What can a Cystoscopy diagnose?

Hi Everyone,

I have not been on this site for a while. I hope everyone is keeping ok.

I have a couple of questions for you if I may:

I had my hysterectomy almost a year ago to the day. Quite soon after the surgery I started experiencing leakage of urine and discomfort down below. My GP said it was a "prolapse" of some kind and I can see a bulge down below too - he described and drew a diagram of a a rectocele to me. I was referred to the uro-gyane (who also did my hyst) who said it was not a prolapse but he could see a "healthy degree of laxity of the bladder"? (I do have Ehlers Danlos Syndrome which is a connective tissue disorder and my consultant for that condition thinks I am suffering from soft tissue laxity as well as general joint laxity).

In September I was diagnosed with Bilateral Duplex Kidney Systems (4 Kidneys and 4 Ureters). This was an incidental finding whilst checking for Gallstones and my uro-gynae says this wouldn't cause me the symptoms I am now having. In Feb of this year I underwent Urodynamics testing which showed Stress Incontinence and I also showed I had a very strong urge to pass urine at an early stage (around 250ml) when my bladder was filled up, even though my bladder was not showing signs on the graph of spasming?

Anyway, I have only just today had my follow up appt. I am still leaking daily and have some pain, although the major discomfort I originally had down below have eased to some extent. I think whatever prolapsed has now found a new position lower down (but that is only my pet theory). Becuase I am still symptomatic, I am now being scheduled for a cystoscopy under a general anaesthetic (so it will be day surgery).

My question is, "if" I did have any form of prolapse, would this be revealed during a cystoscopy? (I think my uro-gyane is trying to cover himself as I warned him about my connective tissue disorder before the hyst and he just dismissed my concern saying I may be prone to prolapses in the future). Also, will the procedure be able to show that I have 4 ureters be visualisng the openings into my bladder? I think this may have something to do with my problems too. My GP even said that sometimes after the hyst the bladder can shrink due to trauma, and as I have double the amount of tubing going into it, possibly draining at different times, this could lead to leakage and possible reflux back into the kidneys.

If anyone could help me out with these questions I would be very grateful.

Thanks,

Sue.

Hi Sue

Here is a link I think will give you some answers. It seems very informative. http://www.emedicinehealth.com/articles/6557-1.asp
When will the procedure be done?
I sent you a pm. I will be waiting to here from you.
Peggy

Cystoscopy is a procedure thats used to look for abnormalities inside the bladder. Such abnormalities include cancer, polyps, Hunners ulcers, irritation, inflammation, infection, etc.
I would assume that the Dr will be able to see the ureters emptying into the bladder, however I'm not so sure the Dr will be able to tell whether this is causing any of your problems. Such tests as an IVP would show more regarding that issue I do believe.
Prolapse is generally diagnosed by a pelvic exam as its quite obvious if the bladder is in its correct position or not--no special tests are usually needed for diagnosis.
After the cystoscopy you might find it a bit painful to void the first few times. You might even pass a bit of blood; this is normal. The painful urination and bleeding shouldnt last for more than a day after the procedure. I'm sure your Dr will give you instructions before sending you home. Patients can resume normal activity the day after the test (this is due to anesthesia..with in-office cystoscopy patients can resume normal activity immediately).
Also, this test allows the Dr's to be able to give immediate results (except for biopsy results) post-op.
stay well
diana

Thanks Peggy & Diana for your replies,

Diana - I have had an IVP already, that is how they diagnosed my Bilateral Duplex Kidney Systems. Apparently, Urologist looked at my results but I was never given a follow up so I don't know what else it may have shown.

I do still definately have a bulge down below, that becomes more prominent if I bear down or sneeze.

The gradual leakage I have throughout the day means that I start off dry on waking but by the end of the day my undergarments are quite damp with a distinctively shaped pale pink/beige stain on them. I have only had a couple of accidents when I havn't reached the bathroom in time after an urge to pass urine. I usually go to the bathroom about 15-20 times a day and get up 1-2 times in the night.

One time I tried putting a tampon in to see what happened and it came out soaking wet with a bright yellow colour on the tip. When this all first started causing me pain (around Oct/Nov last year) it felt like my innards were falling out or as if I had a tampon half in and half out of me. I am pleased to say that feeling has worn off but I do still get the odd shooting pain low down on the right hand side and a stinging feeling as if it is coming from inside my vagina.

When I first saw the uro-gynae I had already completely emptied my bladder to give a urine sample but when he pressed on my bladder I nearly leapt from the couch as I thought I was going to wet myself? Also immediately after the urodynamics test, when my bladder had been emptied - it was filled to the point were they made me wet myself at around 350cc and then completely drained - I needed to go to the loo again and passed quite a lot of urine. I still wonder if it is something to do with having double the amount of ureters draining into the bladder?

I think that they are going to hyperdistend my bladder as well and that is why they plan to do it under a general. The consultant said as I was experiencing such a sense of urgency when my bladder was just filled up normally I would not be able to cope with it being filled to such a high volume whilst awake.
Other than that, she didn't tell me what they were going to be looking for, but did say they are going to put me on some tablets that should help with the urgency/frequency - she is going to write to my GP about that so I don't know what the name of the tablets is?

One last thing. When I went in, she asked me how the physical therapy was going? I said I hadn't been given any and she seemed confused. It looks as though I should have been having some specialist therapy or biofeedback since I had the urodynamic tests in February, but no-one ever arranged it for me. This is so typical of the treatment (or lack thereof) I have been getting lately, due to the fact that the hospital has lost a load of my records. Amongst other things, I had an Echocardiogram at the beginning of April and until this Friday, the results of that had been missing from my file. Patient records have now assured me all my missing notes have now been found, so hopefully these notes will still be there when I go for my follow up in July about the Echo.

Sorry to go a bit off topic, but I needed a bit of a rant.

Take care all.

Sue.

Hi

You US ladies are so lucky having anethesia to do your cystoscopies, I didn't get anything at all just shoved the thing straight in and I went through the ceiling. They didn't even use any kind of lube either. I was in a bad way for 5-6 weeks. And the cheeky urologist had the gall to write to my gp and say I felt the procedure uncomfortable. I told my gp that as long as I live there will never again be anything going in to my urethra.

I'm nearly 16 weeks post-op and have a bladder prolapse now.

Carol

Hi Sue, I hope this helps. I had a cystoscopy a little over a month ago and what mine showed was stress incontinence and yes it did indicate a slight prolapse. My cystoscopy was done in the Drs office without any pain meds whatsoever, but I guess all Drs are different. Honestly it really isn't bad at all and hopefully after its done you will get some answers. I wish you all the best. Melanie