Scared of cystoscopy...

[ScrabbleMom]

Hello,
I was hit by a UTI a couple of months ago, but the urgency just never went away. I also have constant pressure. For the past month, I have shown microscopic blood in my urine. I also have vulvodynia. I believe I have IC.

My big issue is that I am scared to get the cystoscopy. Even getting catheterized is very traumatic for me. I'm definitely a big baby about this part of my body. I really want to be put out for the procedure, but the doctors office keeps telling me that no one gets knocked out for this and it's "just not traumatic." (yeah, right)

Do you think that one can demand general anesthesia for this procedure? I've read that when they do the hydrodistention on a possible IC case, it is RECOMMENDED that they go under.

In your experiences, were you put under general anesthesia during cystoscopy? Has anyone been able to convince a doctor that they needed anesthesia even if the doctor generally doesn't do it?

Thank God for this message board where I've been lurking for the past month...

Teresa

[mlzippy7]

Most do not have anesthesia for a cystoscopy only BUT you can and after many bad experiences I now will only have cystoscopies with anesthesia.
You know your body best. You do not have to endure the pain. Good Luck!!

[icgennifer]

I told my doctor that if he had to do a Cystoscopy then he had to give me anesthesia.. I despise catheters! he actually told me he wouldn't do it any other way! He also did a bladder biopsy and hydrodistention. The cysto/hyrdo revealed a normal bladder but it was the biopsy that revealed the mild inflammation..

[ScrabbleMom]

Thanks-- this gives me confidence to stand up to the doctor on the anesthesia issue. I really don't think I can go through with it if I have to be awake. Just the catheter was a nightmarish experience for me.

[ICNDonna]

I have had several cystoscopies without anesthesia. If you can manage to relax it isn't bad at all. The more tense you are, the more it can hurt. It only takes a few minutes and my uro always used a surface analgesic to help with any discomfort. I much prefer to do it that way than to be put to sleep.

Donna

[Goldfinch]

In-office cysto--which I assume is what your doctor is planning--is very different than cysto with hydrodistention, which is done in the hospital under general anaesthesia. Any procedure that is typically done without anaesthesia is judged to be less harmful or risky to your health. Going under has many risks--and it's expensive. If you have insurance it might not cover what may be deemed an unnecessary hospital procedure.

I understand your worry. I too was very nervous about the in-office cysto and the catheter, but the doctor was adept and it was far less irritating than I expected. You could ask for a lot of numbing stuff, and you could also request that they make sure it has at least 20 minutes to become completely effective. Having a bladder full of water wasn't fun, but it was over pretty quickly. You could also take a valium or xanax before-hand, but ask your doctor about that to make sure it's okay. If you explain how nervous you are I'm sure that would be an option, and you will be more relaxed (just make sure you have a designated driver to and from the appnt!)

Worth mentioning, if your doc doesn't volunteer: request that the doc write you a script for a prophylactic antibiotic on the way out, so you don't get a UTI, which can happen after being cathed. It happened to me. Just as the after-effects of the cysto started to go away (two or three days) I realized I had a UTI. Now THAT was unnecessary!

[ScrabbleMom]

Thanks for these replies. My doctor is putting off cystoscopy because of my anxiety. He diagnosed me after hearing my symptoms, but thinks it would be good to do the cystoscopy at some point. Goldfinch, your tips help TREMENDOUSLY.

[Briza]

Thanks for these replies. My doctor is putting off cystoscopy because of my anxiety. He diagnosed me after hearing my symptoms, but thinks it would be good to do the cystoscopy at some point. Goldfinch, your tips help TREMENDOUSLY.

I have had the cysto/hydro under anesthesia and yes there are risks associated with that that you would not have w/ an in office cysto. Goldfinch's suggestions to make an in office cysto more bearable are right on the money. I would want valium or something like that, an antibiotic, and in addition something like Pyridium and/or pain meds to take post procedure...I have high anxiety and low tolerance for pain.Not a good combo for IC patients who may get poked and prodded in places we'd rather not! I know that others may post that the in office cysto is not that big a deal, but for those of us who have high anxiety AND low tolerance for pain, it is really important for dr and patient to take that into account so that any procedure done does not cause you even more anxiety and fear of pain. But it seems your dr is willing to wait on the cysto, so that is good, b/c that means he is listening to you and your worries or concerns. Always a good thing Take care!

[Goldfinch]

You have a uro who listens to you and is willing to move at a comfortable pace for you, which is a great thing. But he's right about the in-office cystoscopy--it would be a good idea to have one in the not-so-distant future: a doctor can rule out bladder cancer and cysts or stones that are visible from within the bladder or other abnormalities. It isn't a diagnostic test for IC, although obvious signs of irritation can indicate what next step (like a hydro and/or biopsy) would be useful. My in-office cysto showed a pristine bladder and two uros were willing to diagnose me with IC based on my symptoms and my response to diet. Everyone's different--and everyone's uro is different!

[LittleRed333]

There is such a thing called "conscious sedation" you could discuss with your doctor......You are awake during the procedure, but remember nothing about what happens.....they use it for colonscopies.....why not an in-office cystoscopy?? But again as mentioned before, I am not sure if insurance would be willing to cover the cost of a cysto with conscious sedation which is probably considered less invasive than a colonscopy......it is just a suggestion.....

Here is a link about it:

http://www.surgeryencyclopedia.com/P...Conscious.html

Bless, Sharon

[KarenAnne]

I had a cysto/hydrodistention/bladder biopsy under anesthesia in a surgi-center. I was told the hydrodistention was the only way to see if there was IC & that it would be too painful awake.

They don't intubate you w/ general anesthesia for this, it's an IV sedation, so it's usually much safer. You're in a deep sleep & are also given a drug that's an amnesiac. I've never had a problem w/ IV ("MAC") anesthesia. I agree w/ Goldfinch about getting bladder Ca, etc., ruled out. Best of luck w/ your decision.

[Briza]

Yes, I have heard of "twilight" sedation such as would be used during dental procedures. And I believe that is thru IV and does not involve intubation like general anesthesia. but again, I imagine would have to be done in hospital setting unless a particular uro is set up for that kind of thing in office, which seems most are not.
Well, in office cysto may not diagnose IC, but then neither does the cysto/hydro 100% of the time, nor does any other procedure guarantee a 100% for sure dx or not of IC. But in office cysto can be useful for seeing any visible growths on bladder wall (benign or malignant) and also some drs will do bladder wall biopsies during an in office cysto.
Some doctors and patients are willing and prefer to take a more conservative approach to diagnosis...based sometimes on symptoms and response to treatment and diet alone, and possibly an in office cysto and/or Potassium Sensitivity Test.
But no, in my previous post I did not mean to say that an in office cysto wouldn't be helpful...it may be VERY helpful in ruling out some things and if in the future you and dr decide to go that route when you are ready then if both dr and patient feel the need for a look-see in the bladder...this would be one lower risk and possibly helpful ruling out of other things way to go and much less recovery time and MUCH less expensive than a cysto/hydro.

[ICNDonna]

Many doctors have surgery centers these days. I know my uro's office is in a building with a Urology Surgery Center. It's lots easier than a hospital visit --- and less expensive.

Donna