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QUESTION: I went to see a urologist to determine the cause of burning in my penis and anus and he performed a prostate exam on me (I'm 33), and didn't really mention anything about any possible findings from that, and so he told me that in 2 weeks he would perform a cystoscopy on me to get a good look into what might be causing issues. I am looking over the forms the varies people in the office gave me before I left and I received another healthcare proxy form and a form asking that I confirm that the doctor told me the risks involved with the procedure. Honestly he told me we'd just do the procedure in two weeks and meet again 4 weeks after that. He said nothing regarding risk. This procedure is classified as surgery? Is there ever any great risk when doing this? just shoving a thin fiber optic camera into my penis and looking around, right? All this proxy business is making me paranoid. Also I think i would feel shame having to tell family members about my penis pains, and why they need to sign a proxy for me.

ANSWER: James:

A cystoscopy is technically classified as a surgery.  While the risks are minimal, there are some.  It could be uncomfortable or even painful.  It could initiate an infection or cause bleeding and possibly scar tissue later one.  These risks are relatively minimal and usually easily treated, but that's not the same as no risks.  

The scope isn't exactly "shoved".  It has to be placed gently and carefully.  A lcoal anesthetic gel is usually used to minimize discomfort and it's usually far less painful than most people would think.

I have no idea why anyone needs to have a proxy sign for you.  At 33 you should be able to sign for yourself.  You should not sign anything until all your questions are answered.

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QUESTION: I would be awake for the whole procedure? There is no reason I'd loss awareness needing someone else to make decisions for me? Well the proxy isn't required by law, but I am just concerned that someone somewhere must think this procedure is risky enough that I should be aware of my rights.

Scar tissue inside of me or external where they can be seen?

Is this procedure the primary way urologists learn about what is causing issues?

He put me on Phenazopyridine for the pain, but actually it seems to increase the pain to some degree. I had pain when trying to poop earlier, and for the most part it doesn't make the pain that much better. Also I am dying my underwear orange because of it. When a medication says. "...If needed" should I assume that I don't require it if I feel better without it? Also it says 3 times daily. Could I in this case of a pain killer just take 2 daily until they're gone?


Patients are usually awake for the procedure.I don't see any reason you would be unable to make any decisions and I have no idea why they require a proxy.  
Scar tissue would be inside which is why they need to take a look inside.

Cystoscopy is the primary diagnostic procedure in urology.

I don't see how phenazopyridine would increase urethral pain.

Regarding how to take the medication, you should ask your physician to clarify the instructions.  


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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