A prospective, randomized, double‐blind study comparing lignocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy

Choong, S.; Whitfield, H. N.; Meganathan, V.; Nathan, Myooran; Razack, Abdul; Gleeson, Malachy J.

doi:10.1046/j.1464-410x.1997.00214.x

Cited by 58 publications

(60 citation statements)

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“…Herr and Schneide's study showed no difference in pain relief between cystoscopy performed immediately after lidocaine gel instillation and after 15 min delay [20]. Choong and associates further stated that lidocaine gel was effective in decreasing pain when cystoscopy is performed after 15 min or longer of the instillation [21]. Other previous studies indicated that effective local anesthesia and lubrication of lidocaine gel or plain petrolatum instillation should be done by remaining the gel in the urethra for 10 to 15 minutes before cystoscopy [21,22].…”

Section: Discussionmentioning

confidence: 97%

“…Choong and associates further stated that lidocaine gel was effective in decreasing pain when cystoscopy is performed after 15 min or longer of the instillation [21]. Other previous studies indicated that effective local anesthesia and lubrication of lidocaine gel or plain petrolatum instillation should be done by remaining the gel in the urethra for 10 to 15 minutes before cystoscopy [21,22]. Currently, it is a common practice in busy outpatient clinics to perform cystoscopy within 5 minutes after the intraurethral instillation of lidocaine gel [23].…”

Section: Discussionmentioning

confidence: 99%

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Factors Predictive of Pain During Cystoscopy: A Prospective Study

Özdemır¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada sistoskopi esnasında hastanın konforunu artıran ve ağrı duyusunu azaltan hasta özellikleri ve yöntemler arasındaki etkinlik farkı araş-tırıldı. Gereç ve Yöntem: Hem kanser hem de benign endikasyonlar nedeni ile sistoskopi yapılan hastalar çalışmaya dahil edildi. İşlemler, sistoskopi esnasındaki ağrı ve rahatsızlık üzerindeki tecrübenin önemini belirtmek için, asistan ve diğer sağlık personellerine anlatılarak yapıldı. Hastalar sözlü anlatım yapılan ve sistoskopi görüntülerini yapan ürologla beraber ekrandan izlemek isteyip istemediklerine göre gruplara ayrıldı. Hastaların ağrıları 10 mm VAS skoruna göre değerlendirildi ve ağrı noktası lokalize edildi. Bulgular: Sistoskopi yapılan 146 hasta (99 rijid, 47 esnek) değerledirildi. Yaş ve VAS skorları arasında farklılık yoktu. Esnek sistoskopi esnasında ortalama VAS skoru rijide göre düşüktü. Univariate analizler gösterdi ki; düşük vücut kitle indeksi, klinisyen tarafından aynı anda hastaya detaylı anlatım yapılması, düşük klnisyen tecrübesi ve ilk sistoskopiler ağrı ile anlamlı derece ilişkili idi. En ağrılı durumlar, esnek sistoskopi esnasında lidokain instilasyonu ve rijid sistoskopi esnasında mesane yan duvarlarının görüntülenmesiydi. Tartışma: Teknik, esnek veya rijid sistoskopi, tecrübe ve ilk sistoskopi ağrıda önemli role sahiptir. Anahtar KelimelerEsnek; Rijid; Sistoskopi Abstract Aim: To determine the patient characteristics and surgical conditions which is associated with patient pain and discomfort during cystoscopic procedures. Material and Method: Consecutive patients who had a cystoscopy for cancerrelated and benign indications were included. Patients were randomized to undergo either rigid or flexible cystoscopy. Procedures were performed in a teaching setting that included residents and attending physicians to assess the impact of experience on pain/discomfort. Patients were further subdivided into the groups that were received detailed verbal explanation during the cystoscopy and allowed to watch the video screen together with the urologist during the procedure or not. Patients were asked to assess their pain on a 10-mm VAS after the procedure the location of the pain was noted. Results: A total of 146 outpatient cystoscopies (99 rigid, 47 flexible) were evaluated. There was no correlation between patients age and VAS scores. Mean VAS during flexible cystoscopy was lesser than rigid one. Univariate analysis showed that lower BMI, real time detailed verbal explanation by the physician, lesser physician experience and initial cystoscopies were significantly associated with painful cystoscopies. Lineer regression analysis confirmed that type of instrument, detailed verbal information, physicians experience-more than 3 years and history of previous cystoscopy were independent factors related to VAS scores. The most painful localizations were lidocaine injections during flexible cystoscopy whereas visualization of the side wall of the bladder for rigid technique. Discussion: Instrument type (flexible or rigid), explaining the procedu...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Özdemır¹

2014

Ann Clin Anal Med

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“…There has also been a study showing the opposite result from our study. Choong et al [10] back in 1997 found that the most adequate time of 20 ml of 2% lidocaine gel exposures to urethra may be 15 minutes; they assert that time is needed for the anesthetic ingredients to infiltrate the urothelium. We believe that the discrepancy may be due to the differences in the volume of the injected lidocaine gel.…”

Section: Discussionmentioning

confidence: 99%

Intraurethral Lidocaine Usage in Office-Based Rigid Cystoscopy on Pain Experience

Choi

Cho

Min

2017

Urogenit Tract Infect

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Purpose: Cystoscopy is one of the most reliable urological examinations. However, it also a painful one. Intraurethral lidocaine gel injection is widely used to relieve pain during cystoscopy. The purpose of this study is to compare between the use of lidocaine gel and lidocaine solution as a pretreatment for cystoscopy. Materials and Methods: Between March 2016 and May 2017, we studied 147 patients who had undergone cystoscopy at our institution. Patients were divided into four groups. Lidocaine gel and solution were administered just 10 minutes before each test. For randomization, the patient groups were divided into either odd or even number for the test day and as the patient number, irrespective of medical condition. The amount of lidocaine gel and solution of 10 ml each was uniformly injected. After the procedure, patients were asked to rate their pain on a 10-point visual analogue scale. Results: The average degree of pain relief was in the order of solution/10 minutes, gel/immediately, gel/10 minutes, and solution/immediately. The gel was associated with significantly less pain in the immediate group than in 10-minute before group, whereas the solution was associated with significantly better pain relief in the 10-minute before group than in the immediate group. There were no complications to report in all groups. Conclusions: Lidocaine gel and solution showed different changes of pain relief over time. Further prospective studies with a larger population is necessary to better develop a less painful method of cystoscopy in the future.

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“…Choong et al . [12] first reported a significant reduction in pain during flexible cystoscopy when 20 mL of 2% lignocaine gel was left in the urethra for 15 min compared to 5 min. However, multiple authors have since failed to replicate these results [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double‐blind, controlled trial

Wong¹,

Huang²,

Yong³

et al. 2011

BJU International

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(glucose) powder four times a day for two days after the procedure. Trial outcome was assessed by estimating the change in pain incidence and severity from before to two days after by post-procedural questionnaire. RESULTS• Painful voiding was present in 84 of the 300 patients post flexible cystoscopy (45 of 160 patients receiving Ural®; 39 of 140 receiving placebo), but overall mean pain scores were low (1.25; standard deviation 2.4; on a 0-10 scale).• Treatment with Ural® compared to placebo was associated with a nonsignificant reduction in frequency of pain (28.9% vs 31.3%; incidence rate ratio 0.66; 95% CI 0.29-1.46; P = 0.30) and severity of pain (odds ratio 0.72; 95% CI 0.30-1.74; P = 0.47). CONCLUSION• In the replicable context of low postcystoscopy pain levels, we believe Ural® does not reduce painful voiding after flexible cystoscopy.

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A prospective, randomized, double‐blind study comparing lignocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy

Cited by 58 publications

References 1 publication

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Intraurethral Lidocaine Usage in Office-Based Rigid Cystoscopy on Pain Experience

Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double‐blind, controlled trial

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