Trip to the Urologist

I had an interesting day at the urologist today. A female nurse practitioner ended up reviewing my medical history and doing a complete genital examination. As I was standing there she requested that I drop my shorts and did a very though inspection of my genital area. First she examined my testicles, rolling each of them gently between her fingers looking for any growths and then checked for any signs of a hernia. Next she carefully examined my penis, spreading and then looking closely into the urethra and then checking the glans corona area. During the sensations I could feel my penis beginning to become erect. Next she carefully inspected the penis shaft to insure there was not any chaffing or redness. As she poked and prodded she ask it I had any pain or discomfort during urination or intercourse. Next she had me lean on the exam table while she preformed a complete DRE examination. She was extremely comprehensive pushing her finger all the way in and twisting it around feeling for any irregularities. I could feel the prostate fluid beginning to leak from my urethra before she stopped.

Nice experience for you...... I'm envious. Wish she was in my area (Venice FL)

I have to admit it beats having the male urologist do the DRE. I actually believe she did a more in-depth DRE (no pun intended). I would say she was in her forty or fifties.

I would wonder whether it was because she was an NP -- they tend to be quite thorough -- or because she was a woman. My urologist is a woman, and she has given me without doubt the most thorough genital checks and DREs I have ever had. She had her finger in my butt for about two+ minutes...I mean real clock minutes. Believe me that is a long time. My PCP, also a woman, takes about 20 seconds, 30 max, of insertion time. And she literally examined my penis and testicles for not less than six or seven minutes of actual touching time. I got an erection and she kept on going. In fact I wondered if she did it so that I would get an erection. I am not saying that all women give long genital and DRE exams, but I do suspect that the longest and most thorough exams come from women, and they are not at all shy, some of them, about giving you an erection in the process. The second time it happened (by my urologist) I felt a bit shy about it (to my surprise). But it can be considered a legitimate part of the exam, I realized, so I laid back and enjoyed it. (Also I had mentioned to her that I had had a couple of ED situations in the prior few months.)

OMG, I found out that I am going to require a cystoscopy examination! Has anyone here been through this experience? I am a little apprehensive about the procedure. The Nurse Practitioner told me that while it wouldn't hurt, it was less than comfortable. Apparently they don't anesthetize you for this particular procedure. I guess I am going to find out what having a fiber-scope push from the tip of your urethra all the way into the bladder feels like!! Ouch :'(

Capri, I have not had this procedure done so can't help you there. I just want to wish you good luck may you have good results.

Capri, I've had two cystoscopies -- one in the hospital overnight with anesthesia back when I was 18, and another almost 3 years ago, outpatient, done by my female urologist and her nurse. The first one was pretty much painless until I woke up after the procedure (which was done in an operating room under full anesthesia).

The second one was was done outpatient in the urologist's office, and frankly, it was more painful. I was completely nude during the procedure except for a small, blue drape about 18" round with a 9" hole in it that was placed around my genitals. It was there to keep the instruments sterile, I was told. The nurse prepped me and squirted some lidocaine (I think) in my urethra to numb it...it burned going in, then it went partially numb. She also held my penis part of the time during the procedure. I got partially erect, though I could not feel it (I could see it). (I have wondered numerous times if this was intentional on their part to make it easier to put in the scope.) My urologist is a beautiful woman, dark-haired with large luminous dark eyes, and her nurse is a looker too, but I do not think I got partially erect because of them. It was either because of the nurse's handling of my penis, or the situation itself, or because of some sort of automatic reflex.

The actual scope work took a long time once the catheter/scope was in and frankly I felt pretty uncomfortable during the procedure, an odd, full sort of feeling in my penis. She also pumped my bladder full of sterile water to distend the bladder so she could see better, and when it was over I had to get up and walk into the adjoining bathroom, naked, with the nurse guiding and holding me...it was good she did because I got a bit woozy and got both pain and blood as I peed out the excess water in my bladder.

It hurt for two days afterwards whenever I peed, a sort of burning+painful sensation, enough to make me shout with surprise when I peed. This was done on one of the coldest days in January which turned out to be a blessing, because I discovered that if I went outside to pee and left my penis exposed for a minute or two before I urinated it deadened the feeling considerably and made it just slightly painful. The lidocaine burned going in and the pee later burned coming out, but I have certainly read that both things affect different men differently. Some feel very little. I also did some bleeding afterwards by the way when I peed. I had wondered why I was nude during the exam but when I got home and discovered that my boxers were all but ruined by the amount of blood on them that I realized they were aware before hand I would probably bleed. The nurse had specified I take everything off and she had not offered a gown, which I found odd at the time, but I was so anxious it made no real difference to me then.

Overall, I gather I had one of the less good experiences. I sincerely hope yours goes well and better than mine. On the other hand I don't want to alarm you. It was an unpleasant experience but I have had worse.

The reason she did it by the way was because I had had some unexplained urine in my bladder/urine. After ruling out every thing they did the cystoscopy to check if there were tumors in my bladder. As it turned out there were none, so the final explanation I got for the blood was "we don't know"...but in the years since there has been nothing at all, so I guess it was ok.

PS The bleeding was no doubt exacerbated (if not caused in the first place) by the fact that I was taking warfarin, a blood thinner, at the time. I had asked my urologist if I should stop taking it before the procedure but she told me to keep on with it.

I want to thank you for the detailed description. Hopefully mine will be easier. The Nurse Practitioner said the procedure lasted about five minutes. I had another ultra-sound yesterday and my bladder is not emptying completely which seems to be the center of everyone's concern. The NP explained that as a result of my BPH condition I probably had strictures in my urethra. In any case I'll find out on October 10th.

A cystoscopy need not be a painful or traumatic experience. For my own cystoscopy, which took place a few years ago in a hospital day surgery unit, I was sedated through an IV line and was for all practical purposes unconscious throughout the procedure. When I "came to" a while later in the recovery room, I had absolutely no memory of what had taken place. There were no after effects such as Al C has described.

Best of luck, 312 Capri.

Thanks, mine is scheduled to be preformed in the Urologist's office. I asked if I would need someone to drive me home and they said no. They also advised me to stop my baby aspirin regime the week prior to the procedure. I am therefore assuming that the procedure will be performed without the benefit of any relaxants. He's a young urologist with a good reputation, and furthermore his father was a urologist.

Capri, I think you should definitely request some sort of relaxant/anethesia/numbing agent from your urologist. Upon re-reading what I wrote I think I may have accentuated the negatives. I think I was surprised by the difference -- in my case at least -- between my hospital vs. my outpatient experience. I believe your baby aspirin regime is similar in intent to my warfarin regime, so discontinuing it I think means they want to limit or eliminate bleeding, which is good. My urologist asked me, just as I was lying there and she was waiting for the gel to numb my penis, if I had been catheterized. She said, reassuringly, that it would be no worse than that. When I said I hadn't she was taken aback, which also alarmed me.

I suspect I have a smaller than average urethra, a situation that can be dealt with by a smaller sized urinary catheter but cannot be accommodated when a cystoscope is used because it is larger (it contains a scope line with light, a fluid input tube and an output tube). When I looked at it it seemed about 1/4" in diameter. In any case, urethra diameter is the only thing I can think of that explains the differences in various reports about pain or lack of pain in urinary catheter and cystoscope experiences. The pain I felt afterwards was like what I would have expected from my urethra being stretched too much, stretched to tearing.

Thanks for the update! I understand they induce the topical numbing gel before they start. I'll get all the details on October 6 which is the week before the cystoscopy. I had several fairly large cysts remove from my scrotum many years ago and they gave me a shot of Demerol and then local Novocaine injections into the scrotum itself. I am an easy knock out, so by the time they started I was so high from the Demerol I didn't care what they were going to do. Here I am laying in all my glory with my doctor's attractive divorced nurse assisting and smiling at me and I literally didn't give a crap! I remember that later she became the live in nurse for a very rich prominent local attorney. She could have come to my house any day she wanted and I would have gladly invited her in! 😉

As a nurse who works in a cysto room, you will be asked to undress and given a gown. You should be placed in knee stirrups, your genital area washed and covered. numbing agent will be injected into your penis and your penis clamped until the doctor is ready to go to work. Depending on the length of your penis I may have to hold it in line for the doctor. The most painful part of the procedure is the insertion after it is in you will feel the doctor moving the scope around. I tell my patients that it will burn the first time you pee, and it maybe easier to pee in laying in the tub.

Thank you very much! Having never having anything inserted into my urethra, not even a catheter, after a surgery, tends to bring up the anxiety. My penis is of normal 6 inch length and I am a grower rather than shower, i.e. it's shorter when flaccid. So what exactly do you mean when you say, "my penis may be clamped"?

I appreciate all of the information I am receiving. I was kind of stunned at the first visit when the NP said please drop your shorts! I received the most comprehensive genital inspection I believe I've ever experienced and certainly more than my previous urologist ever performed. I am sure it happens a lot but I was getting semi erect at the conclusion, and during the DRE, which was every bit as thorough as the genital inspection. By the time she was finished with the DRE prostate fluids were dripping from my urethra!

Whew! Well I had my follow up visit yesterday. Things where shifted around and I saw the Urologist rather than the Nurse Practitioner. He reviewed the x-rays and ultrasounds and told me he thought I would be fine. No cystoscopy! I ask about my originally scheduled appointment with the NP and he told me she was no-longer with them. She did such a through examination during my intake visit I was sorry she wasn't still there. I believe she sensed that I had a medical fetish and that's why my examination was so intense. As I said earlier I've never had my testicles and penis so completely examined. Especially the DRE, which was deep enough and long enough to cause prostate fluid to leak from my urethra. I shall keep this NP in my fantasies for a long time! I wonder if she makes house calls?

You know, if you really like that NP as much as you say, and I can understand why by the way, then why not track her down and go visit her there? She's got to be doing much the same thing somewhere I bet. I know this sounds a bit excessive, but as one medfetter (?) to another, you are going to regret it later and wish you had made an effort. Good examiners are worth their weight..etc.

Quoting 312 Capri:

OMG, I found out that I am going to require a cystoscopy examination! Has anyone here been through this experience? I am a little apprehensive about the procedure. The Nurse Practitioner told me that while it wouldn't hurt, it was less than comfortable. Apparently they don't anesthetize you for this particular procedure. I guess I am going to find out what having a fiber-scope push from the tip of your urethra all the way into the bladder feels like!! Ouch :'(

The modern flexible cystoscope is a wonderful invention. Any male can easily pass this instrument with minimal discomfort. I will not tell you it is pain free, but discomfort is more the operative word than pain. The scope is only about 18 Fr, while the older rigid cystoscopes were 26 Fr. It is somewhat stiffer than a catheter and you will feel some discomfort, mainly as it enters your prostate and then your bladder. It will pass.

The majority of urologists do use some local anesthetic to numb the meatus and outer part of your urethra as these are the areas that will be most irritated. Depending on exactly what the urologist will do while you are being scoped, it will take only a few minutes, perhaps 5 to 10 minutes to complete the procedure.

If you are experiencing BPH, I strongly suggest having a laser reduction done such as the Evolve laser procedure. I had this last December and my bother score went from 26 to less than 1.

Good luck, ask questions if you need answers

Speed

Due to a minor birth defect, it was necessary for a urologist to enlarge my urethra. This was a painfull experience as the Doctor used larger and larger sounds. After several visits, when the Doctor put the sound in, it slid up and down my urethra easily,causing an erection. Since that time I've been in love/lust with urethral insertions.

Well at some point I will probably need to have my urethral passage enlarged. Having never even experience a catheter insertion, I'm sure I will be somewhat apprehensive! Reading the experiences of those here involved with urethral play, who knows it might be fun. If the NP was going to do it I would probably achieve an erection. She got me semi erect doing her inspection and DRE exam. As I said earlier I believe she sensed my medical fetish tendencies.