During this procedure, your urologist views the inside lining of the bladder using a rigid or flexible cystoscope. Cystoscopy is performed through the urethra which is the tube that carries urine from your bladder to the outside of your body. Cystoscopy may be performed for various reasons but the most common reason is to rule out any bladder pathology that may be causing blood in the urine. The following are other possible symptoms that would require a cystoscopy:
- Frequent urinary tract infections.
- Blood in your urine (hematuria).
- Urinary Incontinence
- Unusual cells found in a urine sample.
- Persistent pain when you pass urine.
- Difficulty in passing urine (which may be due to prostate enlargement or a stricture (narrowing) of the urethra).
What Happens During a Cystoscopy?
Cystoscopy is done in the office on an outpatient basis.
You will be asked to lie on your back on the exam table. The opening to your urethra and the nearby skin will be cleaned. Some ‘jelly’ is then squirted into the opening of the urethra. The jelly contains a local anesthetic to numb the lining of the urethra. This helps the cystoscope to pass into the urethra with as little discomfort as possible. The doctor will then gently push the cystoscope up into the bladder. The doctor will look carefully at the lining of the urethra and bladder. Sterile water is passed down a side channel in the cystoscope to slowly fill your bladder. This makes it easier for the doctor to see the lining of the bladder. As your bladder fills you will feel the urge to pass urine which may be uncomfortable. A cystoscopy takes about 5-10 minutes.
Depending on your urologist, the cystoscope may be attached to video equipment that will allow the doctor to view the inside of your bladder on a TV monitor. The cystoscope is then gently pulled out. Your urologist will explain what they saw inside your bladder. You will be given 1-2 days of antibiotics for infection prevention.
Penile Doppler Ultrasound is a procedure that is used to predict the response of your erectile dysfunction to vasodilator medications. It allows the urologist to determine and document if you have an inflow or outflow type of erectile dysfunction. Erectile dysfunction has many etiologies. Some respond well to vasodilator drugs and some disease such as arteriosclerosis, high blood pressure and diabetes exert their effects on blood vessels throughout the body, including the penis.
If your disease causes an inflow erectile dysfunction, overtime or when you present to our office, the vasodilator drugs may not be able to dilate the arteries feeding the erectile bodies.
If you have a severe outflow erectile dysfunction then any therapy that causes an increased inflow during erection may not be adequate for maintaining erections hard enough and/or long enough for satisfactory intercourse. Depending on the severity, these outflow problems may only be treated adequately with penile prosthetics.
The ultrasound study proceeds as follows:
You will be lying on your back on the examining table. A penile injection will be performed to provide the penis with a medicine that causes increased inflow by vasodilating the penile arteries. Once this is accomplished at timely intervals (5 and 15 minutes), an ultrasound of the cavernosal arteries of both sides of the penis will be performed. To do the penile Doppler study, a probe is lubricated and placed on the penis. There is no pain involved. You may experience a very short, mild discomfort initially during the penile injection.
Please tell the doctor if you are allergic to alprostadil or any other drugs
Please inform the doctor of any prescription or nonprescription medications you are currently taking.
Please inform us if you have ever had anemia, bleeding disorders, sickle cell disease, leukemia, cancer, kidney or liver disease.
If you have a penile implant, alprostadil should not be used.
Side effects are not common but may include:
- Erection lasting more than 4 hours
- Redness, swelling, tenderness or unusual curving of the erect penis
- Nodules or hard areas on the penis
- Pain on injection