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should i have cystoscopy?
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should i have cystoscopy?

Hi,
I am a 24 years old female. I had a blood test and urine test occasionally, and they found blood in my urine which is not visible to me. I only go to bathroom a lot, but I also drink lots of water. I was referred to a urologist, and he wanted to start with cystoscopy. They used some metal tubes, but when they were only half the way they had to stop cuz i started crying. it was so painful, it turned out to be that i got the infection after the examination. used a week of antibiotics and cleared out the infection which I didnt have before.i couldn't hold my pee for two weeks and the doctors told me that that is strange. after that i had my cat scan and blood test. everything was fine. my kidney functioning ok, no stones tumors anywhere. my doctor told me he cant do do cystoscopy with me as it was so pinful before. and he also told if it was a tumor down in the bladder, the blood in the urine would be increasing fast and would be visible to me in 6 months. i was assured. then i went to a better clinic for a second opinion. they still think i need to have cystoscopy to make sure. they say it is really unlikely that i have the cancer cuz i am young and dont smoke. but they still need to see inside the bladder they say. and also they say they wont use metal tubes as the other doctor did but a flexible tool like a cable. i dont know, still i remember the time i tried to have it done. i couldnt hold my pee for two weeks and i was so scared that i made a wrong decision to start the cystoscopy. i cant go back to that again. other than that i have a pain on the rite groin but the doctors didnt think it would be related to that. besides i had an ultrasound on my pelvis and they detected a cyst on my ovary, however in the cat scan i had two weeks after the ultrasound they didnt see the cyst on my ovary. cat scan says my ovaries are within limits, while ultrasound before told that rite ovary is bigger. why is that maybe the cyst has gone with my period or cat scan doesnt really visualize everything? so is it a really good way to visualize any stones or tumors on the urinary tracts and kidneys? and also i know that cat scan also visualized my bladder. but why do i need cystoscopy, i still dont understand. cat scan does it only look at the surface of the bladder? cant it see inside? i dont understand. what would happen if there is really a tumor (cancer) and i dont take care of it rite now? would i die? or what would i not be able to hold urine? is there any other way to know if i have the cancer or not cuz i can't have this cystoscopy. please help i am crying everyday. can my age and the good results on the cat scan on my bladder assure me a little bit?
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Avatar_dr_f_tn
Hi,

I do understand your concern. I know that you are scared about all these. You are young and you do not have the risk factors that strengthens a diagnosis of  cancer.So please do not worry too much.

"Studies have found the following risk factors for bladder cancer:

Age. The chance of getting bladder cancer goes up as people get older. People under 40 rarely get this disease.

Tobacco. The use of tobacco is a major risk factor. Cigarette smokers are two to three times more likely than nonsmokers to get bladder cancer. Pipe and cigar smokers are also at increased risk.

Occupation. Some workers have a higher risk of getting bladder cancer because of carcinogens in the workplace. Workers in the rubber, chemical, and leather industries are at risk. So are hairdressers, machinists, metal workers, printers, painters, textile workers, and truck drivers.

Infections. Being infected with certain parasites increases the risk of bladder cancer. These parasites are common in tropical areas but not in the United States.

Treatment with cyclophosphamide or arsenic. These drugs are used to treat cancer and some other conditions. They raise the risk of bladder cancer.

Race. Whites get bladder cancer twice as often as African Americans and Hispanics. The lowest rates are among Asians.

Being a man. Men are two to three times more likely than women to get bladder cancer.

Family history. People with family members who have bladder cancer are more likely to get the disease. Researchers are studying changes in certain genes that may increase the risk of bladder cancer.

Personal history of bladder cancer. People who have had bladder cancer have an increased chance of getting the disease again."

Source:http://www.cancer.gov/cancertopics/wyntk/bladder/page4


Firstly, let me ask if you had this blood in your urine for quite some time already?How many times did they do the urinalysis and did they see blood or RBC's each time? Also, was a urine culture done to rule out an infection initially prior to your first cystoscopy attempt?

Asymptomatic hematuria may be due to strenuous exercises, straining, and certain medications .If you have been through too much stress or too much exercise prior to giving your sample for a urinalysis then you may opt to have your urinalysis repeated. Hematuria may be due to several causes. I understand  a CT scan has been done. Yes, the CT scan will able to define any abnormalities, stones, obstruction in the urinary tract. It may be able to visualize urinary tract stones. A cystoscopy however will be able to help your physician directly visualize the insides of your urethra and bladder. It is important however, that a bladder infection has been ruled out in your case.Cystoscopy should not be done in the presence of an underlying bladder infection.

Discuss your concerns with your physician. Also, discuss with your physician the probability of you condition being a glomerulopathy. A urine cytology may also be indicated. If all tests are normal but the blood in the urine or hematuria persists then this needs further evaluation and a cystoscopy may help.
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Avatar_f_tn
no they haven't done any cultures before th exam, but they didnt see any white cells that mite have an infection. i mean noone suspected of infection, i kow it wasn't a culture they did. was only simple urine test, but there was no infection. after the exam they did a culture and they saw infection. after i got antibiotics for 5 days i had the culture again and they didnt see any infection this time. ok, and when it coms to my urine test i took it almost five time in the last 2 months and every time there is blood. none of the doctors told me about cytology though should i ask them if they can do that? now i read it and it can somehow say that if i have cancer cells. but what is glomerulopathy? i dont understand that.but i for sure dont want cystoscopy. thanks. i would be glad if you reply soon.
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