Flexible cystoscopy (male)

Tests and investigations
1

I'm a 36 y/o male and underwent a flexible cystoscopy last week. Thought I'd register with this forum just to share my experience with other chaps who might be worried about the procedure.

Once you're prepped and ready to receive the cystoscope, the procedure, itself, lasts probably around 5 minutes, or so. The cystoscope is approximately the thickness of a pencil with a rounded end containing a flashing light. The first step involves disinfecting the area around the genitals... just a few dabs/wipes of antiseptic. This is followed by an injection of anaesthetic gel into the urethra (pee hole). The gel is injected from a syringe with no needle attached. The surgeon injects the gel with a fairly quick firm push on the syringe plunger and this feels weird and a bit uncomfortable (but not painful). The anaesthetic does sting slightly as it goes in, but it's not what I'd call painful, as such... just pretty uncomfortable for a few seconds.

In my case, the surgeon left no real time for the anaesthetic to 'work' and proceeded straight away. As it happens, the cystoscope was somewhat tangled-up and he spent about 30 seconds to a minute dealing with (which I was quietly thankful for as it probably gave a little more time for the anaesthetic to take effect). Usually, I watch needles going in and am not squirmish about things being done to me but, in this case, I had no desire to watch the cystoscope going in! Instead, I focused by attention on the video monitor, which kinda detaches you from the experience somehow. Although I could feel the cystoscope going in, I didn't feel any pain or discomfort... until the scope reached the area of the prostate. If you're having this procedure, it's likely you have possible prostate trouble and, as most prostate problems involve enlargement of the prostate, the urethra will be narrowed at this point depending on how enlarged the prostate is. I suspect how much discomfort/pain you feel at this point of the procedure will depend on how enlarged your prostate is and how much it occludes the urethra. In my case, the urethra was very narrowed as the median lobe of my prostate is enlarged (the source of my symptoms). The surgeon paused at this point and asked me to relax as though I was trying to urinate. I tried to do this, but as soon as the scope moves forwards, you naturally tense-up, which defeats the object of trying to relax in the first place! This was the most uncomfortable/painful part of the whole procedure for me. The pain was enough for me to screw my eyes up and shout 'owww' a few times, but it wasn't unbearable and only lasted a few seconds until the scope had passed the narrowing. After this, the scope enters the bladder and the surgeon has a good look around... you cannot feel this at all. In my case, my bladder was then filled with 400ml of water through the cystoscope as I was to have a flow study conducted immediately afterwards.

When the cystoscope comes out, it's a very strange feeling as you feel a bit like you're urinating (but you're not, obviously), but it's not painful. For me, the after-effects were minimal... I was anxious about urinating afterwards, but it wasn't too bad at all... some slight stinging the first couple of times, but that was all. Certainly no need for pain-killers.

All in all, the flexible cystoscopy wasn't too bad for me. It's not an experience I'd be in a rush to repeat(!), but it needed doing and it didn't last too long. I'd say it's no worse, really, than having something like a root canal at the dentist (which I've also experienced). Uncomfortable with the occasional fleeting bit of pain, but nothing too major.

Good luck!

2

I am a 53 year man and I had a flexible cystoscopy today. I was told on arrival at the hospital that they wanted a urine sample. This held me up because I had to drink a few beakers of water and hang around for an hour. Finally, I produced the sample and went into the op waiting area to get undressed and put on a gown. I went into the theatre and they injected some anaesthetic gel via a syringe into my uretha (pee hole).

This sounds worse than it was because all I felt was a mild stinging sensation. The Doctor then inserted the cystoscope and began looking around and took some photos. The only discomfort I felt was the sensation of wanting to pee. When he took the scope out I again hardly felt a thing. The whole procedure took around 2 - 3 minutes.

Following the procedure I went to the toilet to urinate and there was a mild stinging pain on the tip of my penis. I went home and after urinating another 4 times the pain went.

If you have been worrying about having this procedure, relax it is nowhere near as bad as it sounds.

3

Thanks for that info. I'm having the procedure this Tuesday, and this has given me peace of mind! Cheers!

4

Thanks, hubby is having this on Sept 2cnd so reading this will reassure him hopefully!

5

Both reports on cystoscopy have proven useful for me to pass reassuring comments to my brother who is nervously awaiting same procedure. I realise they were posted a couple of years ago but are much appreciated, thank you.

6

My husband is also having this procedure in a few weeks. I think you put him at ease (a bit) .... Thank you ! 

7

Thanks so much all for posting your experiences. I'm having one of these tomorrow, and I'm a total wuss!

You've all put my mind at rest!

8

I am a 21 y/o male and I am about to undergo this procedure on Wednesday as I have been experiencing increased urine frequency, weak flow and I am also unable to fully deplete my bladder. According to the urlogist my prostate is fine, with no lumps or bumps or abnormalities (on the outside) and I have been prescribed Tamsulosin which hasn't made any significant changes. As an anxious individual anyway, I was/am very nervous about this procedure but reading about it on here as gave me a better idea about what to expect. So thank you for that.

It has gotten to the point over the last few months that what I am experiencing is manageable. It's not depressing me any, but the side effects of Tamsulosin are (any sexually active male knows the problem with Tamsulosin) so if this is something I am just going to have to live with and take medication, i'd rather not take the medication.

Anyway, waffling on abit now, thanks for the insight about this procedure smile 

 

9

Thank you for taking the time to share your experience and explaining everything for easy understanding. Kind regards

10

I had 3 operations in 2010-2011 to increase my urine flow, but my skin seems to heal very quickly and the pee hole got narrower as time goes on after each op. Each time it was an op that I had to stay overnight in hospital. 

Today I just received a letter from the hospital booking me in for Flexible Cystoscopy tomorrow. It was at short notice, and I was worried what is that? Does that mean I need not go for any major op to open up the urinary hole? Can I drive home after this procedure.

Thank you if someone can help me on this question?

 

11

This site was vey useful, as I underwent a cystoscopy and BPH ultrasound this morning. I agree with most of the posters that the procedure is unconfortable, even a little painful, but easily tolerable. I am 69, 6'3" and 235 lbs and have a prostate 2 times the normal size. I am sure that more pain is involved in the procedure if you have a current UTI or prostatitis or if your prostate is unusually dense. My Dr. told me size of the prostate is not as important as the density of the gland regarding discomfort. I received a Cipro tablet (to avoid UTI post-op) and was told to undress from the waist down. I was covered with a drape. The nurse injected the numbning gell (a little too quickly if you ask me) and did not "clamp off the external urethral opening (as I have seen other offices do on YouTube). She did not massage the gell down the urethra either. The gel is dark brown and does get all over the drape and bedding. I waited 15 minutes for the Dr. to enter the room. He told me he was using the latest version of the cystoscope. It was no longer than 12" and appeared thinner than those I have seen in doing my Internet research. The insertion to the bladder took all of 15 seconds. Going through the prostate did cause a burning and I did grunt momentarily. He told me to take a deep breath and not to tighten up. By the time I took one deep breath he was in the bladder. He spent a good 15-20 seconds examining the bladder then slowly pulled the instrument out. The exit of the cystoscope caused no discomfort. Total time from entry to exit = 30-40 seconds. The prostate ultrasound took only 15 or 20 seconds, at most. It was actually not as uncomfortable as a regular DRE, although I have had this procedure in the past where a different urologist spent at least 10 minutes moving the probe around and I found this quite long and arduous. He took a photograph of the prostate and described its position to me and that I was a good candidate for the laser mimimally invasive surgery to widen the intra-prostatic urethra, which I will have done under general anesthesia. I next had to have blood drawn for BUN and Creatinine (I have a history of trace blood in the urine and he wants to check out the kidneys, as well) and will have a CT scan of the abdomen prior to the surgery. Thanks to all who help those of us undergoing this procedure to understand the majority of patients find it only uncomfortable, within easily tolerable pain levels, and not worth the lost sleep we all experience thinking about the upcoming event.

12

Jus to endorce Ian's comments. I am a 60 year old man who has just recently under gone a flexible cystoscopy and it is just as he says. It was a walk in the park, compered to a rigid cystoscpy. With the rigid op, I found after the procedure, as during I was under general anesthetic and didn't know anything about it. But waking up tethered to a urine bag with a rigid plastic pipe through my uretha somewhat very unpleasant. The feeling of wanting to pee nearly all the time and pushing to go. Being attached to a pipe felt unatural. you somehow had to try and relax and I found this difficult. I'm sure other people may have different experiences with this procedure, but this was mine. 24 hours before I had my pipe removed. I couldn't wait.

13

So had this done today 5 November 2014. So panicked for two month's. Waiting for this day.So here go's my story after the paper work was complete and urine sample taken.Once in the room gel is pushed in the urethra it stings a little then no pain at all,total time 3 mins finished.I wish you all well with this cystoscope exam it's not a big deal from the worlds biggest whimp me

14

Just been to my first outpatients appointment with flow test and bladder scan (not emptying with 200 ml still in) and was told iam going to be booked for this procedure, i have had this done before back in 1996 when i had my original stricture cant remember it being that painful then just uncomfortable, maybe things have moved on since then as well. Iam on Tamsulosin as have enlarged prostate and weak stop start stream, hope to get sorted soon!

15

I would suggest that everyone who is going for any check regarding their bladder always attends with a comfortably full bladder. It is much easier to have a pee if it's not required than keep drinkin water and hanging aound - also if you need a pee naturally then they get a more representative sample. Most hospitals tell you on their appointment letter to attend with a full bladder.

The urine is checked for infection before cystoscopy and many abdominal ultrasounds require a full bladder so the sound waves will pass through t easily.

 

16

I have had a colonoscopy (6 feet of camera up the bottom), a flexible sigmoidoscopy (about 2 feet of camera up the bottom) and an endoscope down my throat into my stomach. I too was nervous about the cystoscopy; I think because, for men, getting kicked in the testicles is really painful we assume the whole area is super sensitive.

Whilst I think having your penis held and swabbed is somewhat intimate and possibly embarrassing the rest of the procedure, in my experience, gives less discomfort than any of the others (and I had my colonoscopy and sigmoidoscopy with no sedation). After the sting of the lubricant/anaesthetic which lasts a few seconds, I honestly didn't feel anything; I didn't realise the scope was in until the doctor told me to look at the screen and see my prostate. Then it was on into the bladder then out. A slight stinging for the first few pees then back to normal.

 

17

I had this done today. The whole thing is very simple and there is no pain whatsoever. A mild stinging sensation when they inject the anaesthetic gel, the rest is nothing to worry about. I have a low pain threashold and the only slight discomfort is the feeling you want to pee. If you are having this don't worry - it's really nothing.

18

Look this biggest problem with this cystoscopy exam is this I think for men.The name of the instrument Cystoscope sounds scary it's just a flexiable tube containning a fibre optic light and camara and water supply and can also take samples.Cystoscopy exam is a mental challenge for any one,my blood pressure before I went in was through the roof.Yes some people in the room are going to see your penis,good chance they will be women nurses.You have a choice if the challenge is too much for you,maybe don't go but you will always wonder if you did the right thing.A man's penis is a very private thing I know I have one.Every one you meet in that room are there for you.All the best   

19

Hi. I understand what you mean about people seeing your penis, but it is just a penis and all us men have them. the urology nurses are dealing with them day in and day out and for them it's no different from a nose or finger. Having said that, when I had my cystoscopy most of the nurses were female but most of the patients were men; and given that many older men may be uncomfortable with a strange woman handling their penis it might be that the same consideration should be given to men as for women - that is same gender nurses if requested. When I had mine done a woman went before me and they removed the male nurse to get a female nurse (without asking her); for me I just got the female nurse with no consideration. Fortunately, for me, I consider all healthcare workers as just that and don't worry about gender but it is something that maybe men should be more concerned with.

 

20

Hi Guys, Just an update on my cystoscopy which i had down 3 days ago.  Just to give you some history beforehand i had a urethral stricture back in 1996 and warned me then it might come back but with enlarged prostate diagnosed recently and weak stream etc i was booked in for the procedure.OK after waiting in the waiting room for over an hour with anxiety running quite high, had a preliminary chat with the doc about the procedure and previous history and then soon down to business. I wasnt asked to change into a gown but lay on the couch and told to take my trousers and pants down past my knees. The area was swabbed by one of the nurses and then i was told they were going to inject the gel / lubricant in, i held my breath and oh my god the pain! I almost jumped off the couch! He then said he was going to place the scope into me but to be honest i then felt a little stinging but i then heard him say he was aborting the procedure due to my stricture which was all too obvious at this stage i guess. So i think the reason for the pain is because the gel was being forced past the stricture and into me against the natural flow. Anyway i have been booked in for a optical urethrotomy in the new year, in which they open up the stricture again and then hopefully normal service instead of a weak / split stream etc, anyone who has had this procedure recently please let me know if things have changed since 1996 when i first had it done.