful, almost all other medical procedures have local anaesthesia to fall back on, or General anaesthesia is automatically used for larger scale interventions, but other than about 2 inches at the penis end, there is no means of anaesthetising the rest of the urinary tract, so naturally it isn't going to be a laugh! Uriology departments are SO busy, that has never been seen as an option other than for children, so I suppose they just get used to causing pain, like in pre-anaesthetic days, so they just play it down.

I Can assure anyone reading this, IT IS painful, usually more so for men than women, as the prostate is a big part of the pain,  but I doubt it is exactly comfortable for women either.

How unpleasant that pain will be is not simple to quantify, because it is going to be different for everyone. 

Male bravado is a strange thing, AFTER the event - At the time, they scream just as loud as those who don't have so much of it.(Others were doing plenty of it as I waited to be seen!  Like everything else, it is a mix of luck and circumstance how it goes:

If you are lucky, have the right physical anatomy (size means EVERYTHING), have it carried out skillfully and with the careful application of anaesthesia (although it has very little real effect, and debatably may actually make the after-effects worse, and peeing more difficult!), then you will have a far less unpleasant time than those where things don't work out in your favour.

Prostate Enlargement WILL make it worse, as you might expect, it slows down urine flow going through, so it will certainly get in the way of a scarily thick tube. More likely to bleed as it can tear the tissue to a varying degree, that hurts, take my word for it. I only have slight BPH, but it still bled profusely. 

Something few mention - Pressure during the procedure can be distressing for some, not for others, no idea why, maybe related to technique by those carrying it out, or just personal anatomy? I found it nearly as bad as the prostate pain, and lasted a lot longeer than that.

Afterwards, infections... luck of the draw, Antibiotics can be given, and these MAY be Fluoroquinoline type, which have SERIOUS risk of horrendous tendon damage and other side effects, avoid unless life-threatening as other types have far less serious risk of these side effects. Talk the options through beforehand. For once, I was lucky, didn't have one, although I have had urinary tract infections before.... not nice.

Don't count on getting back to work (same day some info sheets say!) I found it was some days before I was able to leave home for more than a few minutes at a time - peeing dozens of times daily, I was not confident that I would pee at all for a couple of days, during that time a LOT of  burning, eventually and slowly, (very slowly it seemed) getting better, sleep deprivation during that time becomes very wearing, and because peeing is painful, you are wide awake every time too. It was a couple of weeks before I was starting to get more relaxed about urination, something few seem to mention - it was a LOT longer before I was confortable about ejaculating, I was far too terrified to try for about 6 weeks, then the next 5 or 6 times had fear of ejaculation as it HURT. Bit of a pssion killer.

Eventually I stoped thinking about it ALL day, (that was over 2 years back) until now I need to have this again - I haven't slept for a week, but at least this time I have cancelled everything for 2 weeks so don't have that worry of having to cancel comittments at short notice like last time.

Hi

Just had the same procedure as Ian_uk1975 today. I was worried for several weeks before hand and really wasn't looking forward to it!!!

The description by Ian_uk1975 is fairly accurate but a couple of things I would add, it probabley took Ian longer to write his descrition than the whole proceedure took. I was really suprised how really quick it was and I'm suprised Ian remembered all of the details. If I had to choose this procedure or the dentist I would definatley go with this every time.

Problems - when I peed immediatly afterwards there was some blood but not much and the first couple of times you pee it's a bit sensitive but nothing that bad.

It turns out I have an enlarged prostrate (nothing abnormal I'm told if your over 50) and it had no effect on the proceedure, oh and I'm a fully paid up member of the cowards club!!

If your going to have this done dont worry about it, being stressed when you go in can make the proceedure slightly more difficult. As for taking time off work afterwards, I was back at work same day.

I'm sure as can be seen from other replies some people do not have a good experience but I believe mine was typical of what most guys can expect. And to the comment on another reply that size may make it easier that was not the case with me, he was lucky to find it.... 

Hi I am a 38 year old male and had my cystoscopy done today. I would like to share my experience.

I was very nervous prior to the procedure, when I arrived at hospital I was required to give an initial urine sample for testing prior to the procedure.

After a wait I was called into a room where a nurse checked if I was on medication or had any allergies, I was given 2 gowns and told to remove trousers and underware and put on gowns.

When I went in for the procedure the doctor gave me a quick clean, then inserted the syringe of numbing gel - immediately after inserted the cystoscope, which was fine going into penis but going past my prostate I yelped in pain they pumped water in which made me have the desperate feeling of needing to pee. It was very quick when the cystoscope was removed I never felt anything but I did leak everywhere. I was told to expect blood as I had a structure at my prostate hence the pain I was given a sample pot and had to pass urine - it was sore and as expected bright red with blood and clots.

All the way home I was in pain a mixture of aching, burning and needing to pee.

When I got home i had blood on my underpants as I'd been leaking I sat on the toilet in pain passing blood

I took some of my wife's strong prescription painkillers and am now getting relief - I'm scared to pee later when the painkillers wear off cause no doubt I'll be still bleeding and in pain

Hi Ian

i went for the same procedure under a local anaesetic but i could not even take

the gel being given the pain was intense and my body would not relax 

A week later I went back to have it done under a general anaesetic when I awoke

the top of my penis was battered and bruised and bleeding I was then sent to a 

nursing home as the hospital was short of beds I dripped blood and drops of urine

all night long not having been explained that this would or would not happen I just

had to put up with it

I went home that morning trying to recover but realised that I could only pass

drips of blood or urine at about 2PM I had an acute pain and contacted 111 an

ambulance was not availible so they sent a taxi to take me to A-E there I awaited

about 2 hours until I tolda doctor that I feel so bad that I am about to collapse

within minutes I was seen by a young doctor who said I had gone into retension

and needed a catheter inserted I broke into a sweat at the thought of it but was told

by the doctor my condition was now serious and it had to be done it hurt but I then

filled 2 catheter bags full of blood and urine I was kept in hospital overnight and then

?sent home with catheter bags by ambulance

The next day I went downstairs for a coffee on returning to the bedroom I collapsed

in acute pain I contacted 111 again and went through the normal questions and then

was asked do you think you are dying I replied as I have never died before I would

not know the feeling but I am in acute pain

A para-medic was sent to me and she wanted to take me in her car but she realied

that I could not bend an ambulance was called and I was rushed back to hospital

I was told my bladder had reacted to the catheter and it had to be removed then

another tube was inserted to pump me out Iwas then kept in for 2 nights and every

time I passed urine this was about every 15 minutes day and night it had to be

measured they wanted to keep me in longer but i said I could manage at home

now after 24 days I still feel bruised and the top of my penis has not returned

to normal

the doctor said my bladder is ok but that I have a huge prostate and he wants to see

me in 3 months time I asked for a drug that I had read about that may cause the 

prostate to shrink [finasteride] but it can take up to 3--6 months to work

I am telling this to you to say that everyone is different in my case lots of trauma

but I came through it

I am 74 years old and still play walking 5 a side football twice a week

Great post Ian. Very re-assuring. I read it the evening before my flexible cystoscope and knew exactly what to expect. Went precisely as you described. Many thanks. Hope you are now well.