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Cystoscopy Anxiety: What to Expect I recently had a cystoscopy, with a flexible scope. I want to share my
experience for all those who may be facing this and feel understandable anxiety. I
have BPH and occasional bouts of prostatitis.
First, I've had two of these procedures 12 years apart; the first under
general anesthesia with a non-flexible scope, the second, very recently with a
local anesthetic. This account concerns the second procedure, which was for
examination purposes, not surgery.
Most patients will undergo a cystoscopy with local anesthetic in your
doctor's office. Like me, you will be nervous about this prospect. Indeed, I lost a
lot of sleep for a couple of weeks beforehand, imagining the worst. Here is
what you need to know, from someone who just underwent this procedure.
First, the local anaesthetic (usually Lidocaine) is very effective. So
effective, you will experience little at all through most of it, certainly no pain.
Your doctor may (as mine did) administer a calming drug, Valium (10 mg),
about 20-30 minutes before the procedure. This helps. If he doesn't offer it,
ask him for it. It doesn't make the experience more painless, it just reduces
the anxiety.
If you are extremely anxious, you can ask for a shot of Demerol as well. I
did, but in retrospect I don't think it was necessary. Mostly the Demerol made
me feel a bit woozy after the procedure. In any case, if you have
Valium or Demerol, somebody will have to drive you home after the procedure.
Once the Valium has taken effect, the doctor will inject a Lidocaine gel into
your urethra. This is not as bad as it sounds. The doctor does not use a
needle. The syringe is just that, a plastic tube without a needle. Pressure
alone suffices to get the stuff in. You will hardly feel anything at all as
this happens. He will probably inject it twice to get the full dose. Don't
worry about this part, you will hardly feel anything.
The Lidocaine works fast, in about 20 seconds. They doctor will then proceed
with the cystoscopy. I used a sheet so I didn't look, to reduce anxiety. I
didn't feel much at all. Only a vague sensation that something was happening.
Reading these forums, I expected some discomfort when the tube reached the
prostate (I have BPH). To my surprise, I didn't feel anything. (I did keep up
a dialogue with the doctor during all this, a technique I have long used
during any mildly uncomfortable medical procedures to distract attention: I
recommend this in any case.). The next thing I knew, the doctor told me he was
looking inside the bladder. I was surprised a bit, because I hadn't felt the
scope enough to know where it was.
I did feel a twinge or two during this phase, which lasted about a minute,
maybe a bit more. I seemed to feel these twinges when he moved the cystoscope
around to inspect the bladder. They were twinges, not painful, just a little
unfamiliar. Believe, nothing to worry about.
I had also read and worried a bit about the part of the procedure when the
doctor injects water into the bladder to make it more accessible and visible
for his inspection. I had expected to get an urgent feeling of needing to
urinate.
To my surprise, this did not happen. While he injected water, I hardly felt
a thing. Only the mildest feeling of fullness, well within easy tolerance.
When he was finished his examination, he slowly pulled the instrument out. I
could hardly feel this until I felt a gush of water on my pelvis, after
withdrawing the instrument. It was all over, having taken at most 2 or 3 minutes,
probably less.
Bottom line: this procedure is a lot less uncomfortable, let alone painful,
then is the worry and anticipation leading up to it.
Now for the bad news.
After the procedure the local anesthetic wears off very quickly, within three
or four minutes, When it does, your bladder and urethra will feel sore.
Urinating will be painful: a burning sensation. It will take a long time to
begin to urinate, with a thin stream, and be quite uncomfortable for the first 12
hours. The second 12 hours it will be a bit better, but only a bit. After
24 hours it will still be burning, but not nearly as bad. After 48 hours you
will feel almost normal. Complete normality, in terms of urination and
ejaculation may take a few more days, but this period is without any real discomfort
at all, only the realization that you are not completely back to normal.
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