Cystoscopy
I posted back on the 11th of this month i was scheduled for a cystoscopy as the first test to investigate a PSA level that had increased this past year. What follows is a description of that procedure.
I was escorted to a procedure room about 10 X 15 feet with an reclining exam/couch in the middle of the room. To the left was an equipment rack that held an Olympus cystoscope (flexible borescope). Next to that rack was an IV stand with two bottles of sterile (saline?) solution hooked to an IV line that attached to the cystoscope. At the top of the equipment rack was a small monitor you could watch the insertion of the cystoscope and once inside the bladder, go in a 360 degree exploratory mode.
The pleasant nurse had me get undressed from the waist down and then proceed to climb on to the exam table and cover myself with a paper blanket. The nurse had exited during this part, but soon came back with an iodine wipe and a syringe with a Lidocaine infused lubricating gel. Once she got everything set she took the head of my penis and swabbed the head with the iodine wipe after ascertaining I wasn't allergic to iodine or latex; I answered to the best of my knowledge that I was not. She then proceeded to tell me the Lidocaine gel would feel cool (room temperature) and it did while she injected the syringe to dull/deaden the urethra. Once the gel was injected, she left to get the doctor to tell him the prep was completed.
About ten minutes later the doctor and nurse appeared; at this point the doctor said the entire procedure would likely last about 30 seconds and he was very close on his estimate. He started inserting the cystoscope while also injecting the IV solution just ahead of it to expand the urethra while he was pushing the scope into my bladder. There was no pain, and just a slight feeling of pressure passing through the muscle that clamps off your flow of urine from the bladder. I watched as he looked around inside the bladder which mostly appeared whitish with red blood vessels running in every direction. The one odd appearance was of some air bubbles that also got introduced into the bladder that reminded me of an air pocket at the top of an underwater cave. He then proceeded to slowly remove the flexible cystoscope while having one last look at the urethral walls. He pronounced everything in good condition. At this point, the doctor left and the nurse directed me to evacuate all my bladder contents into a measurement pail with a funnel (for aiming) in an adjoining restroom off the procedure room. Once I was done, the nurse had me get dressed but requested I leave my slacks unbuttoned and my shirt lose so she could get an ultrasound reading of any remaining water in my bladder (per the doctors orders). The nurse said the doctor wanted to see less than 200 ml remaining, I passed the test with 15 measured with a small ultrasound probe held just above the pubic bone.
I then checked out at the front desk and was given one 500mg Amoxicillin tablet to ward off any possible infection. Once I got back home, I drank a 12 ounce glass of water on the hour for the next three hours. During my bladder evacuations after the procedure, I have not had any pain during urination, just a dull feeling of pressure just prior to the start of flow. I have not seen any indication of blood in my flow.
Tomorrow brings a new "first" when I have a prostate biopsy procedure at 08:30 with the same doctor and nurse. I'll let you know what that feels like....