Re: about having cystoscopy


"marcia" <design1@xxxxxxxxxxxxxx> wrote in message
news:1149431928.177082.34040@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Jane Cohen wrote:
Thanks for your comments, Pete. I know it seems crazy to make such a big
deal of this but I've been doing a lot of reading on the internet and it
sounds hideous. I can barely stand getting a pap smear. Did I say I'm a
bad patient?

The whole thing took me by surprise and I didn't get all the details
from the uro, like does he have anesthesia in his office. He didn't
offer anything to make me comfortable, though. He said it's not so bad.
He said it's like a colonoscopy. Well, I'd never be awake for that!

Anyway, Pete, thanks for your opinion.


I have never had a cystoscopy, but my husband had a colonoscopy once,
and they gave him something to sedate him. He says he doesn't recall it
being terribly uncomfortable, but wouldn't want to have it done wide
awake.

It sounds like you discussed your concerns with your doctor, and he
tried to reassure you, but didn't offer any specific solutions to your
problem? It may be his clinical experience that most patients tolerate
the cystoscopy with minimal discomfort, without needing sedation. But
you're an individual, and if your fear is that strong, you deserve to
have it addressed.

You might consider calling his office and asking if he can prescribe
something or administer something to help you relax during the
procedure. If you can't (or don't want to) talk directly with the
doctor, try enlisting the help of one of his nurses (they can be great
allies). Reemphasize your fear, and don't be shy about it. Axiety can
make anything physical less comfortable, which can, in turn, increase
your anxiety. If you have a negative experience now, you may be less
likely to pursue needed testing in the future. That's not a good
outcome.

FWIW, it sounds like you've found a thorough and competent doctor, and
I would definitely follow his advice about having the test. But be
proactive about getting your fears addressed beforehand, however. And
don't feel bad about having them--I'm a total weenie about needles and
have difficulty going in for a simple blood test, so you're not alone.


Flexible cystosopy is most usually an office-based procedure. The urethra is
topically anesthetized. It tends to be less uncomfortable for women in men
because women have a much shorter urethra. It tends to be not very painful,
I'm told by patients, but that is indeed an individualized perception.

Certainly it can be done with sedation, but that would be very unusual to be
done in the office - sedation requires a substantial amount of monitoring
equipment and trained personnel that are well beyond the scope of the
*typical* urologist's office. The OP should check with her own urologist.
Every doctor is different, but generally speaking, most surgeons would
consider "calling his office and asking if he can prescribe something" to be
a bad idea and refuse, instead recommending that it be done in the hospital
under intravenous conscious sedation if the patient's anxiety was that bad.
Be aware that that would be more expensive, and that some insurance policies
may not cover the added expense of doing what they consider an office-based
procedure in a surgical facility.

Colonoscopy is almost always done with intravenous conscious sedation
because it *does* tend to be uncomfortable. It has nothing to do with
cystoscopy, and cannot be used in any sort of comparison to that procedure.

HMc



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