Talk:Cystoscopy

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Hey Ed! Read this!

This article is edited down from the public domain NIH Publication No. 01-4800, at http://www.niddk.nih.gov/health/kidney/pubs/cystoscopy/cystoscopy.htm

especially the bit that says:

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
Oops! Sometimes my protective instincts verge on paronoia, eh?
Sorry for being such a prick :-) --Ed Poor


Post-cystoscopy pain

I have performed about 6000 flexible cystoscopies. While some patients have post-procedural dysuria, most are fine. Thus I have made the changes to reflect this. Jfbcubed 09:45, 20 May 2006 (UTC)[reply]

I've edited it again, removing someone's comment about men getting post-procedural bladder spasms. It happens sometimes, but not commonly, and not solely in men. The one-line comment was unhelpful and inaccurate. Jfbcubed 20:38, 27 December 2006 (UTC)[reply]

I thought this piece sounded like it was written by a urologist. Of course you guys don't want it known that a cystoscopy without general anesthesia is the closest thing to legalized gang rape there is. A valium will definitely not be sufficient. If you just look at the photograph of the scope at the beginning of the article, you can see that it will not fit without forcing into most normal urethras. You know, the whole point of Wikipedia is for this kind of information to be included, whether it offends the profession or not. —Preceding unsigned comment added by Godofredo29 (talk • contribs) 14:54, 21 November 2007 (UTC)[reply]

I would disagree with the above comment, anyone who is having to force a fexible cystoscope through is not competent to be wielding the instrument. If it doesn't fit the options are gentle dilation with urethral sounds or a GA procedure with an optical urethrotomy or similar if needed. Euanagreen (talk) 18:16, 14 January 2008 (UTC)[reply]

In my 31 years practicing as a urologist, I have NEVER forced a cystoscope into any urethra, nor have I sounded the urethra prior to obtaining an initial, bi-directional view of the entire urethra, ejaculatory duct, and urinary sphincter. Most fiber optic scopes measure between 4 mm and 7 mm in diameter, ensuring more than enough clearance for a proper, comfortable insertion (to the point of finding physical obstruction - calculus, stricture, prostatic hypertrophy, etc..). Although commonly performed as an office based procedure, if the symptomology is severe, I will usually elect to use a hospital or surgery center OR, where very often IV Diazepam or another IV benzodiazepine is employed to (both) make the patient comfortable, and relax the urinary musculature, facilitating a smooth insertion. Furthermore, a viscous topical anesthetic (I use Anestacon) is almost always instilled into the urethra prior to scope insertion for reasons of patient comfort and ease of insertion. Should a Visual Internal Urethrotomy be chosen to alleviate a discovered stricture, IV sedation and an (infiltrative) injection of lidocaine or other local anesthesia into the stricture will usually suffice for cutting the pie-wedge oriented dissections into the stricture with the urethrotome. Should the diagnosis become more involved, then (and only then) would I elect for general anesthesia. PA MD0351XXE (talk) 19:53, 11 April 2011 (UTC)[reply]

I've gone through cystoscopy at the age of 2. The pain was so great that I screamed as hard as I could. The doctors grabbed my limbs and continued despite my agony. My life ended that day. When the procedure was over I only had desire to kill my parents. Back there I screamed so hard that I got hernia that strangulated at the age of 4 and had to be surgically removed which was another hell. My whole youth I've spent with only desire to kill my parents for what they've done. Now it became a full-blown schizophrenia, or maybe it was even in the youth. Now, 25 years later, I still want to kill my parents for what they've done. And then myself. FaTony (talk) 15:25, 21 February 2018 (UTC)[reply]

Post Procedure Info

Re-wrote and separated the post procedural care instructions from the section describing the procedure, also clarified the prescribing of antibiotic and anti-infective agents and urinary analgesics. PA MD0351XXE (talk) 01:08, 19 April 2011 (UTC)[reply]

Opening is clumsy

Someone should try to edit the lead so that it flows better. I'll do it if I get the chance. I'm a medical writer, I would prefer that an MD do it..Scott Adler 18:58, 11 September 2007 (UTC)[reply]

size of cystoscope

It says: Cystoscopes range from between the thickness of a pencil, up to approximately 9mm and have a light at the tip

I suspect it should say

between the thickness of pencil lead, ....

Thickness of a pencil would require more than anesthetic. —Preceding unsigned comment added by Tracychess (talk • contribs) 17:42, 19 May 2011 (UTC)[reply]

The average person can tolerate urethral insertion of surgical devices and catheters measuring <12 mm with no problem (maybe a little wincing). There is almost always some minor discomfort (usually burning) which occurs during removal of the device. Some urethral sounds measure nearly the diameter of the male index finger, and are tolerated by most with only topical-local anesthetic (while others require general anesthesia).
I've seen pediatric cystoscopes (physician's demo models) listing a diameter of 2.5 mm. In my opinion, the resolution of the image was not all that great. Cystoscopes capable of bearing affixed instrumentation (urethrotome, resectoscope, biopsy punches, stone retrieval basket, etc) are usually 6 mm and above. Long story short, Cystoscopy is a procedure which may be slightly uncomfortable to some. It should in no way be feared, and should an obstruction or other problem be discovered during the procedure, very often local anesthesia and a sedative (IV benzodiazepine, or sedative hypnotic, most likely) will be employed for optimum comfort. PA MD0351XXE (talk) 22:39, 2 June 2011 (UTC)[reply]
I realise this is an old discussion but nevertheless felt compelled to reply. I'm sorry but this sort of attempt at downplaying, almost denying, the possibility of significant pain is the sort of thing that destroys patients' trust of medical professionals. I had a cystoscopy with only a local anaesthetic and found it excruciatingly painful, particularly during the procedure but also when urinating afterwards. I cannot describe such pain to someone who's never experienced it, but it was so extreme that I would absolutely refuse to go through another one without general anaesthetic no matter what the circumstances. The only other people who've had the procedure and spoken to me about it also experienced severe pain. "Slightly uncomfortable" to me is something like that reflex test where they scrape a pointy thing along the sole of your foot to make your toes curl: the phrase is no more applicable to my experience of cystoscopy than to childbirth. Contains Mild Peril (talk) 18:13, 17 February 2013 (UTC)[reply]
I'd go along with moderately painful, having had about 20 cystos under local only. But not excruciating.Bellagio99 (talk) 21:11, 17 February 2013 (UTC)[reply]
Note that the original post suggested that the statement of the range of sizes of cystoscopes was unreasonable, and likely inaccurate. The second editor commented that the average person can tolerate such scopes with only minimal pain or discomfort (eg not everyone can do so). Let's keep the discussion focused on the improvement of the article, and avoid getting sidetracked on criticisms of the health care system. Negative personal experiences are not relevant to our purpose here on wikipedia. Rytyho usa (talk) 02:27, 9 June 2013 (UTC)[reply]
Let's get back to the original question, the range in diameter of cystoscopes. To say: "from the size of a pencil up to 9 mm" is mixing apples and oranges. Pencils that I'm familiar with are about 7 mm in diameter (just did a measurement); so one improvement would be to say: "from about 7 to about 9 mm in diameter." However, the discussion throughout this talk page suggests that these numbers are not up to date. If there is no further comment on this matter, I propose to change this text to "usually from about 6 mm to about 9 mm, about the size of a pencil (pediatric cystoscopes are much smaller)." And BTW, I am not an MD but I am a patient, and have had about 20 cystos in the last 8 years. The very first one was quite painful. However, the second one and every time since has been perfectly fine, just a slight sense of discomfort. The difference, I think, was that I quickly learned to relax for the procedure.Ajrocke (talk) 16:16, 14 February 2016 (UTC)[reply]

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