Can a Flexible Cystoscopy Check-Up be 'too gentle'?

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May appear an odd question, but there is some logic behind it. 

I have had (I think) 11 or 12 Flexible Cystoscopies, including the first one where Trevor was first seen. 

After most of these I have experienced discomfort, and a very frequent urge to dash to the toilet, and well as some tenderness / discomfort when doing a No 2 (I understand this can be a result of bruising near to the Prostate as a result of the camera going in, and then moving around). 

I accept that these side effects are unpleasant, but usually only last a day or so. 

However, during 2 of the most recent Flexis' I have experienced little, if any discomfort after.  This was after the most recent (assuming I have had 12, No 12), and No 9.   
On each of these occasions I experienced hardly any discomfort, and the examination seemed to be very quick. Both of these check-ups also did not find any Trevors hiding. 

This has set me thinking.  During check-up No 10, They found a smallish Trevor, hiding very near to the Urethra Opening/Prostate, which was not seen on exam No 9.  
Compared to exam 9, exam 10 felt it lasted a lot longer, and there felt there was a lot more pulling about as the Doctor appeared to be doing a very in-depth check, looking in every nook and cranny.  Afterwards I was in some discomfort for a few days.  

A TURBT after exam 10 (my 6th TURBT) could not find Trevor, and the thinking at the time was it may be detached itself, or possibly been knocked off as the Flexiscope was withdrawn. 

Flexi checkup no 11 was very similar to no 10, in that there was a lot of pulling around, and they found Trevor still in place, near the Urethra, but a little larger than previously.  He  played a game of hide & seek during this check-up, and kept disappearing behind the flexi-tube, and apparently withing folds in the bladder.  It book a lot of bending of the camera, and pulling around to finally get a good look at him. Once again, afterwards, I was tender for a few days. 

Trevor was located in TURBY no 7, and evicted, and the surgeon saw me after, and said it was tricky to find, but they had got him.  
Subsequently had a course of Mitomycin-C, and Friday had my 12th Flexi check-up.  

This check-up which set me thinking.  usually after a Flexi, I find the desperate urge to dash to the toilet, before I have even got out of the hospital.  
That never happened, and I am pretty sure was the same after check-up 9. 
Nor did I have the discomfort from previous exams, in fact after a couple of hours, it felt like I had not even had the procedure. 

I am now wondering if the Doctor who did exam 9 & 12 (which just happens to be the same one), is particularly gentle, and a master of his art, or if he is only carrying out a cursory look around, so not causing the bruising, and other irritations. 

Is a little worrying, as now have that niggling concern in the back of my mind that if he is the latter, Trevor could be missed if he grows back near the Urethra/Prostate and I have the same doctor again.  

Am I just reading too much into this? 

  • Hi JJ. some interesting thoughts. I have lost count of my flexis. I think it is now well over 20. For the first couple of years it was done by the same nurse who was brilliant and I had no discomfort. Since she retired I have had it done by many different doctors. Most were ok, but I have had the odd rough one. Had a few false alarms over the years. On one occasion we saw something that looked like a new growth. Rather than a TURBT they decided to do a double check a few weeks later. When I went back, there was nothing there. Overall I have coped well with these procedures. I have now been moved to annual checks which is a bit disturbing. I was quite happy with the reassuring 6 monthly ones. Best wishes.

    Best wishes to All,   rily.

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  • I completely follow the logic if that's any encouragement to you JJ. People often imagine bladders as a smooth balloon. But a friend with interstitial cystitis explained it is like one of the giant balloons that start out with lots of folded lobes, within which Trevors could well be missed.

    Denby

  • Hi All not posted for a while, I had 6th cystocopy on Monday thankfully all clear. Am now on Annual checks. The first one I had back in 2019 was agony the other 5 not so bad but I must admit I have found them all really uncomfortable. After my first cystocopy both the  nurse and doctor suggested I use a catheter twice a week after peeing to widen the opening sorry for the graphics! this has seemed to work and the cystocopy procedure is now just uncomfortable rather than agony. In all the checks they do seem to do a good look round..  Best wishes to all

  • Hi AllotmentP,Good to hear you are clear and that the catheter is helping.Best wishes Jane