Bladder biopsy with local anaesthetic

[Addictedtohotbaths1]

Has anybody had a bladder biopsy done with local anaesthetic?

I have the option of that or General Anasthetic but obviously the local will be over much quicker and less chance of complications from GA.

But... I have had a very traumatic birth plus complications from a surgery last year which meant I ended up with a catheter at home which I found terribly distressing and I'm freaking out that being awake for a pretty invasive procedure is going to trigger a panic attack or something..

Thanks in advance

[SomedayMyPrinceWillCome]

I've never had this procedure but I am a complete wimp & would opt for a general anaesthetic. I'd much rather be asleep & unaware of what was being done, even if it meant a few hours recovering.
Also, if they're offering a GA, I wonder if that's because the procedure is quite unpleasant?

[Addictedtohotbaths1]

Hi Someday, yes that crossed my mind if it was a completely easy procedure they probably wouldn't offer a GA?

[Haskell]

Please could I advise you not to do this procedure under local (actually a spinal block).
My DH had this last month. It was horrifically painful (and he has a very high pain threshold).
It was very upsetting for him.
He was in until midnight recovering too, so don't think the recovery is any quicker.

[Addictedtohotbaths1]

Haskell - sorry to hear your DH had such a terrible experience. I think it's much worse for a man due to anatomy??

[Addictedtohotbaths1]

They wouldn't give me a spinal block but Anasthetic on thing before it goes in eurethra.

[Haskell]

It wasn't the 'getting there' that was painful. It was the taking of material for biopsy that was excruciating.
Please have the general.
Why do you think they wouldn't give a spinal though?
The problem for him was that his spinal didn't work properly.

[flumpybear]

With a sedative then you may be able to talk to the surgeon during the procedure which may be helpful. Youll be numb so won't feel anything

[Addictedtohotbaths1]

Did he have a biopsy testing for cancer? Mine isn't testing for that so I think it's not as deep tissue hence the less full on anasthetic?

He said options were local Anasthetic or GA but didn't mention spinal.

Your poor DH that must have been awful, Is he ok now?

[Haskell]

Yes, I didn't realise there were different ways to biopsy!
The consultant described it to him as 'local' but it was a spinal block. Perhaps there's a proper local option too then?
But if the catheter is going to distress you, GA might well be better.
DH was recovered and only had a little discomfort the next day, and as you point out, him being a man, his discomfort was from having a bruised urethra to pee through, not pain from his bladder.
He's fine now, thank you, biopsies were all clear

[Addictedtohotbaths1]

That's a great relief for you both.

Maybe the sedative is a good idea? Does that make you feel out of control?

[Chippednailvarnishing]

Had it under a general.

Have the general, it wasn't nice!

[Haskell]

It's more like it numbs your reactions. I think it blocks short-term memory, so that you're not distressed by the procedure.
The anaesthetist will talk about the procedure as much as you want, I'm sure. All the ones I've met were very keen to ensure the patient was well informed about what would be happening so as to help keep them calm.
I know your previous procedures were traumatic, but there's no reason why this one would be. Do you have someone that can be at the pre-op with you, to advocate, and to make sure all your questions are answered?

[AbbeyRoadCrossing]

I've had both OP.
First one was local anesthetic down there - it wasn't a spinal. So had to keep still. It wasn't painful but I could feel it. I was quite nervous and was really worried about moving.
Second I had a general. This ended up being a good decision because a small operation was needed. I didn't know at the time but they were putting a camera in and saw a problem so all fixed in one go rather than coming back. Coming round I'd a strange sensation and a bit confusing but really it was fine.
Happy to answer anything I've forgotten
Hope all goes well

[PollyPerky]

It's very different for a man though because their urethra is long compared to women's. There is much further for the equipment to go.

OP- do you have IC by any chance or the possibility of it?

If so, (I was a long term sufferer) the newest treatment I understand is to treat symptoms, NOT mess about with invasive things that can cause more pain. I refused all those types of things under 2 uros and my lovely GP agreed to treat me with meds based on symptoms.

[Addictedtohotbaths1]

Haskel - my family are rubbish at being my advocate unfortunately.

Abby - can I please ask you, now you've had both which would you have if you had to do it again? Were there lots of people in the room and did they talk to you or ignore you?

Polly - not IC but sort of similar symptoms they think I have a mast cell disorder that's causing my bladder to thicken and be painful but they need to confirm with a biopsy before they can treat.

I think I'm going to ask for the GA I'm feeling really freaked out about it now.

Thanks so much for all your very helpful responses.

So far nobody has said take the local!

[PollyPerky]

Polly - not IC but sort of similar symptoms they think I have a mast cell disorder that's causing my bladder to thicken and be painful

I thought the point of a biopsy for IC was to find mast cells?
I found relief thru anti histamines that reduce mast cells.

[Addictedtohotbaths1]

Polly yes they are looking at what's going on with the mast cells (as well as confirming there is no other underlying cause of inflamation such as deep rooted infection) which will confirm if I have a systemic mast cell disorder which will mean a lifetime of medication to get my bladder symptoms and other issues under control, they said they cannot treat until they are certain of the diagnosis.

[Addictedtohotbaths1]

Sorry that should say multisystemic

[Unhappyhousehunting]

I have IC and have had one of these under GA. I wouldn't do it any other way to be honest.

[Addictedtohotbaths1]

Thanks Unhappy

[ILoveMyCaravan]

Reading this with great interest as I also have a bladder biopsy booked for next week. I am having it under a GA. originally the surgeon wanted to just look with a camera without GA but I refused due to previous traumas, so he agreed to a GA on the basis that he does a biopsy at the same time as he thinks I will need one in the future anyway and so gets both done in one go.

Really not looking forward to the recovery as I have suspected IC and think I will be in a lot of pain afterwards 🙁

[PollyPerky]

I thought the 'new' thinking on IC was to treat the symptoms and avoid anything that causes trauma? I refused investigations for that reason and thankfully my GP at the time prescribed drugs based on my history . All drugs for IC are trial and error and GPs can prescribe pretty much all of them. The COB foundation has lots of advice and support.

Good luck Addicted.

[ILoveMyCaravan]

Had the cystoscopy and biopsy yesterday. Surprised at how little pain I have today. Would definitely recommend a GA for this procedure. Urologist was amazing, was very gentle and gave me morphine and gentamicin whilst I was asleep, and iv tramadol in recovery which helped enormously. I pee'd a lot of blood afterwards but not painful just a bit stingy.

Hope everything goes well for you OP, wasn't half as bad as I imagined.

[Addictedtohotbaths1]

ILove thanks very much for updating and great to hear it went well for you. That sounds like a lot of pain relief considering under local it sounds like all you have is the gel?

Do you think you feel well enough to go to work today? I'm not planning any extra days off.

I've decided to go for the GA option and feel very relived at my decision!

Polly thanks for your good wishes - I will post back after in case it helps anyone else.

[ILoveMyCaravan]

Sorry that was meant to read that I DID have it done under a GA. Urologist said he would still use the gel even though I would be asleep and said he would be very gentle as he knows how much pain I am in normally and he was just trying to lesson the after effects.

Re work. You definitely won't be able to work or drive a car for at least 24hrs after a GA. I am off work today in bed as I keep randomly falling asleep and will be taking it easy for the rest of the week. I work from home anyway so it is easier to manage. Every nurse I saw yesterday kept offering me sick notes, so I think it's perfectly normal not to go straight back to work.