Male flexible cystoscopy - is procedure visible to patient?

Tests and investigations
1

I've had painful urination for several weeks and came up negative for UTI, STD etc. The doctor said not much more could be gathered from blood or urine tests and suggested a cystoscopy to see if there was a deeper problem.

After he explained the basics I was not looking forward to the concept of course, but agreed we should check all avenues for what's wrong.

I am unlike 99% of patients whose reflex is probably to close their eyes and pretend this isn't happening. I'm someone who actually watches needle injections into my arm and similar things. It makes me MORE secure/comfortable to see what's happening to my body in these situations than not to see. Call me crazy but that's how it is.

So, my questions are:

1) Can the patient see what's going on with this procedure? I understand you are draped, but I don't know if the penis and tubing is in the line of sight.

2) Would it be insane to ask to Dr to make it possible for me to see? Maybe they even go out of their way to cover it up from your sight. It might be strange for them to get this request, but I don't see how it would interfere with the procedure so maybe they're fine with it.

Would greatly value info on this from medical professionals or people who have had the procedure. My concerns may be just about the opposite of others, but if they can be accommodated I'm going to ask! Thanks.

2

Yes you can look down there and see the scope going in your penis, but you might be more interested in looking at the t.v. screen so you can see the inside of your urethra and bladder.

3

Hi, yes you can see if you tilt your head forward. You’ll be lying on your back wen they do it. Also, depending on what scope they use you can view it on a tv screen and see inside your bladder. 

Good luck 

4

I totally agree with everything you are asking would prefer the same hope you get some answers 

5

Good morning Adam.  I am the same way  I like to see what is going on.  Blood work everything.  I look to make sure what is going on.  When your doctor does the flexible cystoscopy you can watch.  They have to lay down to get you ready and but the gel in. But after that I lift myself up to see him insert it.  Your doctor will not say anything mine never does.  Good luck  Ken    

6

Dear Adam,

From an entirely personal perspective, this makes at least two of us with this same trait, and I welcome your company!

No, you're not crazy. A few years ago a report was published describing two groups of patients undergoing the same surgical procedure. One group was allowed to view events in full detail, the other was not. The first underwent a significantly better experience. If you are interested in following this up I will be happy to send you the details, providing I can find them in my system. Just send me a quick 'yes' or 'no' for me to start searching.

I am going to describe my own experience to address your questions #1 and #2. I am an 88 year old male, retired, residing in the northeastern U.S.A., with a background in mechanical engineering. I underwent a flexible cystoscopy some 18 months ago. Most of my requests were granted without question. The most important of these was,"No Lidocaine or other numbing agent, please; just oodles of lubricant.", granted.

Direct visual link, not granted, just watch the monitor. In fact, it was the monitor which was judiciously positioned to block any direct view I might have of proceedings.

My only complaint was that everything was over and done with in the blink of an eye. I was also warned that I would pass some blood with the first few voids (did not happen) and that I would suffer some pain (nothing).

So, there you have it, as they say.

Warm regards, alan86734.

 

7

Thanks all for your feedback, very useful! Definitely happy to know I'm not alone in this preference. I used to be very squeamish with needles. Then my cousin told me he looked directly at it, and I tried that and it was much easier.

As far as the positioning though it seems like it varies doctor to doctor based on your stories, but maybe in most cases you have a line of sight. I guess everyone is saying it's pretty brief and not so painful so that's good.

Anyone with different experiences, or confirming the ones that have already been stated? Thanks!

8

Good morning Alan.  Can I ask you why did you not want any Lidocaine Gel.  My doctor uses it all the time.  I have had it done with and without.  I perferred with.  Same as a catheter Had that done both ways.  But to each his own.  I all ways watch.  They tell me to lay down but I sit my self up all the time.  Take care  Ken

9

Hi, Ken. Good to hear from you! Why no Lidocaine or numbing agents? If there is a likelihood of the patient becoming the sole operator of the procedure, as in Clean Intermittent Catheterization, then there is every reason for that person to retain acute awareness at all times. When others are involved the need to maintain a high level mental competence is substantially reduced.

However, the learning process that is virtually guaranteed by good two-way communication can be corrupted by lack of quality of the "return" leg. Ken, just look at your own, generally excellent comments which you make quite frequently. Keep up the good work!

Regards, alan86734

10

Thank you.  I like to be aware of everything that go around me or to me. It's our body's and we should pay attention.   Take care  Ken

11

Hello adam234 -- I'm an engineer who had a cystoscopy last November to rule out bladder cancer (my Urologist had detected a small amount of blood in my urine).  I can share my experience with you and try to answer your questions.  I understand your wanting to observe the procedure - I usually watch needles go in, as well.  

First, my Urologist's procedure room had just the one monitor, so I didn't get to see any images of my urethra or of my bladder.  The Urologist stands between your knees, facing you, while he or she is performing the procedure.  My Urologist used the eyepiece (lens) at the end of the scope, so I don't think she used the monitor at all. 

I was offered a drape, but I discussed using this with the Doctor's assistant, and she and I agreed that it was OK for me to be naked for the procedure.  I was in a reclined chair with my legs in stirrups, so my penis was easily visible.  During the procedure, what I saw was the penis pointed up, towards my Doctor, with the black tubing of the scope coming out of it, with the hand controls and lens assembly at the far end. 

Before I was prepped for the procedure, my Doctor advised me to relax and avoid tensing up as the scope was inserted.  Then, I received some Lidocaine and lubricant gel from her assistant, and we waited for a few minutes for the anesthetic to work.  The Doctor and her assistant then readied the scope, and I relaxed and closed my eyes.  After a few seconds, I felt the scope being inserted, and it was passed readily up into the bladder.  The sensations while the scope was being inserted were all very pleasant.  Once the scope was in my bladder, I didn't feel anything.       

As the Doctor was examining my bladder, I opened my eyes and watched her work.  She rotated to scope to scan the entire inner surface of the bladder, and used a syringe to aspirate liquid from it to send to the cytology lab.  I recall that she used the eyepiece exclusively.  She announced that the bladder looked normal and then gently withdrew the scope from my body.  The whole procedure took only about ten minutes, including the prep time.

I would expect that you will be able to watch your Urologist perform the procedure (in terms of inserting, operating, and removing the scope), and his or her assistant do your prep work, but if the procedure room isn't set up for a patient to view a second monitor, I wouldn't ask them to set one up for you - it's really not worthwhile to do - for such a quick procedure.   I imagine that the use of the drape is optional - if you want to see what's going on, they very likely will be OK with that. 

Your Urologist will be looking for something that may be causing the pain you experience on urination.  If he or she finds the cause, some video saves may be taken to document this.  

What I always tell people is that if you have any questions, you should contact your Urologist's office and speak with the staff about your up-coming procedure.  Let them address your concerns.  You shouldn't worry about the procedure, though, because it should be relatively comfortable, and completed in a timely fashion. 

Good luck with this - I hope the cause can be located and treated successfully.  

Alan12675  

     

12

I have had three Cystoscopy's in the last two years the insertion and movement of the scope can be a little uncomfortable, but in my case the procedure takes less than a minute. You can see whats going on and normally there is at least one colour monitor to watch

With the first procedure they found early stage Cancer, subsequently within a month I had this removed.  I am now monitored every year and am clear.  So far so good, very glad I had the first inspection.