This in-office biopsy, lazar out and cauterization is another good subject for the topic Let’s Talk Turkey and can be very informative for newby's. I have finally found a urology practice than can and does do office procedures. Take this from my seven year experience with recurrent bladder cancer and also some spots that just fell apart or were too little to send to pathology. I encourage all to find a urology practice that can do in-office procedures. There are times during a cystoscopy when something is seen that can be identified as a low grade small recurrence that is easy to zap or sample right in the doctors office. Through my years involved in the email Acor discussion group part of bladder cancer web café, I intially heard from some others who have had that done in the office and feel the same as I do. They would rather have a bit of a pinch of pain from the wide awake in office procedure. Consider this: Those urology practices that are not equipped to do that type office procedure have you reschedule for a hospital or surgical unit date to put you asleep. Not only must you reschedule but you must first go through all the time consuming pre-op tests such as blood tests, EKG, chest x-ray BECAUSE you are going under anesthesia which greatly increases the risks to us of unrelated increased complications. Remember your pre-op paperwork stating all those unsavory and threatening things that could happen to you because of the anesthetic. - including death. I don’t concur with the reasoning that lying still is the best reason to be put asleep. Rosemary just said a leg and movement can occur even under anethestic. We are not put asleep when we have dental work done like deep cleaning or gum scraping or root canals. Remember the dentist saying now your going to feel a little pinch? I know there are those with a low tolerance for pain who would rather go through reschedule, pre-op tests, chance the complications that could come from being put under but given a choice, I would rather take the little pain of the in-office procedure. My seven year history and four TURB’s have shown me that office ability would have saved me lots of time and worry.
Actually, concerning the subject of anesthesia...... I have gone back and remembered my 4 biopsies, and now remember that two of them were during TURB's and therefore being asleep was aready a given, amd the other two were with spinal blocks while dozing under the twilight drug in outpatient services. I have never had a biopsy while awake and in the examining room.
I remember now that my tumor was situated very close to a nerve and my leg kept jumping and that is why the doctor had so much trouble getting a good muscle specimen. I did not know that your leg could jump even when you are asleep and under General Anesthesia....
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006
Remember all any of these hospitals the teaching hospitals with these consent forms as I said that one here I never saw a form that looked like that they all have front doors that you walk through and they have the same doors that you can walk out if you don't like what you see just my opinion. Joe
At my last cystoscopy the urologist took a biopsy... but I was wide awake and chatting with him at the time... Is it normal to be sedated during a cysto/biopsy??? It was negative thank goodness... I would love to be in LaLa land during a cysto... ugh!!!!
I've had my share of cystoscopies and painful urethral dilations with no sedation and only lidocaine gel to dull the pain... but biopsies without anesthesia :o
The lidocaine gel doesn't anesthetize the inside of the bladder. A biopsy involves cutting into tissue. How can you do that with no anesthesia?!? If there were a local anesthetic that worked well enough, I'd be fine with being awake, but nobody pinches me inside my bladder without anesthesia. My old urologist did that once in his office after he got his "new toy" and I told him never to do it again. And he didn't even get an adequate specimen. I asked my new urologist and he said they never do bladder biopsies without anesthesia.
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...
Is it normal to be sedated during a cysto/biopsy??? It was negative thank goodness... Have had two TA G1 surgeries... I would love to be in LaLa land during a cysto... ugh!!!!
There is a risk of a person jumping or moving during a biopsy, so it's common to knock people out for it. I do know of many people who are wide awake, usually those with frequent recurs of Ta,G1 tumors that can be safely lasered in the outpatient setting.
Your uro must have a very well-equipped sugical suite?