A Routine Procedure living with Chronic Pelvic Pain, what you need to know about it when living with Bladder and Bowel endometriosis, pudendal neuralgia and myofascial pelvic pain diagnosis’s.
If you have either of the above you may struggle with your bladder, trouble voiding from two to five minutes at a time with normal urges to pass urine and painful urination follow you intuition and see your Doctor for a referral to a Urologist Specialist to have this investigated.
A rigid cystoscopy with hydrodilatation is often described as a relatively straightforward urological procedure. For many people, recovery is uncomfortable but manageable. Most people are sedated for a rigid cystoscopy due to discomfort and pain.
But when you live with endometriosis involving the bladder and bowel, pudendal neuralgia, and myofascial pelvic pain syndrome, there is no such thing as “standard recovery.” Don’t allow this to be passed off as the run of the mill procedure if you do have chronic conditions like above.
This is my experience both the medical reality of the procedure, my doctor passed it off as it’ll be fine and it wont hurt to much. (he is an amazing doctor just reassuring me Im sure) but its different for me, what it’s like when your nervous system is already living in survival mode, flared ups and inflammation can absolutely make a straight forward procedure painful and with rest and recovery, pain medication and a heat pack or five can calm this till it settles eventually.
What Is a Rigid Cystoscopy and Hydrodilatation?
A rigid cystoscopy is a procedure where a urologist inserts a rigid, telescope-like instrument (cystoscope) through the urethra into the bladder. Unlike flexible cystoscopy, this is typically done under general anaesthetic or heavy sedation, especially when combined with hydrodilatation.
Once the cystoscope is in place, the surgeon can:
Inspect the urethra
Examine the bladder lining
Look for inflammation, ulcers, bleeding, scarring, lesions, or endometriosis involvement
Assess bladder capacity and structure
Following this, hydrodilatation is performed.
This involves filling the bladder with sterile fluid around 1 litre, under controlled pressure and this starts stretching the bladder walls beyond their usual capacity. The bladder may be filled and emptied multiple times. This stretching can:
Help identify bladder pain syndrome (such as interstitial cystitis)
Reveal subtle inflammation or bleeding not seen when the bladder is empty
Temporarily reduce pain and urgency symptoms for some patients
In simple terms: it’s both diagnostic (to find answers) and therapeutic (to try to relieve symptoms).
Why I Had This Procedure
I underwent this procedure due to significant trouble voiding, difficulty emptying my bladder properly, hesitancy, burning, and worsening symptoms during inflammatory flares.
These symptoms are often triggered or intensified when:
My pelvic inflammation increases
I’ve had another intervention, such as a pudendal nerve or myofascial block
My nervous system is already overwhelmed by pain
In my case, I had a pudendal and myofascial block just one week prior, meaning my body was still recovering when I went into another invasive pelvic procedure.
Walking Into Surgery With Anxiety and pelvic pain.
I arrived at hospital deeply anxious which isn’t my style but I had never had this procedure and of course the unknown always leaves you feeling anxious.
There’s a strange mental load that comes with having surgery on a body part that technically works. I worried that touching, stretching, and dilating an already sensitive system would create more problems than it solved.
Perfectly normal worry for anyone living with chronic pelvic pain
For people without chronic pain, recovery is often predictable.
For people like me, with endometriosis, nerve pain, and pelvic floor dysfunction, the body doesn’t follow neat timelines like a clean easy patient.
Waking up and then the pain takes over, the surgery itself went well.
But waking up is another story.
I came to with burning and stinging pain, and sharp, deep muscle pain that literally took my breath away. It wasn’t just surgical pain, it was nerve pain, muscle guarding, and pelvic floor spasm all layered on top of each other.
The first time I went to the bathroom, it burned like absolute hellfire.
I went pale.
I became shaky.
I felt faint.
My nervous system, already overloaded from years of chronic pain, screamed at me loudly. It was a body response, not just discomfort. Pain medication helped eventually, and after fasting for eight hours, I finally got my appetite back once things settled.
The First Night and Following Day
That night was rough going to sleep with muscle spasms, muscle/nerve pain and feeling exhausted.
Pain levels were high, and muscle spasms made rest difficult waking up at midnight for an hour unable to sleep but my body felt calmer. The next day, my abdomen and pelvic area were inflamed, tender, and sensitive to touch.
Passing urine burns like fire and not urinating but this will pass eventually, and there was a-lot of blood present, which is expected for 2-4 days (it settles and already is) but confronting, it didn’t alarm me its normal.
This is the reality of stacking procedures when you live with chronic pelvic pain:
A nerve block can cause flares before it helps
A urological procedure can inflame the same already having a sensitive reactive pelvic area.
The body doesn’t get a chance to fully settle before it’s challenged again
So now, I rest
I hydrate.
I use heat.
And I ride it out patiently, even when it’s frustrating.
The Relief of Answers
Ironically, the easiest part of this whole experience has been the results.
Most findings came back normal, which tells me something important: a large part of my trouble voiding isn’t structural damage, it’s bladder bowel endometriosis-related inflammation, nerve involvement, and pelvic floor dysfunction.
That confirmation matters.
It validates what so many people with endometriosis already know:
Symptoms can be severe even when scans and scopes look “mostly normal.”
Chronic inflammation can disrupt function without leaving obvious visual damage.
Wrap up of this procedure
This procedure wasn’t easy, but it was necessary.
For anyone with chronic pelvic pain, endometriosis, or nerve involvement considering a rigid cystoscopy and hydrodilatation, know this:
Recovery may not be linear
Pain doesn’t mean failure
A “normal” result can still be a powerful answer.
Sometimes the goal isn’t fixing everything, it’s understanding your body better, so you can treat it with more precision, compassion, and care. Right now, for me, that means rest.
You do require a referral to a Urologist from you GP/Doctor and take the best possible treatment to figure things out.
There is another procedure thats similar called a Flexible Cystoscopy, as I have chronic pain diagnosis’s I opted for being sedated than a quick procedure like a flexible Cystoscopy where your awake and only local lidocaine gel is used. I would advise strongly against that if you do have chronic pelvic pain conditions.
I hope this helps anyone about to experience this surgical procedure and what to expect.
Cassie x
Welcome Beautiful 