Doctor told me we can do it one of two ways.  In his office with a "local", or at the hospital and "knock me out".  Have to have my urinary tract "checked out" and he has to look at my bladder from the "inside".  Has to insert a "scope" in through my penis.  Any words of wisdom?  How bad is this going to be with a local?  I told the doctor we'd do it in his office with the local.  Any experience that might want me to change my mind would be appreciative.  Thks

{cold sweat}

If insurance will cover it go to the hospital and get sedated. I had a 6mm kidney stone broken up with shock waves this past Monday while I was sedated. You nod off, you wake up, it's over, you go home.  

I'd definitely do a local over "knock out" any day.  There are times when people don't ever wake up, and I'd rather not have that happen to me personally.

God Bless Texas

Please do not confuse "sedation" and "general anesthesia". Sedation is like a short nap, while general anesthesia is more like an induced coma.
Maybe some medical types around here can give us some more info.

13f, email me and I'll help you out.  I administer anesthesia every day and can answer your questions.  Dennis

Go for the local anesthetic, cystoscope procedures are done regularly. And I dont recall one ever going under three component general anestheasia for it.

If the indication for the cystoscope procedure requires general anestheasia then do it that way. If not, I would not go trough the extra hassle of being intubated(sore throat afterwards) and nauseus afterwards from the painkillers and sedatives.

YMMV

Kuiper

Go for a local or epidural.  Also ask for some Pyridium (sp?) for the pain and irritation afterward.  Good Luck to you!

Go with the local. It sucks no matter which way you do it. I unfortunately speak from experience. It hurts like hell, and afterwards it still hurts, and it feels like you have to pee all the time. It lasts for (as I recall) almost 2 days. There is something to take, that helps a little, and it turns your pee a funny color. They sell it over the counter for urninary tract infections, and I would get some before you go so you can take it right afterwards.

13F--

1.  I have to agree with the others, take a local if available and you can stand it.  Even people with no history of surgeries go bad under general anesthesia (malignant hyperthermia is rare, but happens)--HOWEVER, in the last 5-10 years a couple of simple devices have dropped mortality rates by a factor of 10 or more (CO2 monitor on the breathing mask and a blood O2 saturation meter), so a lot of the "problems" you hear about with general anesthesia are from old anecdotes, not more recently.

2.  Even locals can have allergic reactions, but they are rare, and the office should have an anaphalaxis kit handy.  

3.  You ain't gonna care anyway--the Dr. is likely to give you Midazolam or Diazapam beforehand anyway to calm you down (basically Valium).  Tell him your concerns ahead of time, and your preference for the local.

AFARR

Well heck, if I'm going to get valium...[:)]  Seriously, I figured I'd take the "local" and deal with it.  Worst case scenerio it'll be over in "a little while".  Figured it's going to be a little rougher than the prostate exam he gave me!  Thks for the input.

Am I the only person here who has had a procedure done while sedated, as opposed to being put under general anesthesia? No tubes, no breathing masks, no nausea and no sore throat. Just a short nap and when you wake up it is over and you feel fine.
13f, if this is one of the options you are being offered I really think you should consider it. Why be awake when you could be having a short snooze?

B27, thank you for the input.  The impression that I received from the urologist was that if I choose sedation, I would have to go to the hospital, which I really would like to avoid (VERY MUCH!).  The urologist also mentioned that I may, or may not have difficulties (pain) with the procedure.  Please keep in mind, I don't know if the doctor had mentioned "sedation" or "general anesthesia".  I will ask him about that option though.  
Dennis, I did e-mail you, but I don't know if you rec. it because I didn't get a copy that I sent myself. Please feel free to offer your expertise.  Thks

"Knock you out" doesn't necessarily mean general anesthesia. Many patients undergoing minor (I know it's not minor to you) procedures receive a drug called Diprivan (also known as Propofol). It's a great drug with very little risk when properly administered by an anesthesiologist/anesthetist.
You go to "sleep" quickly and wake up quickly with no "hangover" associated with other sedatives.  
But it probably will mean a short hospital visit (outpatient). Good luck.

If he can do it under "conscious sedation" in the office with pulse ox and monitor then that will work OK.With Versed you won't remember,even if it bothers you.You will wake up and "say Ok lets do it"
If they won't use enough Versed then go to the hospital and go under.
cpermd
ps Propafol is nice too to crash patients with.
That is good,not bad
cp

Out of all those,pancreas will fuck you the most and most folks don't know what it is.
cpermd

 



13f, What you're going through RIGHT NOW is the worst part of all.

Millions of people go through it every year, often with fear or doubts about whether the right step is being taken, [i]they don't [u]want[/u] to know.[/i]  
But not us.
The same "need to know" that makes people great at spatial conception (& all "gun nuts") turns into a curse in this situation.
Not knowing [u]exactly[/u] what's involved, or what to expect almost always means putting yourself through as much grief as the procedure itself, & sometimes almost as much as the procedure will ultimately do away with.
The curse is that there's [u]never[/u] enough information for us, & there's not much you can do about it.

Your doctor will tell you whether the procedure calls for local anesthesia, but I've always trusted the anesthesiologist's opinion a little more on that part.
Anesthesia is an art (and science, of course) of relieving pain and keeping you safe and stable during any procedure. To someone already nervous about the impending medical procedure, the idea of being unconscious isn't a comforting thought (It's usually an unconscious fear of not regaining consciousness more that the fear of pain).  
Ask the anesthesiologist if anesthesia is recommended for your procedure, why, & what the side effects to expect (Hoople's right about the "drug hangover," I hate that!).
If there's any pain afterwards, it's always more of a "sore" feeling than outright pain (FWIW, they'll keep you out of pain).



JMO, [i]After breaking my stupid neck, my arm in 4 places, half of my ribs, wrecking my starboard kidney, my spleen, & part of my liver. After five surgeries my pancreas gave me the finger too (you need that thing!).
Isn't racing great![/i]

buh ba ba ba ba
buh ba ba ba ba
I wanna be sedated....

I was sedated for my hernia operation. From what I recall, I had a shot, passed out, only woke up when they wheeled me into the operating room. Woke up a couple of hours later. Real easy.

This year I had a vasectomy - local anesthetic preceeded by a valium. Didn't hurt, just  a slight tug, and the valium made me not care.

If it can be done with a local and valium, I'd go with that. Just make sure you have enough valium and you'll be feeling no pain.

I've had it done 3 different ways about 6-8 times during the past 2 years.  Just a bit of cream ahead of the scope to help deaden the sensation, in "happy land" when also taking photos, and knocked out when taking a biopsy.  All are fine...  you'll be fine.  No pain whatsoever with any of the 3 different ways.  Forgot to mention, some burning sensations for a day or two afterward whenever you take a wizz.  Find a doc with a cute assistant...  makes the entire adventure much more interesting.
W

**winces**

If there has ever been a bit of reading that has ever made me grab my peepee in a sort of defensive posture mode, this is it.

[:X*]

It doles out enzymes through the pancreatic duct into the intestine for digestion, and (insulin?) to control blood sugar.

I know that but most folks don't
Hep C is getting to be a bigger problem here than HIV
cpermd

13f
I didn't get a message but here goes.

Local anesthesia in the office cbe done for this procedure.  The urethra (passage to your bladder) is made lined with tissue that can be easily numbed with local anesthetic applied topically.  This is usually done by using a syringe like device and injecting lidocaine jelly into the urethra, placing a clamp like device on the penis which gently squeezes the urethra shut and retains the jelly for a few moinutes to allow it to work.  You may or may not be given some oral medication to sedate you
for the procedure which you would takebefore you went to the office. You would be awake and aware of what was going on.  You would still be able to feel pressure, and may have some discomfort depending on what else is needed.  
The real problem with sedation given in the office is the level of monitoring that is done. I would not allow them to give you anything IV for sedation in the office unless there is someone there to monitor you that is not involved in doing the procedure. You MUSt be monitored with pulse oximitry for your safety.

If you were to have this done in the hospital you have a range of options. You could have a general anesthetic, and unless they are doing something besides a cysto it should not be necessary, nor should an epidural or spinal anesthetic.  If I were having this done, or taking care of someone having it done i would have it done in the hospital. I would have local anesthetic with iv sedation. You would be monitored by an anesthetia professional, an anesthesiologist or nurse anesthetist. You would be given supplimental oxygen, and sedated if you wish to the point of not knowing what was goingon.  Most importantly whoever was taking care of you would be trained and equiped to care for you in the event that you were unable to maintain your own airway and breath for yourself.

The urologists at my hospital always travel around in a group and I get endless pleasure saying: "Here comes the(take your pick)"
                          1. Stream team
                          2.  Weenie genies.
                          3. Dick docs.
In one urology suite I once saw a tray that said: LONG CYSTOSCOPE.  I wonder what the quailifiations are make them decide to use that.  You could sure brag about getting that one.

Thks for the info dmuldrew.  I don't have a lot of "experience" with the medical profession (thank god), and usually when dealing with an "expert" (as in Doctor), my response usually is "well, your the doctor, what do you recommend".  On a side note, from what I gather from you're post, if they were to "sedate me", I would think that they would have a professional monitoring me, if for nothing else, for legal reasons.  Boy, am I really looking forward to this[:X*]

Again
Pulse ox and monitor and make sure they have resusc equipment and meds and you will be safer than you were driving there.

I had a cystoscopy done with only a local.  No biggie.  It's a little uncomfortable, but a lot of the discomfort is mental.  The idea of having a tube shoved up your peehole isn't exactly exciting.  There's no reason I can see why you would need anything more than a local.  Oh, and by the way, I'm a major wuss when it comes to pain and I was ok with it.  Just my personal experience.

SeMPer Fi

It'll hurt to pee for a day or two afterwards (to me, it felt like a layer of skin was getting peeled off by the stream);  just relax, you WILL heal fine.  Good luck.

I ususally tell people who are having sedation that they will not know the difference between it and a general anesthetic.  But to me there is a lot of difference. To you , you get sleepy, you wake up, the procedure is over.  
On the other hand you would be surprised how much sedation is given in offices and clinics without proper monitoring. Our journals are full of reports of mishaps.  The most important thing is MONITORING and the knowledge and skill as well as the tools to treat problems if they arise.  As with most things, problems are much easier to avoid if you are prepared. Good Luck