Cystoscopy

Hi.  My doc wants to do a cystoscopy.  But, I told him I don't want to be awake.  But, then he said the only other option is general anesthesia.  Does anyone know why they can't use some type of sedation technique like when you have a colonoscopy?  I dind't feel that test at all, yet I didn't need general anesthesia.

[Trinity22]

I had a cystoscopy in the office but it was too painful so I was told we needed to do it under general anesthesia.. They gave me the option of having an epidural  or general anesthesia.. im not sure if they gave you the same option. but I chose to take the epidural since I didnt want to have  general anesthesia, the side effects from getting the general usually lasts in my system for a few days making me feel sluggish. and when I had the epidural I felt less like this and I was half awake but do not remember having the cystocopy done. I will be getting one done in another few months due to my medical condtion the doctor does a Bladder distention regularly for me.. hope this helps some.

[Trinity22]

forgot to post this and couldnt edit my post they gave you Local anesthesia for the test you had before. did you ask if the doctor was able to use the Local anesthesia

[miclus]

Not yet.  But, I want some type of anesthesia where you are asleep like when you get a colonoscopy.  I'm just trying to see if it's possible with cystoscopy.

[Trinity22]

thats good hopefully they will let you use local anesthesia if not the second best would be general anesthesia since you wont be awake at all. the epidural makes you not feel pain but you are still awake.

[Matthew007]

I did it awake.. not fun at all but I wasn't in super bad pain.  There was residual pain after the procedure (due to stretching..)

I could probably do it again awake - hope yours goes well. :S

[facetime]

I just had one yesterday.. no walk in the park, but very quick.

If you MUST be put out, ask for Diprivan (Propofol) which is what they use for colonoscopies. Has a half life of 90 seconds and leaves you wide awake within 15 mins of turning off the drip.

Still they require an anesthesia doc there and someone to drive you home.

Frankly the pain from the cysto was so brief that it would have taken longer to put me out and wake me up than to scope me three times.

They do use a local topical gel... but they can't get that up to the prostate and bladder neck and that is where you get the "pinch."

I say bite the bullet... skip the drugs.

[keith214]

Need a cystoscopy need to know the deferent between rigid or flexible

[jaannee]

I had a cystoscopy done 5 years ago. They gave me nothing before this test.  It was so painful, I passed out and the nurse pulled the intruments out very fast which was also painful. I am  having UTI's and bladder spasms worse now. I need to be tested but am terrified of going to see a urologists. And I also wonder if her jerking these tubes(which she called hooks) out did more harm? Please let me know what they can do for pain during a procedure like this.

[djkyosti]

I did this test yesterday with just the local antisthetic gel.  The test was over in less than five minutes and was never painful.  It is mildly uncomfortable because it feels so strange to have a camera in your penis, but it only slightly pinches when they go past the prostrate.  I don't think sedation would be needed unless you have a serious medical problem that will make this test painful for you.  

Peeing after the test on the other hand is no picnic.

[worrier77]

I dont understand why they make such a big deal about simply putting the patients to sleep for 10 minutes like when you're getting a gastroscopy.
WHY on earth can you simply do this during a gastroscopy and not also during a cytoscopy? Just a small propofol or dormicum injection and you're gone.
I don't understand this one bit. It's almost as if they want to see you suffer. This is insane.
I once got a urethra swab and already passed out from it.

[djkyosti]

Worrier, I think that the risk of the sedation is probably not worth it for a test like a cystoscopy which is why they do not routinely sedate patients for that test.  Colonscopy and endoscopy would be very difficult for the doctor if the patient was not sedated.  Certainly a colonscopy would be very painful without sedation.  No sedation is used in many countries and some people can handle it while others can't.  I think in endoscopy the gag reflex is the problem?  Cystoscopy is unpleasant but not painful.  I am a wimp and I thought it was ok and mercifully it was very quick.

[worrier77]

What risk are you talking about?

I think the risk of getting a collapse or having your pulse and blood pressure go through the roof out of sheer fear are higher.

And you can also get a gastroscopy without sedation. Some people can do this.

[Jary08]

i had a gastroscopy without sedation...just throat spray...and while it was very quick (5 mins) if i ever have to have it done again im getting sedated, i didnt like it one bit.

I have to have a cystoscopy next month. ive heard of them giving you full anaesthetic or an epidural but as far as i know ill just be getting a local anaesthetic on the outside of the urethra...which i hope is the case, if not, then its full sedation for me, i cant stand the thought of having a needle in the spine.

[rmprdl1964]

Hi, I have numerous cystoscopies to the point that I don't remember the exact number, but it is over 20 times.

The first ones were with a ridget scope and were quite painful. The first time the urologist was quite rough and I also had some biopsies taken. I left the OR bleeding from the urethra. When I returned to the waiting room where my wife was waiting for me, she suggested to just sit in the room for a while. One of the nurses came up to us and told us to leave. There was only about five or 10 minutes after the procedure.

With this in mind I asked for something to deal with the pain for the next cysto. The urologist gave me a general.

One time that my wife could not come with me, the urologist refused the general since I had no other adult with me. I was expecting the worst. To my surprise there was very little discomfort even with a biopsy done.

I think that there are several factors that can change the experience. First of the skill and patience of the urologist doing the procedure. If he is rouhg then discomfort will result. If you are tense and fight the procedure, things will be rough as well.
If a straight scope is used over the flexible scope, more discomfort should be expected.
Even with the straight scope, I have had occasions where there was little discomfort.

One of the mistakes that I made and I'm sure others is to tense up with the feeling to urinate when the scope is passed into the bladder. I strained not to urinate. You will be asked to urinate before the procedure so that the baldder is empty, yet this sensation is there. If you relax and not fight the sensation of urinating, the procedure will be much better then when tensed.

Within a few months I will be going for my fifth cystoscompy for this year. I say that the once that I have had this year have not been painfull at all. I was aware of what was being done, but no discomfort.

Good luck,

Ron

[lovemedicine]

If your surgeon wants you to be asleep for the procedure (a cystoscopy), I am aware of two options:
1)  MAC (monitored anesthesia care) which infers sedation without intubation and
2)  General Anesthesia, which infers that you will be intubated.

Both are administered by IV.  While a cystoscopy can be done without general anesthesia, there are some reasons why the surgeon may want you asleep.  One reason is that the surgeon may be doing a cystoscopy with retrograde, which means that they will insert a contrast die during the procedure so that they can take certain xray films.  To do this, they need to push the scope further up the urethra and they also need for the patient to lie perfectly still.  With a local anesthesia, there is greater risk of patient movement.  Some surgeons may only want to do these procedures under General Anesthesia, but I am aware of patients refusing the General Anesthesia and being successfully tested with MAC.

[Jary08]

I actually read something before....if you are getting the flexible camera then you only need the jelly anaesthetic or a sedative if you are nervous

If your getting the ridgid camera, then youll need and epidural or full anaesthesia.


It was an NHS document that i read so it should be acurate (unless your in the US, then i dont know if they have the same methods)