Cystoscopy Questions...

[Konstantina]

Hi all,

I just had my first consult with a urologist on Feb 12. I have vulvodynia, and urinary symptoms that my gyno said sound like IC.

The uroglogist asked about my symptoms, and said he has to do a cystoscopy to see if its IC. He said they are going to used local anesthetic, and it wouldnt be very painful. Have any of you had one with just local?? How was it?

He didnt give me any details other then he's going to use a small camera to see inside my bladder. Do they always fill your bladder with some sort of liquid?? I have read that just a cystoscopy isnt the best to diagnose IC is that true? He didnt mention anything about Hyrdodistention.

Any information would be greatly appreciated.

[Tracey5399]

Hi,

I think most of us here have had 1 at one time or another.
My'n was done in the office under local as well, was given an antibiotic before she did it but i do not remember having anything put in it before the camera part, however i was really freaked that day about the IC in general but i think that would be something i'd remember. Hopefully someone else can help you on that.
It's a pretty standard procedure, they will look inside for bladder cancer, inflamation etc..My doctor looked at it with me. It's isn't going to tell you if you have IC, at this time the only 99.9% is the hydrodistension that's when you go to the hospital ( most do ) and they put you under, alot of people have done it, some it helps, some are in a bit or alot of pain. I presonally do not agree w/the test i believe you can go by symptoms and ruling out other things such as endo, the cystoscopy as well as trying the IC diet etc.. but that's just me! Everyone has to do what is best for them and discuss it all with your doctor.
I was in a little discomfort when i had my procedure but at that time IC had just slammed out so i was in alot of pain anyway, but the next day i wasn't sore from it.

I hope it goes well for you, keep me posted on how it went and how your feeling,
Tracey

[evanseri]

As far as I know and have read on this website you cannot diagnose IC with just a cytoscopy. You need to have a hydrodistention performed to truely diagnose IC. Many times an IC bladder will still look normal under cytoscopy.
Good Luck

[ICNDonna]

The cystoscopy is a part of the "rule out" process needed to make an IC diagnosis. It's not fun, but isn't horrible either. If you've ever had a catheter inserted, it feels much the same as a cysto. If you can manage to relax, it makes it much easier. The way I relax is to consciously relax my muscles and concentrate on breathing slowly and evenly.

It's correct that an IC bladder can appear to be completely normal and healthy when viewed during the office cysto, but it does help rule out other things.

My diagnosis was made by having a hydrodistention and biopsies in a hospital with anesthesia. The good thing about this route is that about 50% of IC patients experience relief from symptoms for a time after the hydro. I go anywhere from six months to almost two years between hydrodistentions.

Warm healing thoughts,
Donna

[humpieumpumkin]

I was diagnosed with a cysto without hydrodistention. My IC was visable without distention which I guess is rare...But it was obvious. I guess it depends on the case. Inflamation is visable without distention sometimes too, and I think that is more common. I was in alot of pain during the procedure, but I think most people are ok. I would say most people have to get hydrodistention to get diagnosed. I also wasn't having a flare-up. Hope this helps.
Erika

[Konstantina]

Thanks to everyone for the advice and support!

I dont think I trust this DR for some reason. He wasnt rude or anything, just didnt seem very interested when I was telling him my symptoms. After we spoke he said well the only way to be sure if I have IC is to "have a look" he just told me that he would look in my bladder with a camera.

I had never been to a urologist before, and it was odd as the waiting room was filled with older males. Then here I am a 24 yr old woman, who looks more like 18 sitting among them.

When I told him my Gyno said it sounds like I have IC he said you know the hopsital where your Gyno works has a urologist who specailizes in IC. I almost felt like he had never had a patient with IC before, but who knows.

I feel like there is no point in doing just a Cystoscopy, if most times Hydro is also required to get a diagnosis. What then I have to go and have a Cysto done again just to have the Hydro too? Do you all think I should call him, and ask about this? I dont want to come off as questioning his expertise, but I dont want to have another Cysto done again.

Tina

[Tracey5399]

Hi Tina,

Well like donna said Cystoscopy is a form of ruling out other things, i don't think it's a bad idea.
As far as the doc you saw wanting you to go to the doc that speacializes in IC is wonderful advice. I don't think the doc you went to doesn't want to help you, it's just IC is a complicated disease and alot of doctor's either do not want to treat IC patients or just do know enough to give them the right treatment or support etc..
You have a decent doctor there and should consider taking his/her advice.

Good luck,
Tracey

[evanseri]

I can totally relate to the waiting room thing. I don't think i have ever even seen another woman in the waiting room. Always me, my fiance, and a bunch of old men.

[Konstantina]

Hi Tracey,

You're right...I just find it so hard to trust doctors after all the crap I went through before I got diagnosed with vulvodynia. So I always find myself looking into what they say more then I should.

Evanseri...I know eh its too wierd. Its like what does each urologist only have like one female patient!?!

[SandyRN]

Honestly, if it were me, I wouldn't have the in office cysto done because most uro's who really do know how to diagnose IC will do a hydro with the cysto under anesthesia. The part that worried me was that they told you they would insert some fluid into your bladder before the scope....is he going to give you a hydro right there in his office? I would find out the answers to all of this and possibly find a new uro. I've been the only female in an office full of viagra seeking men (literally) and realized that it wasn't the place for me. I want a uro who understands MY anatomy as much as he understands his own.

Just my humble opinion....

to the board

[pingpong]

I agree with Sandy. A cysto/hydro will let the Dr. see everything that an in-office cysto will show and then some. Why should you go through the discomfort, inconvenience and expense of 2 procedures when 1 will do the trick?

[Konstantina]

Hi guys,

Thanks for the advice. I was thinking that way too. I mean If a cysto/hydro will show all and more then just a cysto I dont want to just get just a cysto. I live in Canada, so I wont be paying. I hate our health system, it takes months to see a specailist, and then they dont even have a clue sometimes. Im going to call his office on Monday, and ask why he wont be doing a hyrdo as well.

[L. Thomas]

You might be more comfortable with a urogynecologist. All you see in my urogyn's office is women.

I was diagnosed when I completed a "bother scale" where you rate your symptoms. I had a score of 23 out of 25. My urogyn says he sees no need to do a lot of expensive testing when symptoms are as good an indicator of IC. (this is his latest research project). After 6 weeks of instills I took the bother scale again and my score was 0 out of 25.

I had a cysto in 2002 before onset of IC that showed nothing. I had another one in 2006, after I had been diagnosed and it showed mild IC. Just as the bother scale and interview showed.

I think dsicomfort of the cysto probably depends on the severity of the IC. I did not have any discomfort with the cysto. My urogyn does use lidocaine before he inserts the catheter. But the catheter is a 22fr.

[Konstantina]

Hi All,

Today I was suppose to have my cystoscopy. I had called his office last week, and asked to speak with my DR and the receptionist said Id have to make an appt. So I figured whatever I'll just go ahead with the cysto, and go from there.

So I arrive today at his office, and the nurse starts to prep me. I ask if he's going to be doing a hyrdo, and she responds he'll be "filling your bladder with water so he can have a better look". That confused me as I thought what are they going to give me a hyrdo only with local??? So I thought to myself let him do the procedure then I'll ask some question. Has anyone had them fill your bladder with water with just local?

So DR comes in, and attempts to insert the scope, and it killed. He tells me to relax as I must to tensing my muscles and thats why he is getting all this resistance. He trys again and the pain is unbearable, and hes still struggling to get it in. At that point he says "forget it, you cant relax, and I dont want to traumatize you by forcing it in". He said he'll have to put my under general. He seem very annoyed by all of this. He wasnt rude, but I thought he couldve been a bit more easy going about the whole thing. I dont think I was clinching my muscles, and I was taking deep breath, and I wasnt nervous or anything. As I was leaving the nurse said I probably have narrowing of my urethra, but we'll have to see when he can actually perform the cysto. I didnt get a chance to ask the DR any question, and I was pretty upset because I had been waiting 4mths just to see a URO, and I had to wait 11/2 to just get the appt for the cysto with local. Now I have to wait 2 more weeks to have the cysto done under general. The health system in Canada is the worst!!!

Has anyone had this problem of them not being able to get the scope in? What are your thoughts my situation.

Thanks.

[izazen]

I had an office cysto last week. He filled my bladder with 550 cc's of water, inserted a long tube with a camera and looked around for about 5 minutes or a little more. I had taken a tranquilizer on my own before I left the house so all he did was to put some salve on the urethral opening.

The nurse gave me an antibiotic when I first went, I took off my pants and then walked into the procedure room. ( I told them I had taken a trank on my own and showed him the bottle so I guess he thought that was all I needed.)

I had no problems until he was almost done and had filled my bladder to as much as it would hold. As soon as I expressed the slightest discomfort he immediately cathed out the water.

He did say that -at the very beginning, after he took a first look at my urethra, that he would use a smaller instrument instead to gain entry - after that all went well. Sorry you had a bad experience. Are you sure you want to go back to that same doctor?