My Cystourethroscopy Experience - Professional and Pleasant

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I'm a 66-year-old man, and my Urologist is a woman.  During my 'new-patient' exam and work-up it was discovered that I had micro hematuria.  My doctor ordered a CT scan, bloodwork, and a cystourethroscopy.  With the cysto procedure, I had a vague idea of what would happen, but had never had one performed, so I checked into this on-line.  The search results seemed to run four to one, painful versus OK, so I was somewhat concerned as the day arrived for my test.  It turns out I wasted a lot of energy worrying about this.  What follows is detailed.  I was in the waiting room, when a young lady called my name, and we went back together into a procedure room.  There I met my Urologist, and she gave me instructions on what would be happening, and what I was to do.  She coached me on being relaxed, and not to tense, so as to facilitate the insertion of the scope (which was a flexible type).  The first young lady took my vital signs, asked me a number of questions, then asked me to get undressed.  I complied, then took my place in the comfortable chair, and placed my legs in the stirrups.  She prepared me by cleaning the glans, and instilling the Lidocaine gel into my penis.  A gentle clamp was placed across the organ to close the urethra, and we waited for a few minutes for the anesthetic to work.  The doctor then returned, and the two ladies readied the scope.  I relaxed and closed my eyes, and waited.  The young lady positioned my organ upright, removed the clamp, then I felt the scope inserted into my urethra.  What I felt was like a gentle stretching - no pain - and the scope seemed to glide effortlessly up towards the prostate gland.  As the scope was advanced into the bladder, I felt a pleasant thrill, and then afterwards - generally no sensations at all, as the doctor surveyed the interior of the bladder.  I opened my eyes and asked the doctor if she was going to add fluid to distend the bladder - apparently, I had filled it sufficiently with urine prior to the test.  The doctor then took two syringes of about 100mL each, and removed that amount of liquid.  These samples were sent to a lab for analysis.  The results were that my bladder appeared to be normal, and the epithelial cells from the bladder wash showed no signs of cancer.  The entire process took about 15 minutes.  My Urologist and her assistant were at once completely professional, friendly and supportive, and handled my body gently and with respect.  I felt safe, relaxed and comfortable with them - the entire process was pleasant, and I have had no negative effects from it since that time (at this writing, it has been about a month).  I can't say enough good things about these two ladies - they are wonderful, and I would not hesitate to repeat this procedure if it were to become necessary again.  I found by experience - there was no reason to worry about it.             

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13 Replies

  • Posted

    Hi, alan12675,

    Thank you for your lengthy and detailed post. It reflects my own experience almost exactly. You had the good fortune of being coached by a competent urologist just as I did. The only difference is that I declined numbing agent of any type since I had plenty of self-catheterization experience behind me. A gentle operator is also essential.

    Mindful of the high percentage of contributors to this forum who admit having unnecessarily postponed their cystoscopies for years sometimes, for fear of the anticipated pain, there is a very real need to get the facts straight. True, some of us do have strictures or other issues that could cause pain, but the urologist will know of such possibilities beforehand. And some of us could be just more sensitive.

    So, you have done the right thing here, and I am happy to second you wholeheartedly! Season's Greetings and best wishes for a happy future,

    alan86734.

     

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    • Posted

      Hello alan86734 -- I greatly appreciate your comments on my recent posting.  Indeed, I was trying to encourage people who might hesitate having this done, to go ahead - having had some improved  degree of confidence.  Yes, I am fortunate in having an excellent urologist.  Not only that, she apparently sets a positive tone for her staff, who also are happy and very competent.  I've asked some of these about her, and I'm told that 'we just love working with her', and after two visits with her, I can see why.  She is a real gem, and truly a joy to be with.  

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  • Posted

    I am glad you had such an easy time with it.  I have learned that it really all depends on the doctor.  I am having a much better time since I found the second doctor.  Its sound like they really took the time to explain everything to you which make alot of difference I think.  Debbie
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    • Posted

      Hi, Debbie1203,

      How right you are! Operator skill and attitude are indeed major factors. alan12675 has done us all a great favor by publishing such a detailed account of his mostly pleasant experiences. I was shamed into updating my own profile to which I invite you as soon as you find the time. I would very much like to keep in touch with you and other like-minded folks.

       I would also like to take this opportunity to wish you the Season's Greetings and best wishes for a Great 2018!

      Warm regards, alan86734

       

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    • Posted

      Hi Debbie1203 -  Thank you for your response to my posting.  I can imagine that quite a bit does depend on the doctor's technique.  My doctor has had more than twenty years of practice in her specialty.  I would imagine that if she found any problems with some part of my system - she would know what to do.  

      For my procedure, I had reasoned that the scope would be a flexible type - since this was to be a simple, quick office procedure.  But, I wasn't really sure of this until I was in the procedure room, and saw the scope in its sterile wrapping on the counter.  I was very happy that it was a flexible type.  

      My doctor talked with me a bit during the scope insertion, letting me know what to expect.  She advanced the scope into me fairly quickly, until it came up to the external sphyncter.  She paused for a second, let me know that this was a potential problem area, then proceeded to advance the scope through my prostate and into the bladder.  I think the prostate was the area that produced the 'tingle' I mentioned.  There were no strictures or other problems, so the bladder survey was completed without incident. 

      I think that the success I had was partly due to the rapport I had with my doctor and her assistant.  I like them both very much, especially the doctor, and I was completely relaxed, and confident in their abilities.  I think this is a very important aspect of communication between a patient and the doctor;  the measure of trust the patient has in the people caring for him or her.  So, if you are having a better time with your second doctor, I completely understand.  It would be extremely important for me to like my doctor - under the circumstances. 

      I hope things continue to go much better for you!

      Alan          

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    • Posted

      It's called "Sharing"; when the "Them" and "Us" become "We" and "Our experience". Give your doctor a big hug. She deserves it!!

      Warm regards, alan86734.

       

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    • Posted

      Dear alan86734 -- You hit the nail on the head.  I feel that my urologist actually IS standing beside me and leading me along the way I need to go, letting me know as we walk together WHY we are going this way.  It is exactly an 'Our Experience' type of situation, from my point of view.  Your point is very well-said. 

      I have been 'working out' at my local gym for about a dozen years. Last year, we lost one of our regular guys to advanced bladder cancer.  He didn't know anything about this until he saw blood and it was too late; despite aggressive treatment, he passed away six months later.  When my urologist found blood in my urine, the first thing I thought of was her diligence in having detected a potential problem early.  On the day of my cysto, just before my preparation, I thanked my doctor for having given me a chance to live, that my friend apparently may not have had.  I expressed my gratefulness to her, and I think she appreciated it.  It turns out that my condition was OK, but we really didn't know that at the time. 

      Bottom line is - I would love to give her a hug!  A long one....

      Best regards - alan12675                            

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    • Posted

      Dear alan12675,

      Thank you for your kind words; I really appreciate this! Sorry to hear about the passing of your friend. My understanding is that cancers of the urinary system tend to advance quite slowly, so it would seem that your friend was plain unlucky. But you came out clear and that must be cause for celebration.

      You appear to be new to this forum. I don't know how much you have researched it but a quick heads up follows. Home base is in England with a strong concentration in the United States and in Australia. Sprinkles over the rest of the world.

      I myself hail from Argentina where I was born and bred (Australian father, mother born in America but raised in England. At age 28 I emigrated to England. Spent 19 years in England followed by almost 40 years here in the U.S.A. I like to spread knowledge freely but, when dealing with issues that might be controversial I prefer to focus on specific individuals using the PM (private message) method of communication. Would this be acceptable to you? So, lets give it a try. I will put together a rough outline of what I would like to accomplish. Nothing formal. Play it by ear. Let the cards fall where they may. This should take me two or three days.

      All the best for now, alan86734.

       

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    • Posted

      Dear alan86734 -- Thanks for your note - and sure!  I would love to hear from you.  I am new to the forum, as you surmised.  Please ping me at:.  I look forward to hearing from you.

      Best regards,

      Alan12675

      Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

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    • Posted

      Dear Alan12675,

      I would be delighted and honored! A minor problem has arisen as per the Moderator's footnote. We are restricted to using the Forum's own messaging system. Click on the envelope ikon immediately following your Name ('alan12675' top left corner of page to me). This should open a blank page for you to type your Private Message on. When done click on the 'Reply' button at the bottom right of the page. And I should receive your message.

      While on the subject of good communications, could you please tell me which country you are in, and possibly geographic area if different time zones are involved? I hope I have written the instructions down correctly.

      Warm regards, alan86734.

       

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    • Posted

      Alan

      With my first doctor I also reasoned it would be a flexible scope, I even told the nurse i was worried about the procedure, she then told me that there was nothing to be worried about, the pain level should be no more then a two and no different then a catheter.  Unfortunately she was wrong, they did a rigid scope in the office with no numbing gel.  I will never go back to that doctor as he hurt me badly.  The second doctor, whom I saw today is so much better, I had to have some medication inserted into my bladder and he stopped and told the PA that I was inflamed (still from the 1st doctor) and to use numbing gel and take extra time because of my first experience with the first doctor.  I can tell you this time was a walk in the park, they took it slowly and made sure I was comfortable the entire time.     

      Thanks for your post, it really helped me to realize how things should have been done and help me though the procedure I had to have done today

      Debbie  

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    • Posted

      Hi Debbie -- thanks for your reply, and I'm glad I could at least provide a little perspective on this procedure for you.  And, I'm glad that you had a much better experience with the second physician today.  I'm sure that your new doctor will be able to help you recover quickly and get back to normal.  

      I wish you all the best --

      Alan12675

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    • Posted

      Hi, Debbie1203

      I seem to be unable to get through to you with a response. Are you locking me out? If so, that is O.K. as far as I am concerned. It is your prerogative entirely and I will drop the issue entirely and not waste any more time.

      Warm regards, alan86734

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