Poll on in-office cystoscopy...

[ScrabbleMom]

For those of you who have had in-office cystoscopies, what would you choose to do-- get sedated, or bite the bullet in the office?

Thanks in advance for anyone who replies!!!!!!

[ICNDonna]

That depends. If the intent is just to do a cysto, I would opt for the office. If the out-patient procedure with anesthesia includes a distention, that would be my choice.

An office cysto is uncomfortable, but mine wasn't horrible --- actually I've had several.

Donna

[bigred]

I agree with Donna. If it is a cysto only I would choice the office. Anything else I would go out pt.

[purpletomorrow]

I agree. I dreaded my in office cysto but it really wasn't bad. I took a Xanax before hand and was glad I did. My urethra was a bit sore when I peed for 2 days afterwards but not really pain. Good luck with your visit and decision.

[mlzippy7]

I will NEVER EVER do an if office cysto. That is just my opinion with what I have been through in the past with drs.
As you know we are all so very different and at different stages with IC.
Whatever you decide as long as you are comfortable with it that is all that matters!!
GOOD LUCK!!!

PS you are lucky the dr gave you the option:)

[luvsterriers]

What's the difference between doing in office cystoscopy and out of office when you are sedated?

I never had in office cystoscopy.

Anna

[mary124]

I agree with Donna, I too have had both. If its just a cysto- then to me it wasn't that bad, I have had 2 of them and both of them were in the morning and when I was finished with the doctors I went to work.

[ICNDonna]

Anna, when the doctor does a cystoscopy in the office, it's just to see the bladder lining and measure capacity. When a cystoscopy with hydrodistention is done in a hospital with anesthesia, the bladder is actually stretched.

Donna

[sickofmybladder]

I had an out-patient (surgical) cysto and hydro (bladder distention) - the recovery was somewhat long (uncomfortable for about a week) but well controlled with post op pain meds.

My daughter had an in-office cysto and was in horrible pain for several days after and was not provided any pain meds.

[ScrabbleMom]

Has anyone had/heard of "conscious sedation" for a cysto?

[mlzippy7]

Sure it is pretty common. You normally don't remember anything. With general you get the breathing tube and all and with this they sedate you and you shouldn't feel pain but you don't get the tube. I hope that makes sense.
Here is the definition from online but everytime I had(many) I dont remember a thing!! It depends how and what they give you!

This type of sedation induces an altered state of consciousness that minimizes pain and discomfort through the use of pain relievers and sedatives. Patients, who receive conscious sedation usually are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience to the provider. A brief period of amnesia may erase any memory of the procedure.

[Briza]

In office cysto was not an option for me due to my extreme severe Vulvar Vestibulitis at the time as well as extreme dr appt anxiety... both my at the time uro and I agreed would not be good idea. So I had cysto/hydro under general anesthesia...ok, hunner's ulcers were found and burned off and seems relieved pain from THAT particular symptom but I had severe over the top painful complications that landed me in hospital for a week... apparently RARE complications but when they happen to you they don't seem all that rare.
Anyway, if what was offered to me knowing now what I didn't know then I would ask for cysto and biopsy with VERY VERY moderate distention under sedation twilight sedation (like what they give for oral/dental surgery). JMHO from my experience if I could turn back time hahahah :rolleyes::bonk:

[jaisa]

I believe they did the Cysto w/o distention on me when I was first diagnosed, I don't think of myself as a wimp when it comes to pain but I swore T would never do that again without sedation. I was in the ladies room with bladder spasms for 30min before I made it to my car. However after about 2 hrs I was ok --I wonder if taking Pyridium first would help or is it even an option?--Good Luck-J:)

[ScrabbleMom]

Mine is going to be without hydrodistention. My uro seems very conservative and slow to do things he think might make the condition worse (I'm glad he's conservative-- before him I went to a quack ob/gyn who tried to force me to have urodynamics testing and instillations before even getting lab results back on my urine). Good lesson there: do not trust ob/gyns with urology problems!

Jaisa, I also have vestibulitis-- I hadn't considered that the vestibulitis may be a good reason to get the sedation. My bladder can go into spasms from eating chocolate. I also couldn't even sleep the night after I was catheterized because of bladder spasms--so I'm pretty much expecting bladder spasms. I definitely wonder if it would be best to be on a Demerol-high for the first couple of hours afterward.

[Krisssy]

I had an in office cystoscopy done with Dr. Robert Moldwin. I did not feel any pain, and it was interesting watching the pictures of my bladder while Dr. Moldwin explained what we were seeing. There was no pain afterwards either.

[GinaGV]

I had 2 in office Cystoscopy done, without any sort of anesthesia. However, I also had to go to the hospital to have the hydro but they did NOT give me any sort of anesthesia. Now, that was not fun, and was very painful. I think my uro at the time was afraid to give me any sort of sedation, for fear I'd have a severe complication (I have all these edemas and it puts huge stresses on my body).

Even with my IC presenting as urethra pain, the in office cystos were very manageable without any sort of sedation, but the hospital Hydro? Well, you must insist upon it, in my opinion.

[Goldfinch]

Of course we'd all love to be knocked unconscious for most any procedure, but for any procedure that doctors and most patients generally find to be tolerable without anaesthesia, no doc will give you a choice about sedation; the risk of complications under anaesthesia are always weighed against the pain of any procedure. There are always exceptions, but most don't find the discomfort of an in-office cysto to be unbearable. I am guessing that very few insurance providers would authorize doing a cysto w/out hydrodistention in a hospital setting under general. The difference in cost between that and a half hour office visit w/one uro and one nurse and a dab of lidocaine gel is enormous.

[blondie45]

I will NEVER EVER do an if office cysto. That is just my opinion with what I have been through in the past with drs.
As you know we are all so very different and at different stages with IC.
Whatever you decide as long as you are comfortable with it that is all that matters!!
GOOD LUCK!!!

PS you are lucky the dr gave you the option:)

I agree, I will also NEVER EVER do an in office cysto. I had this done years ago and the pain for me was comparable to having my children.

[Krisssy]

I think the amt. of pain with an in office cystoscopy has to do with the Dr. doing it and the patient's individual condition at the time of the cystoscopy. My Dr. told me that if at anytime I felt it was too painful, I should tell him and he would stop the test immediately. Also, my Dr. put me on Valium 2mg. 3 times a day and warm Aveeno baths twice a day for a month before he attempted to do the cystoscopy. So, although the pain eventually returned, I wasn't having any pain at the time of the cystoscopy. I think he wanted to quiet things down before doing the test. Having the test when your pain is about a 10, I would imagine would be very painful. Krisssy

[c2miracle]

I had a cysto-hydro under general anesthesia. Upon waking I was in the worst pain in my life. I remember screaming "I hurt.I hurt" She gave me more pain meds thru IV, twice, but it did not touch the pain. Finally a B&O suppository did the trick.
If you are having a cysto-hydro I would "go under." I could not imagine being awake and having this procedure done. Then again, we are all different, and what works for one person may not be the case for another. Whatever you decide I hope you have minimal pain. Think Positive :smile tee

[Krisssy]

I had a cysto-hydro under general anesthesia. Upon waking I was in the worst pain in my life. I remember screaming "I hurt.I hurt" She gave me more pain meds thru IV, twice, but it did not touch the pain. Finally a B&O suppository did the trick.
If you are having a cysto-hydro I would "go under." I could not imagine being awake and having this procedure done. Then again, we are all different, and what works for one person may not be the case for another. Whatever you decide I hope you have minimal pain. Think Positive :smile tee

What is a B&O suppository? Krisssy

[c2miracle]

Belladonna and opium. :)

[BeverlyJ]

Im having my first Hydrodistention tomorrow and wondered what the difference is between the Hydrodistention and the Cystoscopy I was diagnosed in December so im still new to all of this. Im having this done right in his office and wondered what do they do and how long does it take? And are you able to drive yourself home afterwards? or need someone else to?
Thanks Beverly J.

[Krisssy]

I am just wondering how you got diagnosed without the the hydrodistention?? I was able to drive home after the cystoscopy. I haven't had a hydrosdistention, but I have been told you are put out for that, and then of course you couldn't drive home afterward. Krisssy

[jen74]

I actually got Dx with just a regular cystoscopy. I did not do a hydrodistention. You do not always have to have a hydro to see IC, though IC cannot always be seen in some people with just the regular cysto. I also would ask to have a light sedation to do your regular cysto. I had one awake once and it was AWFUL!!! I have a very high tolerance for pain and this was just terrible. Maybe I had a jerk of a uro who just did a bad job, I dont know, but for me I will never do it awake again.
Jen

[Goldfinch]

I am just wondering how you got diagnosed without the the hydrodistention?? I was able to drive home after the cystoscopy. I haven't had a hydrosdistention, but I have been told you are put out for that, and then of course you couldn't drive home afterward. Krisssy

All doctors are different, with varying knowledge of IC and different experiences with patients. Some doctors favor the Potassium test, some hydrodistention as diagnostic tools. Some doctors are willing to diagnose based on an in-office cysto, history of symptoms, response to diet, response to drugs, etc. My uro believes that the Potassium test is going out of fashion and doesn't do it. He also is reluctant to do a hydrodistention under anaesthesia unless he believes a biopsy is indicated. He tries the least invasive routes first, and then goes from there. If a combo of drugs don't prove adequate then he experiments with instills, based on a recipe that his patients have found most beneficial; if that doesn't help than he tries other ingredients.

I was diagnosed with only an-in-office cysto (nothing evident) and a CT scan and my history of symptoms (intermittent for about a year), my response to OAB drugs (didn't work, didn't address the pain) and my response to the diet. And I took three uros to find a good fit for me. As with most auto-immune diseases, diagnosis is by exclusion. Rely on your instincts when talking to your doctor, ask lots of questions, make sure your concerns are addressed, and don't agree to any procedure without thinking about it overnight first, and be as informed as you can possibly be. And always get a second opinion if you have any doubts!

[rgreen]

I personally would not go for an office cysto. I know my urologist does them every day in clinic, and for some people it is fine; but for me I do not think I would be able to handle it. I had cysto done in Feb, but mine was more then a plain cysto...they also did a pyelogram, reflux test etc... so I would not have been able to do it in office anyways. I was in quite a bit of pain for a week afterward, my urologist treated me with pain meds and I was fine, but I was out of work for 1 week and at home resting. Everyone is different though; my husband had cysto under anesthesia and he was okay after 2 days...I think it's all dependent on the person. I just can't see myself having an in office cysto.

[sufferingfromic]

I had this done recently, in the office. They numbed the area and I had no problem. It was not a big deal at all. I was awake and able to see the bladder and the condition it's in. It was a lot easier for my doctor to explain what was going on with the actual bladder in fromt of me. Good Luck.

[waterflow]

In office cysto for me. Have had it done 3 times. Only takes a few minutes and to go through being put out is a lot too. Not very painful unless he started to fill the bladder to much with water but I just told him. He drained some out and all was fine.

[Dakota]

I find this thread so interesting. Everyone had a different experience and the Uro's all have their own agenda. I'm curious as to how everyone feels just having a pap smear and pelvic examine done. My last two were so painful and I'm always wondering why.

[waterflow]

Dakota, I won't have them done again. Too painful among other things but then I never had those things done until after the IC started.

[Dakota]

waterflow: I did not mean to change the topic of this thread, but thanks for your response. I'm actually relieved to hear someone else feels the same. After my last one, I remember thinking to myself that was the last time. I was in so much pain I started to cry and my Gyn really seemed to feel bad. He told me he could see no reason for me to be in that much pain, but did understand about IC and offered to write me a script for Elavil. I never used to have a problem with that exam. I've had a cysto and was sedated but the Uro I had at the time told me my bladder looked fine and the biopsy was clear. I do not see him anymore because he insisted I do not have IC. Second Uro said I do have IC and he does not need a cysto/hydro to confirm it, but diagnosed me on symptoms alone. Anyway I don't wish this on anyone, but I'm glad to hear I'm not the only one who probably will never have a pap smear again.

[VickiB]

I think the amt. of pain with an in office cystoscopy has to do with the Dr. doing it and the patient's individual condition at the time of the cystoscopy.

That's what I think too.

My first one was just plain hell on earth! I've never been through anything so painful in all my life, including natural childbirths! So when my new Uro said he wanted to do one I naturally balked. He said it would be okay and he'd stop at any time, so I agreed. This one was somewhat uncomfortable at times, but in no way comparable to the first.

I found seeing the bladder on the monitor while he explained the significance of what we were looking at fascinating. Afterwards I felt good enough to go shopping.

Vicki

[Krisssy]

I find this thread so interesting. Everyone had a different experience and the Uro's all have their own agenda. I'm curious as to how everyone feels just having a pap smear and pelvic examine done. My last two were so painful and I'm always wondering why.




Although I had no pain during the pap smear, I had a feeling of urgency as soon as the pap smear and routine exam was over. This led to a huge flair which has lasted for 4 months! Krisssy

[blu]

I have had both types of cysto done. I will NEVER have another one awake. My first one I was knocked out. I woke up and I did hurt quite a bit and i had to pee really bad. I could handle that compared to the second one. Now the the one I had when I was awake was 10 times worse. Just putting the anesthetic gel was very painful. I was bawling through out the whole thing. My uro was not sympathetic at all and just kept going regardless of my crying. Afterward I was almost screaming in pain all the way home (we had an hour and a half drive home). Matter of fact the Dr never told me I had IC. His nurse just handed me a pamphlet for Elmiron. If I ever have to have another one I will insist on being knocked out.

[sonjalynne]

I had the in office cysto and potassium sensitivity test done at my uro's office this afternoon and it was one of the worst experiences of my life. It is interesting how different we all are. I cried through the whole thing, but the uro and nurse where very good about it. After, he said that I had one of the most inflamed urethras he had ever seen, and that was why it was so painful. Even before I read a previous post about it, I was thinking that conscious sedation would be perfect for this. I've had it done a couple of times for oral surgeries, and it would have made today much more bearable.

I too had a long ride home after, but my uro was really great about it. The nurse gave me ultram right after and he wrote me a script for oxycodone (and even called the pharmacy in his building to ask them to stay open a few minutes late so I could get it filled :angel: before going home). I would much rather be sedated, but then again, I did live through it and I'm sure it saved quite a bit of money.

But just for the record, it completely sucked!

[ScrabbleMom]

Thanks everyone! I appreciate every personal story on here. Knowledge is power.