As a guy, there are probably few medical procedures more cringe-inducing than a cystoscopy – when a urologist uses a scope to look up the urethra and into the bladder.  Having just gone through the process myself, I decided to blog about this private experience.  Why?  Because people, especially men, have a tendency to not get medical issues checked out when they are worried about an uncomfortable test, and because the overall experience was much worse in my mind than it ended up being in reality.

Let me go back to the beginning…

A couple of months ago, my wife and I applied for some new term life insurance.  As part of this process, we were asked to give a blood and urine sample.  About one month after the test, I was called by the examiner to give two more urine samples, though she could not say why.  A few days later I received a letter from the testing company saying that they had found a small trace of blood in my urine.  The amount was so small it could not be seen with the eye, but under a microscope there were definitely red blood cells.

Blood in the urine can sometimes be an indicator for a larger problem.  Kidney stones are most common, but it can also mean bladder cancer or other issues.  It’s no joke – if there is blood in your urine, you need to get checked out.

So I went to the doctor, and they did another test.  At this point it was approximately one month after my initial sample, and sure enough, there was still blood detected.  hematuria is the technical term for it.  She referred me to a urologist and told me they would likely need to scope to take a look.

Two weeks later I had my urologist appointment.  At that appointment, they did yet another urine sample, once more found the trace of blood, and at that point scheduled me for a CT scan of the kidneys (to check for stones) and a cystoscopy (to check for bladder cancer and other internal issues).

Over the month between when my doctor told me I’d likely need scoped and when the procedure actually took place, I did quite a bit of looking online as to what was involved. Responses ranged from “uncomfortable” to “excruciating”, and at that point I just wanted the whole procedure over with.  To be honest, if it wasn’t for the fact that I feel that ignorance is just rolling dice with your health, I would have been tempted to not go through with it.

After Steve Jobs died last year, it was reported that he waited nearly a year between being diagnosed with cancer and having it operated on due to a combination of hoping it would just go away and feeling like surgery was a violation of his body.  He later said that he regretted that decision.  On the chance that there was something bad going on, I did not want to look back later and regret not getting it taken care of due to worry over a procedure.

The day of the procedure finally came.  I was told not to drink or eat for 4 hours prior to the procedure, and since it was schedule for 9:30a, that was not much of a problem.

First up was the CT scan.  A nurse took me back, had me drink a full glass of water, and then explained that they would be putting an IV in.  The IV would be used to inject a contrast dye into my blood part way though the scan.  The scanner they used was more of a donut, not a tube like I’ve seen on TV, and it looked a lot like this one:

They had me lay with my feet towards the scanner.  I was told I could keep fully clothed, though they had me push my jeans down to my knees but keep my underwear on.  I was given the IV for the contrast dye.  They first tried with my left arm, and while the needle insertion was very smooth, the nurse was concerned that it was too close to the skin.  Apparently the dye can be very painful if injected into the skin instead of the bloodstream.  She switched to my other arm, and while the needle itself hurt more this time, she didn’t see any issue.

The tray slid me into the scanner, an automated voice gave me commands as to when I should hold me breath and release, and it scanned two or three times.  The nurse then came in and injected the contrast dye.  It was a very odd sensation, warming my entire body from head to toes.  They ran me through the scanner a second time, had me wait 8 minutes during which time the IV was removed, and then they ran me through a third time.

That was it for the CT scan – I was sent back to the lobby and up to my urologist.

(I’m going to go into a bit of detail here – this way people know what to expect.  I’ll try not to be too graphic.)

At the urologist’s office, I was taken back to a small exam room.  I was told to remove my pants and lay back on an exam table with a foot rest that came up.  The nurse used a needle-less syringe to inject a cold anesthetic gel up into the penis.  While not painful, exactly, it was a bit cringe-inducing feeling something go up “the wrong way”.  The nurse then left and told me the doctor would be in after a few minutes.

Time passed and I couldn’t help but think “here I am, soon this will be over.”

The doctor came in and showed me the CT scan results from earlier.  My kidney were clear – I had no kidney stones.  He then proceeded with the cystoscopy.  A flexible scope was inserted up the penis (I did not watch – I didn’t care to).  Due to the anesthetic, this wasn’t painful other than an odd interior stinging feeling for a moment and a general “this does not belong” feeling with the movement.  That was just a couple of seconds, and then he said “this is the worst part” while liquid was pushed up into my bladder (this is so they can see inside better).  That stung a bit more as well as gave the sensation of needing to urinate, almost as if you were going but without anything coming out.  Again, just a few seconds.  He then said “a quick loop around” where I felt an odd twisting in the groin followed by “that’s it”.  It was out, and the whole process took maybe 30-45 seconds.

“That’s it?” I asked?  “Yeah, it’s pretty quick,” he replied.  “Wow, that was much worse in my head.”

He found no issues in my bladder.  I asked him if that was the case, and with there being no kidney stones, what is causing the trace of blood in the urine.  Basically, it just happens some times, but it’s best to check it out in case it is something serious.

I was told to drink lots of water and that urinating would initially be mildly painful (burning/stinging) but that the more I went the better it would get.  From my understanding, it feels somewhat similar to a bladder infection.  While the first time stung a bit at first, it did not hurt nearly like I expected, mainly at the point of “catch” if that makes any sense.  By the third time, it was barely noticeable at all.

So there you have it.  All in all, the procedure was FAR worse in my mind than in reality.  If the choice comes down to going through a cystoscopy or ignoring a potentially very painful or fatal disease, do yourself a favor and get the cysto.  I can pretty much guarantee you it’s worse in your head than in reality.