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Rigid versus Flexible Cystoscopy

Posted , 6 users are following.

jimjames
jimjames

My urologist suggested I have a rigid cystoscopy under anaesthesia to investigate possible causes for blood in my urine.

I was wondering how common this was versus what I thought was the more common flexible cystoscopy, where you are not put to sleep. His reasoning was that he could do a more thorough job, including taking a biopsy if needed. 

Interested if any of you have had the rigid versus flexible cystocopy, if they put you to sleep, and any related thoughts. He plans to do this in his office with a dedicated anesthesiologist on hand. 

Jim

0 likes, 15 replies

15 Replies

  • kenneth1955
    kenneth1955 jimjames

    Posted

    The one he whats to do is more painful Thats why he what to put you the sleep.  I would never let that be done in a office.  They can do the some with a flexible one.  Does he think you have cancer.  Why is that the first thing he is looking to do.  I had bleeding after they tried to catheterme for out after a regular cystocopy that I had a stricture.  I would tell him no.  If he tells you no I would get another doctor  Ken   
    • jimjames
      jimjames kenneth1955

      Posted

      My understanding is that a cystocopy is part of a standard workup if you have blood in your urine. I also had a CT scan that showed some sort of inflammation in the bladder that probably warranted a closer look. No, I don't believe he thinks I have cancer, but he does think that it's prudent to take a look and rule it out.

      I was just wondering about the rigid versus flexible aspect of the procedure and if others have done the rigid. As far as the office is concerned, I've had both colonoscopies and endoscopies done in doctor's offices using a similar type of anathesia which is probably more of a heavy sedation although you really don't remember much if anything afterward.

      Jim

    • kenneth1955
      kenneth1955 jimjames

      Posted

      You think you have bleeding now.  Wait till they put that metal rod in you.  I would never have that done.. A regular cystocopy is normal.  You may have a infection in the bladder or kidneys...ken   
  • ianC
    ianC jimjames

    Posted

    I've had both, several times. I think you do need the rigid one if they are to do both a thorough check and take a biopsy. Only that way can they know whether you have bladder cancer or not.

    That said, they could first check with both ultrasound and/or flexible cystoscopy to just visually inspect. But as they are recommending rigid, then I suspect they believe there is a possibility you have bladder cancer. If so, the sooner they deal with it the better. They can only be certain with a biopsy, which needs the rigid cystoscopy.

    Lastly, I would strongly recommend you have a local/spinal anaesthetic - there is evidence that general anaesthetics affects memory, especially in older patients.

  • Guest
    Guest jimjames

    Posted

    I've had both flexible and rigid cystoscopies.   With the flexible one you can be awake and if they use the lidocaine gel you don't feel much with it going in - I had to have a stent removed a couple of years ago which took about 3-4 mins.   In August this year I had a rigid cystoscopy with biopsies taken.  It was done under GA in about 30 mins.  Very painful afterwards in the biopsy sites for 24-36 hours but then OK after that.  They can use tools on both types but it may be the biopsies need to be done with a rigid one.  
  • derek76
    derek76 jimjames

    Posted

    I had a rigid cystoscopy under anaesthesia in 1983. It is surely a thing of the past. I did not have any problems after it apart from stinging/burning on the head of my penis that I put down to some antiseptic that must have been used and caused its skin to peel.

    Since then over the years I have had four flexible cystoscopies that I have watched with interest on the screen and had explained to me as it happened. All very quick and painless.

    • ianC
      ianC derek76

      Posted

      I'm not so sure Derek, much as I respect your experience and opinion. My experience differs. However, I am about to have another flexible cystoscopy on Thursday, so I will ask whether this is still the case - that for biopsies they need to use the rigid one. I've had a couple in the last 8 years, so if rigid ones can now be avoided I'd welcome that too.
    • derek76
      derek76 ianC

      Posted

      They did a prostate biopsy during a cystoscopy rather than from the rectum or is your biopsy for the bladder?

       

    • ianC
      ianC derek76

      Posted

      I should have said: for my bladder cancer. But from what JimJames has written, I'd guess they're checking for bladder cancer rather than BHP/prostate cancer.
    • jimjames
      jimjames derek76

      Posted

      Primary interest is bladder, but I"m sure he will look around. But yes, if they see something suspicious they would then biopsy the bladder, however my non-professional take is that the bleeding is more related to bph as opposed to the bladder. 
    • derek76
      derek76 jimjames

      Posted

      I've had BPH for twenty years and had two laser procedures (130gram prostate) but I have only twice passed blood and that was from a burst blood vessel in the prostate. 
    • jimjames
      jimjames ianC

      Posted

      Based on this discussion and other research, I probably should ask the doctor what he thinks the odds are he wll do a biopsy. If the odds aren't great, then I think I'll ask him to consider doing a flexible first and take my chances that he might have to go back with a rigid. Unless, he comes up with another good reason to do the rigid.

      Jim. 

    • derek76
      derek76 ianC

      Posted

      I would imagine so. A friend has it and has regular flexible cystoscopys with biopsies and laser treatment. 
    • jimjames
      jimjames derek76

      Posted

      The reason I think it's probably related to bph (or prostatitis) is because I've had episodes of blood in the urine going back ten years, and in fact ten years ago I had a cystoscopy to investigate and they found nothing. The doctor then told me that it was probably related to bph. In any event, I'll be finding out relatively soon. My prostate is 65 grams via CT Scan measurement and has never been operated on.

      Jim

    • derek76
      derek76 jimjames

      Posted

      I've had a lot of UTI's and bouts of prostatitis without visible blood but the doctor often finds traces when checking my urine.

      When BPH first diagnosed in 1994 my prostate was 35 grams. By the time I had PVP in 2005 it was75 grams. Two years after the last procedure when 130grams it is now 50 grams.

       

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