Rigid Sigmoidoscope

Has anyone had this exam? If so, what for? Was it comfortable? What kind of prep was ordered prior to the exam? Was it performed by a doctor or NP? Male or female?

:-)

Well, it's not a whole lot of fun, but done well shouldn't be TOO bad. Air is introduced with the scope to dilate the colon while the scope is advanced, which can be a bit crampy. The colon sort of slides over the scope as it's advanced. If there's any bleeding that's too much for a flexible scope, generally that's when they'll use a rigid one.

Doc

[quote author=gntl_45 link=topic=31015.msg289159#msg289159 date=1271898739]

Has anyone had this exam? If so, what for? Was it comfortable? What kind of prep was ordered prior to the exam? Was it performed by a doctor or NP? Male or female?

[/quote]

I've had it; I've done it.

First time that I experienced the Rigid Sigmoidoscope was after a regular physical in my 20s; Dr. S. had noted something during his digital rectal exam, and wanted it checked out by a colo-rectal surgeon. This is a decade or two, or more ago. Ssssoooo, at the surgeon's office I was given a 2 oz enema, and directed to the restroom. Done; and, the doctor examines me. He used a disposable, vs. the chrome model, and I don't think that he inserted it 100%. Twas not painful or uncomfortable. He found nothing noteworthy during the examination.

I got into performing a rigid sigmoidoscopic examination after a woman friend found one at an auction. Knowing of my interest in many things anal, she purchased it and sent it to me as a gift. Well… Before I do unto others, I do unto myself. So, I read up on the medical procedure in textbooks, and then took the instrument in hand; it, coupled with lubrication (and one can never utilize too much lube), was ultimately inserted, all 11.5” until the base kissed my anus. Tis a formidable medical instrument; but with a gentle touch, it is not a terrible intrusion…

It may be that sometime when I have a friend over, we can take that photograph and put it in my photo album.

I explored with it this past weekend, the first time this year, and it was my easiest insertion ever. Actually, it was inserted several times, as the sensation is pleasurable.

I have and it was very painful I can even remember the nurse telling me it was ok to scream I had that test for GI pain as I remember A doc did the exam and I can't remember the prep it was years ago and I WILL NEVER DO ONE AGAIN!!!

I've used on playpatients both my hirschman anoscope http://www.globalsurgicalinstruments.com/default/377412.html

and my longer 20cm Kelly's proctoscope

http://www.surgicaltools.com/product.htm?id=4wolly36

you must insert both instruments carefully and well lubricated. First part of the introduction is done "poiting" to the umbilicus direction.

Patient may be examined in sims lateral position or knee-chest position.

exam must be preceded by a digital rectal exam. The insertion must not cause pain, pain is a sign that something is wrong and a sign to stop.

If you give a cleansing enema first it's advisable to wait at least 30 minutes after patient expels to start the examination.

here's my instruments in one of my albuns

http://www.zity.biz/index.php?action=album;area=showitem;c=3704;id=49948;sort=date;sorto=DESC

I was on a table that raised me up then jackknifed me into a doubled over position butt up in the air and was just the worst! ???

Does anyone know of a pic of the table that goes up then spits. I have read about it but am habving trouble visualiing it.

Irme said...

[quote author=irme link=topic=31015.msg334682#msg334682 date=1297145717]

I have and it was very painful I can even remember the nurse telling me it was ok to scream I had that test for GI pain as I remember A doc did the exam and I can't remember the prep it was years ago and I WILL NEVER DO ONE AGAIN!!!

[/quote]

irme, tis sad that you experienced pain. And, as amaral suggested, pain can be a sign that something is not right; can be...

Please feel free to come to Tx if you would like to experience the insertion, and an investigation of your lower GI tract, without any significant discomfort, or distress. Tis a very unique instrument; and, the 11.5" can pass easily in any one of several positions.

Have a gr8 day!

This tread is about rigid sigmoidoscopie which is even different from a simple anoscopy like when you use an hirschman anoscope, not so different when you use a longer 20cm Kelly's proctoscope ( except for the inflation of air in the rectum that is commoly applied at this kind of exam ) Now from my humble knowledge the insertion of these two must no cause any kind of pain, but the inflation of air may cause disconfort.

Even so, I think ( maybe I'm wrong ) that irme undergo a Colonoscopy, which unlike sigmoidoscopy, which can only reach the lower third of the colon, colonoscopy examines the entire length of the colon. At this exam inflating air is also part of the procedure and the patient may feel cramps as the colonoscope advances and the gaz passes...[/url]

Dr J58 as a great deal of experience about all these procedures...

Thank you Dr. Amaral, I appreciate the compliment from an esteemed colleague.

Irme is likely one of the not-so-rare group which experience extreme pain during a rigid sigmoidoscopy. Some studies done at the introduction of flexible sigmoidoscopy found that approximately 25% of male patients and 33% of female patients were unable to tolerate rigid sigmoidoscopy without sedation or anesthesia. I have found the incidence to be much lower however bear in mind that I play with healthy patients who do not present with inflammatory bowel conditions, as many of those in the studies likely did. If a patient is being examined during a flare up of ulcerative colitis for example, there is a high probability a rigid sigmoidoscopy will be excruciatingly painful regardless of how gentle the examiner may be.

Most patients tolerate instrumentation to 15cm (6 inches) without experiencing pain. Further insertion past the Sacral curve of the sigmoid colon requires the examiner to physically rearrange the colon, and in most cases insufflate the colon with air. During this maneuver the scope will cause pressure on the nerve group known as the Superior Mesenteric Plexus. Most patients experience some level of cramping and discomfort at this point, however some will experience extreme pain preventing the examination from being completed. In most instances these patients will be able to be successfully examined by means of flexible sigmoidoscopy or colonoscopy under sedation.

Thank you Dr J58 and karma for the excellence ( as usual ) of your clarification of this clinical issue

I had this done by a GP when I was in my 30s, before colonoscopy became the preferred test for someone my age. The nurse suggested I do Fleets before the appointment, but I opted for my usual 3 quart home prep. it was not too uncomfortable, I think this doctor did them very frequently, and was very skilled with this tool.

No but would love to have some procedures done no sedation either. I hear they love to knock you out... I say suck it up and stay awake and enjoy the procedures.

No but sounds fun if im allowed to stay awake

I had this done in 1967 when suffering from incipient ulcerative colitis. I was asked to give myself enemas at home in the morning (ETC - enema until clear). I did large-volume enemas but what size I can't remember. I can't seem to hold much at a time, so I had a bunch of small enemas until I got the right result. It was all done standing up as there was little-to-no room in the bathroom.

At the hospital they gave me a Fleet enema to make sure I was "clear." After cdompletely disrobing I was given a hospital gown and told to lay down in a small alcove while the nurse pulled the enema from a row of what must have been hundreds on the wall. She had me lie on my left side with my right knee well up and the left knee just bent while she place the enema tube into me and squeezed rather abruptly. At least it wasn't cold. She then had me get up in the knee-chest position until I had to expel the enema. In about 5 minutes it was potty time. After checking to see if it was clear, I was then escorted into the large exam room and found myself facing about 20 pink stripers, all sweet teenage girls looking just a little embarrassed - faces the color of their uniforms. The nurse asked if I minded them watching the procedure as a learning experience and part of their training. I said I had no objection and the show was on!

They had me kneel on a contraption with knees about two feet apart, and was told to hold onto two handles sticking up in front of my face. Without warning the doc turned a handle (I think it was - I couldn't really see) and my ass end was flipped up into the air. Surprise!! I thought i was going to flip over completely but didn't. So there I was, butt up, hospital gown almost totally off and hanging in front of me and very, very exposed. The position relaxed my sphincter muscles so it was easy to get the sigmoidoscope in. The nurse, an older prototype for Nurse Ratchett, stepped up on the base of the contraption, slathered lube all over my bottom, outside and in. Then the doc got up and rammed the first, I think smaller, scope into me, withdrew the obturator, wiggled it around a bit, then withdrew it. Nurse Ratchett then slathered me again and a larger tube went in, and went in deeper. He wiggled it around some more, then withdrew it and it was all over. It was uncomfortable but mostly because of the position I was marooned in. The position opened me up so that even with a rectum unaccustomed to the intrusion of large objects, there was little pain. And despite the slap-dash slathering of lube, it felt good.

A later sigmoidoscopy was done with the slender tube and me wide awake, just lying on my side in the usual Simm's Positiion. I had to have the usual enemas before going to the appointment, then another given by a younger, nicer nurse. Lately it has been all colonoscopies while totally "out." Ahh the good old days!

I had a proctoscope exam when I was 32 years old as part of an annual physical. I was instructed by his nurse to purchase two fleet disposable enemas. On the morning of my exam I was to give the first one to myself lying on my bed with my right knee drawn up toward my chest. I was to hold it for 15 minutes. As it was a small volume of liquid, it was easy to hold. The second was about the same. When I arrived at my doctor's office, the nurse ushered me into an exam room and had me undress down to my shorts. After she performed the usual pre-exam tests, she left me alone. I looked around the room and noticed an unfamiliar instrument lying on a metal tray. It was about a foot long made of chrome with a black eye-piece at one end and a large 5" diameter black bulb covered in netting. Attached were several wires for the light. On the tray along with the scope were a pair of latex exam gloves and a tube of lubricant. Eventually the doctor arrived and performed the usual examinations including hernia (cough). He told me to remove my shorts and get on the table on my knees with my head resting on my forearms. He had me spead my knees farther apart as he approached the table. I felt the cold lubricant on my anus and a gloved finger soon entered as deep as it would go. I was in position and anticipated the next move. He had lubricated the long shiny tube which would soon be thrust deep into my rectum. Now was my time. He placed the tip of the proctoscope against my anus and told me to push down to loosen the sphincter. I felt the cool friction of the tube sliding into my rectum and up into my lower colon. When in place, he removed the end piece and turned on the light. He also squeezed the bulb introducing air into my colon. After a few minutes of probing around, he removed the tube and declared me healthy. My next two exams over a ten year period were using a flexible sigmoidoscope. These exams are not painful and should be performed when required.

I had this done about 10 years ago. It is not a horrible test--other than the fact that I went to school with the nurse who was on the "back end" of the procedure. I was awake for the whole thing.

An event in my life I'll never forget.

The outfit's Medical Officer was reviewing medical records and noted six of us over the 'magic age' of 35 who had not had their colons inspected. That was in the late '60s when the options were a Barium Enema or a rigid scope.

Our remote clinic didn't have much of an X-ray capability so the Medics decided on importing a surgeon with the gear to accomplish the scoping. A date was selected and a couple of young surgeons were recruited from the nearest Hospital to do the honors. Prep was a limited diet followed by two types of laxative taken the evening before the procedure. Chatting with a couple of older guys who had first hand knowledge of the 'drill' identified the instrument as the, "Silver Stallion."

Next morning I volunteered to be the first subject so that I could head for the chow line. Two Fleet disposable enemas acted as a rinse and moisturizer. (Instructions were to not retain them for more than a few moments.) I got gowned up and mounted the 'table.' When they 'broke it down' I nearly fell to the floor but managed to grab part of the frame so wound up rather spread-eagle. There was some talk that some of the pieces of the table were missing and there was no source of air to inflate the colon. More chatter indicated that they could improvise. With some coaching I managed a sort of pull-up and got positioned where the Surgeons wanted me.

I got my first glance at "The Stallion" was as they were lubing it. One of the surgeons coached my breathing and 'arm-pulls' and, in went the outer tube, bullet point first. Asked how I was feeling, I said fine but was getting shoulder cramps from the constant 'pull-up' I was holding to keep from sliding off the table. Once they made it through what I now know as the inner sphiincter, they stopped and removed the center rod which extracted the bullet-shaped end of the tube.

In went a tube to deliver a shot of lube. The rod with the bullet went back in followed by an advance of several inches. Anally I could feel each mark on the tube that indicated how far it was inserted. Out came the bullet, in went a lighted optical scope. Both surgeons took a quick peek and in went more lube. About that time someone arrived with some heavy canvass straps to tie me to the table right below the armpits. The straps really chaffed so someone found a couple of towels to cushion my armpits. Finally I could relax my arms without fearing a sudden 'unplanned insertion' of the pipe sticking out of my butt.

Then, we were off and running with a series of advances with the 'bullet' in place, each followed by pulling out the 'bullet' and squirting in another shot of lube. A couple of minor repositions of my body helped and within five minutes both Surgeons agreed that getting all but 5cm of the scope into my colon without any inflation was, "mission accomplished!"

In went the optical scope with it's light source. Slowly the scope was pulled out with the surgeons alternating glances through the scope, exchanging comments and taking taking notes. Again, I could sense each half-centimeter as the marks tweaked my outer sphincter.

Getting off the table I suggested that they use a standard parachute harness to secure the patient to the table instead of just a single strap uner the armpits. The guys on the 'afternoon shift' were put in a harness and got some support for their thighs.

Oh yeah, the procedure found no issues! Two years later I had my first Barium Enema (before the days of air contrast).

I've had two rigid sigs. One was in '78 for gross rectal bleeding (duodenal ulcer). No prep., because blood is a great laxative. Simms position and not at all uncomfortable.

Second was 8 weeks after my bowel resection, when the surgeon wanted to see how I was healing from the inside. He put the scope in several inches, when his R.N. came around in front of me and grabbed my wrists tight. She had a very sympathetic look on her face as she stared into my eyes. The air was pumped in and I saw stars! Air had been injected right where the surgical anastomosis had been and that explained her strange behavior and my intense pain! The surgeon declared that it looked as good as it could have and the scope was withdrawn. No prep. because the surgeon said he didn't want anything stuck up there for six months after the resection.

A few years later, I had a Flex. Sig. by my Gastro. and it actually felt GOOD! Again, no prep. because he suspected adhesions at the surgical site.

All 3 of these were done in Simms position, as were my 7 colonoscopies. I get number 8 next month!

I actually have an old school army rigid sigmoidcolonscope, is pretty cool, I use it more for medical anal play and dont actually insert it into the colon. But if you like temp play is good to use too 😃

I had one in a play exam once and it was extremely exciting/nerve wracking. I had never had anything inserted that far or deep into my rectum before but it sure was an expereince that opened many more doors to my medfet world!

My first ridged one was in the air force.after I checked in, the nurse handed me an enema while standing at the front desk. She asked if I ever had one (which I hadn't). She described the process then directed me to the latrine. The latrine was an old one with no stalls and several small padded tables along the wall in front of the toilets where she said to do it. Here was another guy on one of the toilets and he said Pick a table with kind of a smirk. They didn't give me a gown and I felt kind of awkward. I dropped my pants, got up on the table and bent over as instructed. The nurse told me to hold it for 10 min, but couldn't hold it much longer than 5. I was so humiliated, but my humiliation was just starting. Shen I got done, I went back to the front desk and wa eventually led back to a room an told to drop my pants an kneel on lower part of the table. The orderly puhed me down on the upper part of the table and then tilted me almost upside down. One by one she started putting things on a little tray right next to me, ending with a large dollop of KY on a gauze pad. Then she left... But I wasn't alone in the room. There were a lot of people walking back and forth behind me as I laid there fully exposed. The guy behind me in the bathroom was put on the table next to me so I'm sure some of those people walking around we're other patients. all of a sudden someone dabbed their finger in the KY and immediately put it up my butt without any fanfare. Then the grabbed the scope off the tray and started pushing that into me without so much as a hi. It wasn't thick, but it sure was long. It seemed like they had a hard time getting it all the way in. The guy next to me watched the whole thing. He looked kind of pale. I pulled my pants up and saw 3 others in position waiting the same fate. The dr was inserting a scope in the guy next to me when I left. I've always wondered if he used the same scope on the others because my scope was never put back on the tray and I didn't see him pick one up from the other guy's tray.

Thankfully by the time I needed an exam of this type, the Colonoscope was in use, and that went pretty well. From the pictures and stories I have seen and read I'm thankful I didn't have to go through a rigid sigmoidoscope exam, sounds very uncomfortable at best and down right painful at the other end of the spectrum.

I only had this done once, back in 1978. I dont' even remember why I needed the procedure or the outcome at this point. The doc was a specialist that I had never seen (and haven't needed to see since), and during the consultation in his office, he said that he wanted to do a visual with a scope. He called for a nurse who then took me to a large exam room with an oversized exam table and adjoining toilet. She then handed me two Fleets, gave me instructions on using them and to buzz the desk once I had voided. So I do the best I can, and finish up in 10 minutes and signal the desk. The doc and same nurse soon return, and the doc takes a paper sheet off of the scope which had been waiting on a counter and shows it to me. This was my first introduction to sigmoidoscopy and had never seen one of these scopes before, not even a picture. Sounded simple enough. He explained what he was going to do and asked that I get into the knee chest position. The entire exam lasted less than five minutes although there was much groaning during that time. I'm as anal as anyone else in the Forum, but that is not a procedure that I would want to do again.

I guess at some point after 1978, flexible scopes became the norm and I've had that done a few times in doctors' offices. Much easier than with the rigid.

Is there any way to convince a doctor to do this type of exam?

Zohe said:

is there any way to convince a doctor to do this type of exam?

I assume zohe that you mean how could you pretend to a doctor that you needed a sigmoidoscopy just so that you could experience one.

This sort of approach has been condemned on these boards as being an unnecessary waste of medical resources, a likely cause of insurance premium hikes and a course of action which might mean that a patient who was genuinely in need of medical attention might have that attention delayed. As such it would be selfish to present with false symptoms.

I strongly suggest that you reserve play for this site, and real life for when you actually need, rather than want, the medical professional.

I never had one, but years ago my husband did. Up until that point he claims that he had never had an enema. He was told to do a Fleet the night before and the morning of the procedure, but being a bit macho couldn't bring himself to buy them. The night before he wanted me to go out to the pharmacy for him, but I said "no way" and gave him a pair of warm soapy enemas from our bag. Turns out he said that they weren't so bad after all.

My first time about 10 years ago I was having a little pain in my belly went to the doctors the told me to see a proctologist I didn't know who he was or what he did made my appoiment the nurse called me in told me to take off my pants and underware and Neal on the step and then bend over my butt was in the air she covered me ..the doctor walked in lifted the table up now my butt is up in the air higher now ...first he did a little anscope the. I heard him tell her he needed a rigged scope ..he wanted to go deeper to look up inside more ..I looked at him ..he told me bear down he slid that scope all the way in !!in didn't feel that bad until he tried to make a turn in there ..boy did I jump !!when he was all done he said now that wasn't to bad was it maybe in his eyes ..I the. Have to go for a colonoscopy ..

To Moderator: Your reply to "zohe" was a bit judgmental, don't you think? Who are you to decide who should or should not have a particular medical exam? And this site is NOT just about "play" exams. People relate to their past or future exams with a definite eye toward sharing arousing exams. Let's get real!

I had one in the early seventies.... it was uncomfortable to painful.... I think the discomfort level depended on the skill and compassion of the examiner... but, I never want to have one again... I have enjoyed my last 5 colonoscopies much more