BPH

[gott1936]

I am 72 years old. I recently had a urinary passing of blood and blood clots. Since than, except for traces of blood in my urine I feel great. Yes, my enlarged prostate does affect voiding of my bladder a little. My urinologist wants to perform a cystoscopy on me. At 72 years old, does it make any sense to subject me to the possible complications this procedure could create?

[Planetoid]

I can't think of any reason why your age should effect this decision; it is a relatively minor procedure. The cystoscopy will allow your doctor to get a good look at your urethra, prostate, sphincters, ureters, and the inside of your bladder, and may reveal the cause of your bleeding, or other concerns. I've had seven cystos and most were nothing more than a minor annoyance. They can be a little uncomfortable on insertion of the scope, but other than some minor burning with the first few voids after the procedure, the only other issue was to pass a few small blood clots.

[gott1936]

Planetoid, thank for your response, but you did not mention any of the complications that can be caused by a Cystoscopy precedure. Some studies have indicated, although rare, that occurance of urethral stricture can happen following Cystoscopy or other urethral procedures. Also, bladder neck contracture can predispose to a subsequent stricture following Cystyoscopy.

[gott1936]

Planetoid, I was hoping you would response and tell that my concerns of complications from a cystoscopy were nothing to worry about. I believe, once you reach 70 years old , you should not mess with mother nature just to obtain 4 or 5 more years of life in extreme pain. If I was your age I would feel differently.

[Planetoid]

Sorry, but I cannot tell you that your concerns are not valid, I'm not a physician. I can only tell you that I have not experienced any significant post-procedure issues in seven cystoscopies (other than the basics of short term burning and passing a couple of clots). As to the greater risks of cystoscopy that you mention in your posts, you seem to be far more knowledgable than I, so I won't dispute your claims; again, I can only tell you that I have not experienced such complications, nor do I recall ever being warned of some of them. Does age make a difference? Probably; it does with most medical procedures, as healing is often more difficult for us as we age. Ultimately, "the choice is yours," and I am simply making my personal experiences available for your consideration.

[gott1936]

Planetoid, Thank you for your response. I would imagine that urologist, because those complications I identified are rare, would not mention them to their patients. Maybe they should? Anyways, I got my information from the following medical centers, etc.
American Urological Assoc. Interstitial Cystitis Assoc.
Prostatitis Foundation NIDDK
Mayo Clinic Stonybrook Medical Cemter
OHSU Doernbecher Saint Joseph Hospital ( Altanta )
John Hopins Health Alerts And many others.

And, I did not mention all of the complications. At 72, the one that really concerned me was a preexisting condition that is functioning could be aggravated by a Cystoscopy.

Again, thanks.

gott

[gott1936]

This is an update for those who might be interested. I have postponed my cystoscopy for two months. My urologist was understanding, but he said once an event, gross hematuria occurs, even if it is a onetime event, he is required to perform a number of test to try and determine what happened or he could face civil action,etc. Facts at the time of this appointment, two months after gross hematuria, were: No blood in urine and PSA test results was 1.4. Also, the only symptoms I have is a slow urine flow. No urine retention. The test he says he should perform are a cystoscopy, ultrasonic, MRI and/or CT. Unfortunately, my bladder neck is 72 years old and I do not want it bruised or aggravated by a cystoscopy which can happen.
gott

[gott1936]

I was recently browsing through the website " Annals of Internal Medicine " and saw a study by the U.S. Preventive Services Task Force. While it does not mention Cystoscopy, Its concerns address males in there 70's. This study says, " Good evidence indicates that PSA testing can find prostate cancer, however, for men younger than 75 years old, no good-quality evidence shows that finding prostate cancer by screening rather than WAITING UNTIL SYMPTOMS DEVELOP leads to fewer men dying of the disease. For men 75 or older, the benefits of finding prostate cancer by screening are small to none. Good evidence indicates that treatment of prostate cancer found by screening can cause harm, such as sexual dysfunction, bowel and bladder incontinence, and even death. Other harms from screening include pain from prostate biopsy and worry about test results ".
I know you are asking, what has this to do with cystoscopy? Well, some of the complications that can occur from a, so-called, simple cystoscopy search are incontinence, infection and future strictures.
Any comments?