Examination | Cystoscopy Experiences? 4/4

Views: 10454 Created: 2008.02.04

First post

Cystoscopy

I've read through the posts, I thought I'd share a real experience that gave me a perspective about being a patient.

I had to have a cystoscopy once. This is a procedure during which you bladder and urethra are examined with an instrument called a cystoscope. The instrument has a light and a fiber optic lens, and allows a view the lower part of the urinary tract.

After the experience a female friend said she had one and got IV medication for pain. I did not. It just shows all doctors are different. This is my experience.

I was about 36. I saw a little blood in my urine, so I made an appointment with a urologist. I thought I'd be in and out with a prescription. I waited in the exam room. The nurse came in for a chat then had me to give a urine sample.

I returned to the exam room and waited. The doctor came in and I explained my symptoms to him. He had me pull my pants down, he lubricated and inserted his finger inside me and massaged my prostate until fluid came out. He placed it on a slide. He had me clean up and left the room. I pulled my pants up, put on my coat and sat thinking it was all over.

He came back in and said I'll want to take a look inside.

Now, I did not fully appreciate what he meant by that. He left again and the nurse returned. She told me to come with her and I was taken to a procedure room. It had a table in the middle, monitors and lots of medical stuff. If I were playing doctor, I would have liked it. As the patient, I was nervous.

For the first time in my life I heard a nurse tell me, "take off your clothes, underwear too, put on this gown and wait here on the table."

I complied. As I removed my coat and tied, I realized I had said the same thing during medical play. Only now, I was a real patient. The room was cold, although I think part of it was nervousness.

I sat on the table and waited.

The nurse returned and said the doctor was going to scope me to take a look inside. Everyone was saying "look inside" and "scope" like it was not a big deal. I felt strange, but not fearful. I was told to recline on the table. That felt a bit strange.

The nurse was getting things ready. One wonders about those sounds when they cannot see everything.

The nurse positioned two leg crutches (like stirrups, but they cradle the legs not feet) and I got nervous.

"Scoot down."

I inched down. Each leg was guided into the stirrups. The gown covered me, but I felt so exposed.

The nurse lifted the gown and exposed my penis.

"I'm going to sterilize your penis." My penis was grabbed and swabbed. It was over pretty quick. Next the nurse picked up a syringe.

"I'm going to put xylocaine inside. It's going to feel cold, try to relax. If you tense up, it will not go as deep and you may feel more pain. So relax."

I said "okay."

My penis was firmly grasped. I felt the tip go inside. It was not too bad. Then the cold xylocaine entered. It was so cold. I tensed up.

"Relax," the nurse instructed.

"I'm trying."

I could feel the xylocaine come out of me. I knew this was not going to be good.

"You should begin to feel numb," the nurse said.

It burned a bit and I was numb, but I was soon to learn, not numb enough.

The nurse arranged a few things, left the room and shortly the doctor, the nurse and another nurse came in.

The doctor explained that he was going to look inside me with a scope that had a camera on the end. "You may feel some discomfort."

I stared at the ceiling and waited.

I felt a hand firmly grasp my penis.

"Relax, you're going to feel some pressure," he said and he pushed the scope inside.

It was tight. It was almost immediately painful. I was not that numb. I arched my back, my body tensed and a nurse grabbed my hand and said, "Just relax."

The scope was pushed deeper into me. I felt I pass over my prostate. It was strange. In another circumstance, it might have been pleasant.

When the scope got to the opening of the bladder, I was told to relax. I could not. It was pushed in and then that feeling of peeing. My body was so tense.

The doctor said, "I'm going to look around," and I felt the scope move painfully inside me.

"I'm going to fill you with water now," he warned.

I felt myself fill with cold water. Once again he moved the instrument inside me. It was intense.

It seemed like it was inside me for an hour. It was not.

He kept saying how well I was doing and "one more look around."

He allowed the liquid to drain from me.

He began to remove the scope. I felt it being pulled from my bladder and again, that strange, painful, almost pleasant feeling as it moved over my prostate. I felt that all over my body. Eventually the black scope was pulled out of me.

The equipment was moved, my legs removed from the crutches and the doc said everything looked fine. It was probably a small kidney stone.

All that, and everything was fine. I'll never forget that.

I also developed a good understanding for what my "patients" feel like during medical play.

iamweasel2112

@iamweasel2112 Were you on your back for the cystoscopy and on your side for the rectal ultrasound?

Yeah I was on my back for the cysto and then I moved over on my side after he was done for the ultrasound

MedFan15

At one of my recent shockwave treatments, I told the urology nurse practitioner I needed a workup for my BPH symptoms, which though not terrible, have definitely been progressing, He agreed and the office scheduled me for a urocuff test, a cystoscopy and a transrectal ultrasound of my prostate--talk about a trifecta for a urological med fet enthusiast! Of course, now that I have the findings of these three evaluations, it's getting a bit too real, as I now have a Rezum procedure scheduled for my prostate in 2 weeks. I'll be sure to write that one up too after it happens, bound to be an adventure!

The urocuff test, which is kind of simplified version of the mildly invasive urodynamics procedure, was up first. It was administered by a young female medical assistant and her female intern. Basically, it involves urinating through a plastic cuff that attaches to the head of your penis with mild suction into a funnel that measures the rate of urine flow and the output pressure of your bladder as you void, as well as the overall volume of urine. The main requirement is that you show up with a full bladder, which I definitely did. The MA explained the procedure to me, asked what my urge to urinate was (I told her 8 out of 10, which she said is "right where I want you.") She checked my blood pressure, which was elevated, both because of my need to pee and the excitement of having the test done. Then she asked me to come over to the funnel and "drop my drawers" so she could apply sticker electrodes--2 in front, 2 on my hips and 2 "on my bottom." Applying the last two, she said, "pardon my touch down here" as she placed them. I said "you're fine", thinking to myself, yep, this is fine, all right (no perv like an old perv.) She then handed me "the device" and told me to put it on "from the bottom of my penis, " which I did.

She then started the machine, looked closely to check the positioning of the cuff on my penis, and then said she and her intern would step out while I was urinating. Wish I'd had the presence of mind to say something like, "so, watching an old man pee is not the high point of your day?" I try not to be creepy, but some situations just lend themselves to it. Anyway, the young women left and I started to pee. I really had to go, but it seemed to just trickle out, and I could barely feel any suction on my penis, which I was hoping would be more pronounced. As you go, the machine squeezes the urine flow to the point of stopping a couple of times. There are a couple small tubes to drain the urine away on the sides when that happens, but in my case it evidently came out of the cuff and landed on the floor. Fortunately, there was an absorbent pad around the funnel that sucked it up.

After about a minute and a half, the MA and intern came back in and she asked "did you go?" I said I definitely did. I said "looks like I made a mess on the floor" and she said "that's what a swiffer is for, you're not the first and won't be the last." She came over and took the sticker electrodes off and told me to "pull up my pants" and then lay on the bed for a bladder scan. She asked if I thought I'd emptied and I said "pretty much, though sometimes I double void." She nodded and put the "cold gel" on and scanned my bladder, Turns out I still had 196 cc left inside, and I had only voided 193 cc into the funnel. So much for emptying my bladder. She wiped off the gel and I buttoned my pants. I thanked the MA and her intern and left. Two days later, I had the actual cystoscopy, which I will detail in another post soon.

Mtgriz98

My only experience with cystoscopy was when I had I had a kidney stone and they went in and removed with a laser. It was actually a ureteroscopy and it was done under general anesthesia in the ER. I remember waking up in recovery and looking at my penis under my gown and seeing blood on it. Also they made me pee before the would let me go home and there were air bubbles coming out of my dick. That was a weird experience.

Matilde

I have not received cystoscopy in my life. But I have seen several time this procedure like assistant.

I think that we have to do some differentiations, since male urethra and female urethra are quite different by the lenght.

So, I think that, despite the local anesthetic, that most time is lidocaine or something similar, in male patients the feeling is worst than in female ones. Because in female patients the time of the exam is shorter, and primarily the time of inertion is not very long at all, and so it could reduce the pain.

Another point that we have to ponderate is that nowadays there are two types of urethrocystoscopy. The rigid one and the flexible one. I think, by the fact of isotonic solution that lubricate the urethral canal, and may be by the local anesthetic, from my experience the flexible cystoscopy is more tolerated than the other, since it is "lighter": it is not something pleasant at all, but I think especially for women it is not a big deal.

The problem is that if we want to attest a PBNO or other obstructive pathologies a rigid instrument could be more accurated.

So, in my personal experience of a nearly 22 yo student, I see that the use of deep sedation for the rigid exam, if the patient agree, could really help obtaining the results.

And so, an approach that we use, and it may be scientifically valid, is to do before a flexible cystoscopy, that is more tolerated by both sexes, and only if it is needed we may take another appointment to do the rigid one with the support of deep sedation anesthesia.

This could represent an higher cost for the hospital, certainly, but can really improve the quality and the feeling of the hospital journey that the patient has.

DocTemplar

I started with my non-VA doctor for my first exam, and I tell her about the frequent urination, getting up at night, not emptying completely, etc. I'm 61 at the time, so immediately they think BPH. (They were right) She wrote a consult for a urologist. The office called and I made an appointment. The only time I saw a urologist, as a patient, before was when I had a bad case of epididymitis, and that was an emergency and a week in the hospital, (My left nut decided to see what it would be like to be the size of a baseball.) but that's another story for another day.

So, I go to the urologist's office, fill out the paperwork, yada, yada. The nurse brings me back, hands me a specimen cup and points me to restroom. (It was right off the exam room). She took the cup and told me to sit, and the doctor would be right in. After a few minutes, the doctor came in and introduced herself. We went over my history and current symptoms, then she had me strip from the waist down. She gloves up and grabs my penis, gives it a visual inspection, pulls back the foreskin, then does a through exam of my testicles. Lastly, she says to turn around and she does the DRE, very deep to feel the whole prostate. (At least what she could.) I felt like I was going to ejaculate, but she stopped before that happened. She tells me she wants to do a transrectal ultrasound and cystoscopy, and I schedule an appointment for the next week.

I went in the next week, and we did a bit more talking, and she has me go down the hall to the guy who was going to do the ultrasound. He tells me to lie on my lie on my left side, pull my pants and underwear down to my knees, and bend both knees up to my chest. He then lubes my ass and pushes an ultrasound transducer up all the way. I'm in that position about 5 minutes before he pulls it out, gives me a tissue to wipe. I get dressed and head back to the first room.

After a couple minutes, the doctor comes in and pulls up the ultrasound. She reads it over, but it didn't show much. The affected lobe was in the front, and it was hard to find on the ultrasound, or felt with the DRE. So, she tells me to strip completely from the waist down and lie on the table and left the room. I do as tell and the nurse comes in, pulls back my foreskin, and drapes me. I was a bit confused because everything I read says that I would be in stirrups. The doc comes back in and tells me to put my feet flat on the table and spread my legs. I fell her grab me, put a small dollop of lidocaine on my penis, then runs the scope down, holding my penis straight up. The scope was lubed with lidocaine gel, so I felt no pain, but some discomfort when she moved the scope. When she's done, she pulls it out, (Weird feeling) and sends me into the restroom for a sample. My bladder is full, but nothing comes out. I went back in, and they put in a foley and sent me home with it. (First time I've been catharized) I get dressed and go home with a leg bag and had to come back the next day to have it removed. We talk options, and she wanted to do a traditional TURP, but "shave just a little bit off." She also told me about the Urolift system. Went home, did some research, and decided on the Urolift (It seemed more like what I needed, and if necessary, I could have the traditional TURP later) so she had to refer me to another urologist because she wasn't trained on the procedure. (Again, another story for another time.)

Brubaker

As Czorro stated, I actually liked the experience. I found it very erotic although I didn't tell my urologist that... at first.

I was excited when he said he wanted to have a look inside after telling him of a burning sensation occasionally when urinating.

It was just the doctor and I in the room. He had me remove my pants and boxers after a quick genital exam he said lie back on the table. He applied some sterilizing stuff around my groin and injected the lube slowly. He warmed it up a bit on heating pad. He Applied a clamp on the head of my penis then began getting the scope ready. He removed the clamp and positioned himself beside the table about where my hips were. He commented that I seemed a bit nervous but actually I was excited.

When he slid the scope in I watched as each white ring would disappear in my cock. I'm sure it was at least 18 inches by the time he hit entered my bladder.

During the procedure he talked about his softball league and I'd comment when needed. But mostly I was focused on the erotica of having my cock probed from in the inside.

He spent about 10 minutes looking around and slowly removed it. Watching all the length slide out... wow.

He said I was good sport. I told him if he ever needed to train interns I'd be glad to volunteer. He laughed and told me a handful of his patients actually enjoy the procedure. And that made it a lot easier when they did. He never did ask me to volunteer though. Probably for liability reasons but damn I would have enjoyed being scoped by young interns.

SenorDG1967

Only had one cytoscopy, in my 20s, maybe 15-20 years ago. Was having dull achy pain in my bladder after peeing, and my GP referred me to urology.

I went in blind to the appointment with no idea of what was to transpire. In my mind I was thinking maybe they would want to take a look at my genitals, palpate, and potentially do an ultrasound. The first two I got right. After providing a urine sample, I waited in the exam room for some time until the Urologist came in. He listened to my complaints, laid me back on the table and did a bunch of palpation. Then had me lower my pants & underwear below my knees and did a detailed genital exam. After that he had me roll to my side and bring my knees up before sliding a lubed finger in my ass to feel my prostate. No abnormal findings. Nurse then came into the room to let him know there was trace blood in my urine. At this point he recommended a cytoscopy and he said we could do it right then or reschedule with sedation. Not knowing what this would entail, I elected to do it right then.

The nurse led me to the procedure room, where she had me strip down below the waste and get situated, reclined on a table with my legs in stirrups. She cleaned my penis thoroughly with disinfectant, squirted some lube up and covered me with a sheet while we waited. Doc came in, readied the scope and explained what was going to happen. It was a flexible scope and before I knew it he had slid the whole thing inside of me and was easing it through my prostate and into my bladder. After looking around a bit he slid the scope out, gave me some oral antibiotics and said to empty my bladder in the room’s toilet before I left. Lots of discomfort, but no worse than a dental procedure, although it hurt to pee for many days after. No findings and the pain eventually went away by itself.

The experience certainly hit my medical fetish and being exposed and manipulated in that manner is highly erotic looking back.