How do they numb you for a cystoscopy?

For a rigid cystoscopy: you're given an injection of general anaesthetic (which makes you fall asleep) into your hand, or a spinal anaesthetic (which numbs the lower half of your body) into your lower back.

nhs.uk - What happens - Cystoscopy - NHS

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Anyone can have either type of cystoscopy. Ask your doctor or nurse which type you're going to have if you're not sure. Both involve passing a thin viewing tube called a cystoscope along the urethra (the tube that carries pee out of the body) and into the bladder, but they're done in slightly different ways. There are 2 types of cystoscopy: a flexible cystoscopy and a rigid cystoscopy.

Flexible cystoscopy

A flexible cystoscopy is where a thin (about the width of a pencil) and bendy cystoscope is used. You stay awake while it's carried out.

Preparation

You'll be sent instructions to follow before your appointment. This will include advice about eating, drinking, and what to do about any medicines you're taking.

You can usually eat and drink as normal before a flexible cystoscopy.

Before the procedure starts, you'll be asked to undress from the waist down and put on a hospital gown. You may be asked to pee into a container so it can be checked for an infection. The procedure may be delayed if a urine infection is found.

The procedure

For a flexible cystoscopy:

you lie down flat on a special couch

your genitals are cleaned with an antiseptic and a sheet is placed over the surrounding area local anaesthetic gel is applied to your urethra to numb it and help the cystoscope move along it more easily the cystoscope is inserted into your urethra and gently moved down towards your bladder water may be pumped into your bladder so your doctor or nurse can see inside it more clearly – you may be able to see images sent to a monitor by a camera in the cystoscope The cystoscope is usually removed after a few minutes. A nurse will stay with you throughout to explain what's happening.

Does it hurt?

People often worry that a cystoscopy will be painful, but it does not usually hurt. Tell your doctor or nurse if you feel any pain during it. It can be a bit uncomfortable and you may feel like you need to pee during the procedure, but this will only last a few minutes.

Afterwards

After the cystoscope is removed, you may need to go straight to the toilet to empty your bladder before changing back into your clothes. Your doctor or nurse may be able discuss the results of the cystoscopy shortly afterwards. But if a small tissue sample was removed for testing (biopsy), you may not get the results for 2 or 3 weeks.

You can usually go home shortly after a flexible cystoscopy.

Read about recovering from a cystoscopy for more information.

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Should I see a urologist if my PSA is high?

Ideally, PSA levels should be below 2.5. If it rises above this level, it should warrant close follow-up, or, at the very least, a referral to a urologist. While a PSA level greater than 2.5 does not mean a man has prostate cancer, it does mean the level warrants further investigation to see if it remains elevated.

upnt.com - Elevated PSA Diagnosis and Treatment

An elevated PSA can cause anxiety.

Men often worry that an elevated PSA means they may have prostate cancer. Fortunately, only 25-30 percent of men with a PSA between 2.5 and 10 will be diagnosed with prostate cancer, and the majority of those men will have very early-stage cancer. While some criticize PSA screening, it's important to know that prostate cancer deaths have declined 44 percent since it was introduced in 1991. Today, it continues to remain the best way to detect prostate cancer. The PSA is a simple blood test that measures the amount of a specific protein—prostate-specific antigen (PSA)—in a man’s bloodstream. PSA is a protein molecule produced not only by prostate cells, but also by prostate cancer cells. PSA protein should remain in the prostate and within ejaculate where it helps liquefy semen and break down other proteins to help sperm live longer after a man ejaculates. A small number of PSA molecules can leak into the bloodstream, but when a PSA level is higher than normal, it may be a sign of something more serious happening in the prostate.

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