So I enter the treatment room and what can you do but go with the flow? You are in the hands of people who do for a living what you’ve never had done to you before. ‘Name?’, ‘Date of birth?’ ‘Hospital Number?’ ‘I’ll take that.’ She takes my plastic bag of clothes from me and puts it to one side. ‘Take your gown off please and lie on the bed.’ I give her my outer gown and she hangs it up. ‘Now open your surgical gown at the back and sit on the bed here (pointing to a small square soiling sheet) and bring your legs up. I then ask the question most uppermost in my mind at that moment. ‘What about my slippers?’ ‘Just leave them there, I’ll sort those.’ I open the gown at the back and sit on the small square sheet and bring my legs up and lie down. I am aware of two nurses present, one by my side who has been directing me thus far, and one away at the foot of the bed, glancing up at a monitor up to my left. I then notice a monitor to my right which is meant for me to see what is going on. A female consultant approaches and introduces herself and briefly explains what she is about to do. She then catches me completely unawares by saying that she would like to do a rectal examination. I’d had one done at the doctor’s surgery before, but I wasn’t expecting another one now. When I showered in the morning before coming for the cystoscopy, I cleaned myself thoroughly around my genital area, making sure that my penis was absolutely spotless for the anticipated procedure. I had washed my bottom as usual but didn’t go to any extra lengths at making sure I was thoroughly clean there, and since then I had been to the toilet anyway. So suddenly I was acutely embarrassed at the prospect of presenting myself in a soiled condition as I was told to lie on my side, bring my knees up to my chest and almost immediately felt a prodding thrust as the consultant inserted a finger into my anus. After just a moments manoeuvring, she withdrew her finger saying ‘Yes, that’s ok, all good up there.’ I lay back on the bed and with no time to recover any dignity, the consultant pulled the surgical gown up to expose my genitals. It was now just a matter of head back, give myself over to what was to happen and trust. After a little while she said she was going to apply some anaesthetic gel and that it might feel a bit cold. I felt her get hold of my penis and roll back the foreskin, and something was put on, but I couldn’t see how or exactly where, and whatever it was, it didn’t feel particularly cold. I had done a bit of research on cystoscopies beforehand and I was expecting there to be a pause of a few minutes for the local anaesthetic to take effect, but no such thing. Almost immediately she inserted the cystoscope into my urethra. Straight away there is a peculiar sensation which I have never in my life felt before, and although it is not painful in a sharp, stabbing sort of way, it is a prolonged, compressing pain that I am struggling to deal with. I am amazed that I stayed on the bed. It got to be excruciating. Knowing full well from my research what it was, I nevertheless asked if it was a flexible cystoscope being used, because it felt like a coat hanger was being inserted into me. I got two ‘Yesses’ and a nod that it was. Meanwhile, the nurse next to me, who had all the time been trying to reassure me and distract me by asking questions about what I was going to do for the rest of the day, as though we were idly chatting at a bus stop, suggested I look at the monitor to my right to see what was going on. I had to politely reject the suggestion, saying to her something along the lines of, ‘I’m sorry, please, please,’ but no other words came out. She however, then fell silent as she could see I was focussed on trying to manage the pain. The consultant then said, ‘Well done’ and then the pressing pain, whilst still a very present factor, subsided. I only realised later that the difficulty had been in passing the cystoscope past the prostate, which was already enlarged (Benign Prostatic Hyperplasia), thus narrowing that part of the urethra that it was wrapped around. I duly looked at the monitor and there I could clearly see a reddish patch in the lining of the bladder. The consultant said that this would require a further cystoscopy for a biopsy, but that it would be done under general anaesthetic. I was both anxious and relieved at the same time. Before another word was said, I hardly noticed the cystoscope being withdrawn from the bladder and my penis and in the next minute I am being ushered off the bed, given all my stuff back, put my slippers back on and directed to a side room to wash and dry my genitals and get dressed. I’m then free to leave the department with my wife, who is eagerly asking me questions on how it went, but as I mumble some details, the only thing on my mind is the image of the reddish patch in the lining of my bladder.
