Advice for Cystoscopy prep

[Alex Bridges]

Anything I should anticipate or do before a Cystoscopy, other than drink a bunch of cranberry juice?

[Clr224]

I’d recommend talking to your doctor about an antibiotic prescription. Every time a urologist has poked any of his tools in there, I’ve ended up with a UTI a day or two later. 

[Constantlywet]

When I had mine, I had drank plenty of water before hand just to keep things flowing. The procedure was pretty quick and wasn't uncomfortable. I would suggest taking some pull ups to wear for the procedure as once the tube is taken out, you'll be leaking everywhere. I filled a tena maxi pant to the point of leaking between when it finished and when I got back to the changing room. Also take a fresh change with you to get into afterwards. The nurse did have some nappies but they were rubbish. 

[Rob110]

I have gone through 2 of these tests on the first one there was some discomfort when the camera entered the bladder (internal sphincter) but thst only lasted a second or 2 the second test I never felt it entering. keep hydrated but if the urologist uses the same equipment my did he will fill your  bladder at the same time he uses the scope. then they will do 2 mini ultrasound tests to see how big your bladder is and if you retain after going pee. 

The test is quick and easy and nothing to stress about

[Alex Bridges]

12 hours ago, Constantlywet said:

When I had mine, I had drank plenty of water before hand just to keep things flowing. The procedure was pretty quick and wasn't uncomfortable. I would suggest taking some pull ups to wear for the procedure as once the tube is taken out, you'll be leaking everywhere. I filled a tena maxi pant to the point of leaking between when it finished and when I got back to the changing room. Also take a fresh change with you to get into afterwards. The nurse did have some nappies but they were rubbish. 

Will I be leaking even if I'm not incontinent? That's not why I'm having it.

[Constantlywet]

Ah, ok. Sorry, my bad. With it being posted in the incontinence forum I thought that was why you were going. You should bee fine then. Just lay there and relax. It really is pain free and I doubt you will leak like I did if that's not the reason why your going. It will feel a little uncomfortable afterwards when the numbing gel years off. Just drink lots of water and you should be fine. 

[Alex Bridges]

Well, that sucked. But nothing serious. Just a narrow prostate, apparently. I get to start taking Flowmax and doing pelvic floor therapy.

Hopefully the irritation from the scope clears up quickly.

[ppdude]

On 9/7/2019 at 3:55 PM, Alex Bridges said:

Anything I should anticipate or do before a Cystoscopy, other than drink a bunch of cranberry juice?

Not really. They'll numb you prior. You may be able to watch. They'll probably give you a single antibiotic pill afterward. If you have questions before, during or after, do not hesitate to ask. It goes pretty quick. Bet it won't be more than 10 minutes start to finish.

 

[Alex Bridges]

2 hours ago, ppdude said:

Not really. They'll numb you prior. You may be able to watch. They'll probably give you a single antibiotic pill afterward. If you have questions before, during or after, do not hesitate to ask. It goes pretty quick. Bet it won't be more than 10 minutes start to finish.

 

Over and done with this afternoon. More uncomfortable than I thought it would be. Glad I have some AZO tablets on hand.

[DL-Boy]

Mine wasn't really uncomfortable - of course I had been catheterizing myself on numerous occasions prior so I knew what to expect.  The only discomfort was the removal of the camera which they seem to think hurts less if they YANK it out instead of simply easing it out slowly -- NOT!

The flexible cystoscope is a walk in the park.  The rigid cystoscope like they used on me for my UroLift procedure would no doubt be quite stressful on the area.  That's why I was sedated and totally out during the procedure.

Alex, if you have slow urine flow and/or difficulty starting or maintaining a stream, I would advise you to look online for the "UroLift" procedure and research it as much as you can.  If you feel the procedure may be right for you (for BPH relief), discuss it with your urologist. 

I came to my urologist as a new patient, actually already wanting to have the UroLift procedure.  It took a couple of months to get everything approved with my insurance and get the procedure but I can say with certainty that it was worth it to me.  I went from waking up usually 3 times per night, standing at the toilet for up to 10-20 minutes each time to get started and then peeing for at least 2-3 minutes (it also took 2-3 minutes even standing at the urinal at work).  Now I can finish in about 15-20 seconds.  If I wasn't using diapers now, I would probably only get up once per night if that.  I now wake up about twice each night to get into my pee position to void into my diaper but it only takes a second or to to start and then I'm back to sleep.  Every day that goes by, I'm closer to peeing without waking up first.  My wife has told me that on several occasions I have been in my "pee position" (on my back with my knees up) but snoring up a storm, and I didn't remember waking up to get in position.

So look into UroLift if you have BPH.  If they already did a rectal prostate ultrasound, the only other thing my insurance company needed was the IPSS survey to be completed.  They need to make sure your prostate's median lobe isn't in the bladder neck.  They also need to make sure the prostate is below a certain size, over which the procedure would be ineffective (80ml I believe is the max).  The IPSS is a survey you take that assesses your perceived quality of life with your prostate troubles.

6 hours ago, ppdude said:

They'll numb you prior. You may be able to watch. They'll probably give you a single antibiotic pill afterward.

For me they injected 10cc of lidocaine lubricant into my urethra and waited 5 minutes to numb everything.  I did watch and saw the walls of my prostate slam shut when the camera came out (the doctor said this happens naturally and didn't mean anything though).  They gave me a one week dose of Bactrim DS after my cystoscope procedure, of course I had recently recovered from a UTI from an unfortunate catheterization incident so he was probably being cautious.   After my UroLift procedure, they gave me a three day, 1 per day, dose of 500mg Levofloxacin.

[Alex Bridges]

@DL-Boy,

 

I apparently have the opposite of BPH, a narrow prostate, which can have some of the same effects on the ability to fully empty your bladder, start/maintain a stream, and pee with sufficient force to avoid getting most of it on the seat or floor (I currently have four settings: weak stream, drops, spray, and normal.)

I’m not anywhere near the point of needing or wanting a procedure, and I’m hopeful the meds and the therapy will open things up and teach my bladder to fully empty again. Not thrilled with starting a new med, but it may be temporary until the therapy can kick in.

[DL-Boy]

8 minutes ago, Alex Bridges said:

I apparently have the opposite of BPH, a narrow prostate, which can have some of the same effects on the ability to fully empty your bladder, start/maintain a stream, and pee with sufficient force to avoid getting most of it on the seat or floor (I currently have four settings: weak stream, drops, spray, and normal.)

Sounds a lot like a stricture.  Did the urologist make any suggestions about stretching the narrow or smaller area?  I was thinking either by using "sounds" or catheter balloons to expand the narrow area.

Whatever you do, I seriously recommend against considering TURP (Trans-Urethral Resection of the Prostate).  They call it the "Gold Standard" of prostate surgery but many people call it the "Roto-Rooter" procedure of prostate surgeries.  They hollow out the prostate surgically from the inside out!  This can leave you urinary incontinent, non-ejaculate or retrograde ejaculate among other possible side effects.

[deewet]

I had a procedure done called Rezum earlier this year.  It sounds a bit like TURP but is done with water vapor to accomplish the same outcome, reduce the size of prostrate from inside out. It was entirely covered by Medicare and my supplement.  Maybe that should be called the gold standard of prostrate treatments?

I can say that it was successful, but is not easy to endure throughout the process, which is thankfully only about 15 to 20 minutes from start to finish.  In this procedure, the deadened tissue is shed over several weeks following the procedure, so you will see a fair bit of bloody urine over that time, thankfully without any pain after the initial procedure. You will also be sent home with a cath, to wear for 3 to 4 days while the swelling subsides.

As a result, I am entirely off the flowmax meds now, and so far, have had no unexpected side effects.

 

[Alex Bridges]

7 hours ago, DL-Boy said:

Sounds a lot like a stricture.  Did the urologist make any suggestions about stretching the narrow or smaller area?  I was thinking either by using "sounds" or catheter balloons to expand the narrow area.

Whatever you do, I seriously recommend against considering TURP (Trans-Urethral Resection of the Prostate).  They call it the "Gold Standard" of prostate surgery but many people call it the "Roto-Rooter" procedure of prostate surgeries.  They hollow out the prostate surgically from the inside out!  This can leave you urinary incontinent, non-ejaculate or retrograde ejaculate among other possible side effects.

There will be no surgery. Repeat: none. Just taking Flowmax for a time and doing some PT. Not a big deal. 

[DL-Boy]

1 hour ago, Alex Bridges said:

There will be no surgery. Repeat: none. Just taking Flowmax for a time and doing some PT. Not a big deal. 

Well, good luck. I hope the meds work out in your case.  Personally though, the only thing Uroxatrol did for me was to give me indigestion and a lower than normal blood pressure. Maybe Flo-Max will work out better for you. One thing to consider though... My insurance required an "Either/Or" situation with trying medications before approving the procedure. The drug-class that Uroxatrol is in had to be tried for at least 30 days minimum before they would approve the procedure but the class that Flo-Max is in would have needed 6 months trial before approval.  Apparently it works differently so it takes longer to work.

Also be warned, there could be sexual side effects while taking these drugs. I suffered delayed ejaculation while taking Uroxatrol and it could take hours of manipulation before I got release.

 

[Alex Bridges]

On 9/24/2019 at 8:16 AM, DL-Boy said:

Well, good luck. I hope the meds work out in your case.  Personally though, the only thing Uroxatrol did for me was to give me indigestion and a lower than normal blood pressure. Maybe Flo-Max will work out better for you. One thing to consider though... My insurance required an "Either/Or" situation with trying medications before approving the procedure. The drug-class that Uroxatrol is in had to be tried for at least 30 days minimum before they would approve the procedure but the class that Flo-Max is in would have needed 6 months trial before approval.  Apparently it works differently so it takes longer to work.

Also be warned, there could be sexual side effects while taking these drugs. I suffered delayed ejaculation while taking Uroxatrol and it could take hours of manipulation before I got release.

 

I started taking it, and I can’t keep my hands off myself. ?

Seems all my plumbing is working fine down there, though hard to tell whether the meds are helping the actual problem yet.