I have been in therapy over the trauma of the initial cystoscopy. There is a range of reactions and the medical world downplays the extreme reactions, opting for an "average" that claims a cysto is no big deal. On average they are right, but what about teh rest of us? I have had 6 cystos all under general anesthesia as outpatient in hospital since the initial traumatic one. Insist on at LEAST lidcoaine (not just lubricating) and 1.0 mg Ativan plus Tylenol one hour before, if you do it in office clinic awake. I cannot do this but perhaps others can. Or go the full route with anesthesia in hospital. The anxiety is still there for me, but it is reduced. Good luck. This disease is made worse by these primitive civil war medicine practices, done by callous MD's who've never had the procsdure themselves.