Rigid cystoscopy

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Hi after an mri looking for Somwthing else it picked up a tiny nodule on my bladder,I've now got to have a rigid cystoscopy under local.does anyone know why I have to have a rigid and not a flexi please as I've read a rigid should be done under a general but it says a local for me many thanks Michelle x

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  • Posted

    I would be asking some questions WHY..... asnd very LOUD questions too!

    Admittedly cystoscopy is less painful for women, but flexible cystoscopes are bad enough so rigid cystoscopy can't be a joy without anaesthesia (as "local" is a euphemism for nothng at all when dealing with Urological matters - it's simply not in contact long enough to have any appreciable anaesthetic effect).

    Of course procedures are MUCH quicker and consequently MUCH cheaper done without anaeasthesia, so perhaps this is the reason, make sure you are not messed about!

    A quick search hasn't shown me any refences where anyone expects to carry out a rigid cystoscopy whithout General or Epidural anaethesia, so some VERY good reason would need to be given to convince me!

    I have heard of a method where Ketamine is used instead of the usual (useless) Lignocaine which might be much better, but I don't think it is widely used.

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    • Posted

      I've been reading of some women who have had rigid cystoscopy with a local and were fine so I'm more reassured I'm just wondering why a rigid and not a flexi what can they so on a rigid they can't do with a flexi any idea?
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    • Posted

      Certain procedures require a rigid because more instrumentation can be accomodated. That said, my urologist recommended a rigid to screen for bladder cancer (under general) but after consulting with two additional urologists I ended up with a flexible. It's possible that you really need a rigid for your procedure, but it's also possible that this is just your doctor's preference. About how old is your doctor? Here in the States at least, a lot of the older doctors tend to do rigids because that is how they were trained. On the other hand, the younger doctors do flexibles for the same procedures. Given a choice, go with the younger doctor who is more comfortable with the flexible.

      Jim

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  • Posted

    My understanding is that a rigid cystoscopy is generally performed with a general or spinal anaesthetic. I would do a little more research before letting yourself have a rigid with only local. BIG diffference between a rigid and a flex, the latter which is usually performed under local. 

    Jim

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    • Posted

      It's definitely under a local I'm in UK .maybe it's cos Mri has already picked up a tint bladder nodule and with a rigid they can biopsy?or can a flexi do that too I'm not sure?ussually as I've read a flexi is to see if there's anything wrong in bladder and just to check things and a rigid is for biopsies and stuff but I've also read a flexi can do that any idea please ? My mri couldn't tell the difference between bladder endometriosis and a bladder tumour maybe cos they know already I've got to have the rigid ? Thanks Michelle
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    • Posted

      It sounds to me the rigid MAY well be necesssary, as you say for bioposy purposes, but it is the lack of anaesthesia that's the issue, I know from my own experience that Urologists are NOT big on using pain relief at all, but seeing every single comment on this procedure (other than when carried out in very remote parts of the world) relates to the use of general or epidural anaesthesia, I would want to know in some extended detail the  MEDICAL reasons why this was not to be done that way bearing in mind the pain levels WILL be very signifcantly higher! Even the position that this is carried out in is more uncomfortable (and far less dignified) than with a flexible scope.

      Lots of procedures that used to be only possible with a rigid scope can be done  with a fexible one now, so I would be expecting some very particular reason, and cost and time and convenience for the hospital aren't something I would be taking as valid reasons!

      OK it is nore inconvenient for the patient to be anaesthetised too, of course it is, but even fexible cystoscopy means after effects so othe than not being able to drive for a day or so after, I can't see any good reason to suffer the pain.

      Even the NHS advice suggests it is usuall for this to be done under GA: http://www.nhs.uk/Conditions/Cystoscopy/Pages/Introduction.aspx ; -

      "A rigid cystoscopy is usually carried out under general anaesthetic (where you're asleep), or a spinal anaesthetic (epidural) that numbs all feeling below your spine."

      Hospital Consultants at the best of times are very prone to be badly afected by "God Syndrome," and it pays to question their divinity at times or risk being ridden rough-shod over.

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  • Posted

    Well I've rung and I'm seeing a uri/gyno who only performs rigid  cystoscope so at my hospital,however if I was to see a urologist they definite do a flexi,she said it's not cos of the nodule,it's just that this particular Dr only performs rigid and he is a uri,gynocologist,so still not sure wether to speak to my gp as maybe he is the best to look into my condition as the bladder nodule could be endometriosis and it needs him to do it.she said he has been performing rigids with local for two years now,but before then it was under a ga or spinal.any ladies I would like to hear who have had a rigid under a local please as I hear it's more painful for men? Xx
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    • Posted

      What about discussing urgently with your GP and seeing about a referral to another, even at another hospital, where they do 21st Century surgery instead of torture chamber procedures?

      Crazy. If you were an animal then the RASPCA could do something.

      Funny it is only Urologists that want do these painful procedures, any other surgeon is fixated on doing the least painful options. I am having a similar but not related probelm where they won't anaesthetise me to carry out Lithripsy because I am disabled and in pain and cannot lie in the postiion needed for 40 minutes to an hour, so unless the stone blocks me up comptely (as has happend before) and becomes life-threatening, I have to put up with the constant pain and risk of kidney failure!

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    • Posted

      I do wish my spell checker worked on this forum liek it does on every otehr one!!!
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    • Posted

      If your urologist only does rigid cystoscopies then you really need to see another doctor. As for men, a rigid cystoscopy under local is "babaric" and that is quoted from a urologist who does both rigids and flexibles. 

      Jim

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    • Posted

      I will make an appt yes with my gp all I can think of is a uro-gyno is doing it and his secretary said he only ever does rigids with a local.ive heard it's painful for men but less so for women but I'm still uneasy xx
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    • Posted

      Some say flexible scoping is a doddle - and pain free... OK, I am male, but I have had two, one right up horrendous, and one just plain and simply painful, so it is all about technique, ad about teh individual so you won't know until you are right in the middle of it, and it's a bit late to change your mind then! As I say, the "local" does nothing whatsoever (I contend it is actually MORE painful with it as it burns on top of the pain about to come!) so don't rely on that, it makes no differnce at all. The total absence of comments seem to confirm how rare a thing rigid scoping is without a GA, so that says a lot.

      Maybe start looking on Google for others in the NHS who work in the field and try ringing their secretaries, the find a relatively local one and then you know where and who to ask your GP to refer you to!

      Interstingly I can find plemty of cases where Doctors have caused unnecessary pain who have been disciplined or struck off, but still not one other who does rigid Cystoscopy without anaesthesia!

      The only research I can find is a document "Flexible and Rigid Cystoscopy in Women" (Search for it on Google it was the first to pop up!) which sums up..."Although representing a small group, 10 of the patients who had flexible cystoscopy performed had previously had rigid cystoscopy. Among these patients, only one preferred the previously performed rigid cystoscopy. The remainder either noted no difference between techniques (5) or preferred flexible cystoscopy (4)."

      Seems to confirm whihc waty is best!

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    • Posted

      Well the last part has made me feel better 😊1 preferred rigid and 5 couldn't tell a difference so that's better 😊did these women have local on both ? Thanka
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    • Posted

      I found the article and it has given me piece of mind that women can have flexi or rigid with no difference under a local so I am going to go ahead with it. men find flexible less painful but as you say even flexi was painful Ian so I don't know.thanks for all your help x
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  • Posted

    I had a flexi cystoscopy on Thursday last week and now have to go in for a rigid one after finding a lesion on the bladder wall. It's going to be done under general anaesthetic. Have you had yours done already and if so how was it? The flexi wasn't too bad just a little uncomfortable.

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    • Posted

      Hi yes I had mine done

      On June a rigid and I was awake just a local anaesthetic in my uretha.no pain not even uncomfortable I didn't feel a thing,I worried myself sick for nothing..my lesion on my bladder wall turned out to be a endometriosis nodule.you have nothing to worry about.when is your rigid ? Xx

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    • Posted

      Hi Michelle

      I am waiting for a date for my rigid which will be done under general anaesthesia. Glad to hear your outcome was positive. Hope mine is as well. Will let you know more later!

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    • Posted

      No idea why but think I would rather be under as then I have no idea what is happening! I am a big baby when it comes to hospitals!!
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