'Going in through a place where things only go out': Relief and wrong-way traffic on a one-way street



It's not every day that a man has a camera snaked up his urethra. So, I thought, sitting alone in the small, brightly lit room, naked from the waist down, a blue blanket draped across my lap, this should be an interesting experience.

The nurse had said it would take about five minutes. For just a short time, I thought while waiting for her to return, a one-way street was going to have wrong-way traffic. Five minutes.

I exhaled deeply. It couldn't be any worse than the prostate exam I had last year.

Besides the pain in my ass that has cropped up twice, I've dealt with two other lingering, potentially serious issues since I was in San Diego in March 2016: frequent urination and weak stream.

It started on St. Patrick's Day, when I was having drinks with fellow conference workers. I drank a beer or two at one bar and peed before we headed to another. I felt the strong urge to pee again as soon as we arrived at the next place a few minutes later. That's odd, I thought. I have not had that much to drink. I relieved myself again and did not give it much thought as I left the bathroom. However, the need to pee returned again as soon as I rejoined my friends. Something was not right. I held it for a while before returning to the bathroom, a single, unisex room where I needed to wait in line for a few minutes. Unsettled, I called it a night and headed back to the hotel.

Starting that night, I peed a lot more often during my trip through SoCal and the Southwest. To make matters worse, I peed much less efficiently: My stream was weak, it took me forever to finish, and I was never relieved for long. After entering New Mexico, I visited the bathroom at a rest area just across the state line. Soon after hitting the road again, I was counting down the miles to the next exit with services, billboards for an upcoming truck stop teasing me every five or 10 minutes. I danced in the driver's seat and fingered my package through my pants to distract myself from the urgent need to go. Finally standing at the next available urinal, I peed for a surprisingly short time compared to the intensity of the urge. I washed and dried my hands, headed out the bathroom door, and felt the need to pee again.

Things did not improve after I returned home. It affected me off and on to varying degrees, but overall, I learned to live with increased frequency and decreased stream. Did I tell my doctor about it? Not for a while. I thought about it when I saw him for my first pain in my ass but did not tell anyone until last summer, when I decided it was finally time to have it checked. My dad had prostate cancer linked to Agent Orange, so it behooved me to figure out what was going on. I was referred to a urologist, and after initial consultations, sessions with a "high-tech funnel" (which is really a beaker sitting atop a digital scale, all beneath a white funnel stained yellow at the bottom), and medical confirmation that my stream "sucks," there I was yesterday, waiting patiently for a doctor to stick a camera into my bladder.

The technical name for it is cystoscopy. It was the next step in my assessment, a peek inside to see if an obstruction in my urethra was the culprit. A "stricture"—scar tissue caused by infection or trauma—could be restricting flow.

"Did they tell you anything about what's going to happen?" the nurse had asked after leading me into the examination room.

"The basics," I deadpanned. "You're gonna snake a camera up my urethra."

She gave me a knowing nod and smile as she took my blood pressure and temperature, conceding that there was no need to explain any more. "Some people don't understand why we're going in through a place where things only go out," she said. "The scope is only this big," she added, forming a small, four-sided star between the tips of her index fingers and thumbs. It still looked pretty big to me.

She left, I dropped trou, and she returned and prepped me with iodine-soaked cotton swabs (those did not go inside me) and lubricating jelly (but that did) as I reclined on the examination table. (Uncomfortable yet? Believe me, reading about it is much more comfortable than experiencing it.) The doctor entered, greeted me, and then got busy.

"Do you want to see what we see," he asked after inserting the camera. He turned the flat-screen computer monitor toward me.

"Maybe not right now," I replied, taking in the strange sensation of the scope running inside me. It did not hurt and was not awful, but it felt very, very different. However, once the doctor turned the screen, my eyes were drawn to the picture: a flesh-colored tube slowly passing by, bubbles appearing in front of the camera every now and then. It looked like something out of Fantastic Voyage.

The doctor's hands manipulated the scope, moving it back and forth and around, his eyes locked on the screen. "Ah," he said after a minute. The camera had reached scar tissue, a pale ring that narrowed the tube. "It doesn't look it will let us get past," he said as he pulled out the scope, "so I'm going to gently open it."

"Okay," I said.

"You like my choice of words there?" he asked.

I saw the nurse hand him a thick sheaf of long, orange- and red-colored switches of different widths. Some were thin, but others were thicker. He chose a thin one and stuck it inside me.

"We're going to start small and work our way up," he said, adding a thicker switch to the end of the first.

I gave a long "Hmmm" as I felt a strange sensation deep inside me.

"Do you feel it in your bladder?" the doctor asked. "It's like a tickling feeling."

It doesn't feel like tickling, I thought.

"Sorry," the nurse said. "I know I told you only five minutes."

I had no clue how long it had been, but the doctor's gentle opening of the scar tissue was making me uncomfortable. It did not hurt, but I did not like the thought of the switches inside me; thinking about what they were doing and where they were going made me light headed. For a moment, I thought I would faint, but I took a few deep breaths through my nose. The doctor used four or five different switches, and I was very relieved when he announced, "Last one," and then finished.

The scope went back in. The screen showed uninterrupted and wide tube where the scar tissue had been. Pieces of it remained stuck to the walls, waving gently in the fluid inside my urethra.

A deep "tickle" signaled the scope's entrance into my bladder, a large space with a light-yellow tint and veined walls. The doctor manipulated the scope, twisting it around to get a good look, and everything looked good in his opinion. Having seen enough, he slowly retracted the camera. "The best view is on the way out," he said as the flesh-colored tube passed in reverse this time.

When the scope came out, the nurse cleaned up some of the extra gel and covered me. Besides the scar tissue, the doctor said he didn't see anything else that could be causing my problem—exactly what I wanted to hear. "You should notice improvement," he said. However, the gains may not be permanent; the scar tissue would likely return in time. How long? He couldn't tell; it varies from person to person. There are options for a more permanent fix, he told me, but the stricture was not serious, not life threatening. "But I don't think you want to go through this every so often," he said.

I shook my head.

The doctor took off his gloves and threw them, basketball style, into the waste basket. He unplugged the scope from the computer as the nurse collected everything else. They left me alone to dress.

I sat on the examination table for a moment, gathering myself, my legs and groin wet with gel. I looked down at my package and thought of an anxious, whimpering dog at the vet's office, it's eyes asking innocently, "Why?" I felt very weird—the tickling of the scope and switches remained—but thankful and relieved.

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