How different cystoscopy methods influence patient sexual satisfaction, anxiety, and depression levels: a randomized prospective trial

BackgroundPrevious quality of life (QoL) literature in bladder cancer (BC) patients has focused on finding the preferred urinary diversion while little is known about the QoL of patients in medical oncological treatment (MOT). We performed a systematic review to assess the existing literature on QoL in patients with muscle-invasive BC (MIBC) undergoing MOT.MethodsA systematic search of Pubmed and Embase was performed. Inclusion criteria were studies containing QoL data for patients undergoing chemo- and/or radiotherapy. We extracted all QoL scorings at different time intervals and on the six most prevalent domains: overall QoL, urinary, bowel sexual symptoms, pain and fatigue. The study was carried out according to PRISMA guidelines for systematic reviews and GRADE was used to rate the quality of evidence from the included studies.ResultsOf 208 papers reviewed, 21 papers were included. Twenty-one different QoL instruments were applied. The only data on QoL during chemotherapy was from patients in clinical trials investigating new treatments. No studies were found for patients in neoadjuvant treatment. The level of evidence at each time point was graded as very low to moderate. From the studies included the overall QoL seemed inversely related to the organ-specific impairment from sexual and urinary symptoms and increased with decreasing organ-specific symptoms for long term survivors > 6 months after treatment.ConclusionsCollection of data on QoL from patients with MIBC disease undergoing MOT has been sparse and diverse. The present data can act as a summary but prompts for more prospective collection of QoL data from BC patients.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-1077-6) contains supplementary material, which is available to authorized users.

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“…Sexual problems are known to have a significant impact on QoL which makes this development in Fig. 2 a paramount finding in this review [41].…”

Section: Discussionmentioning

confidence: 99%

Quality of life in bladder cancer patients receiving medical oncological treatment; a systematic review of the literature

Taarnhøj

Johansen

Pappot

2019

Health Qual Life Outcomes

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“…Previously cystoscopy related pain was evaluated with 10-point visual analog self-assessment scale and reported to be ranging from 2.5 to 4.5 points for flexible and 2.8 to 5.1 points for rigid instrument use (4-7). Krajewski et al showed the superiority of flexible CS over the rigid one in terms of pain perception, but also in sexual satisfaction or anxiety levels in male patients who were under cyclic surveillance because of NMIBC (8). We have demonstrated significant reduction of pain in the FC arm (2.57±1.83 vs. 4.48±2.18, p<0.01).…”

Section: Resultsmentioning

confidence: 49%

The Effect of Flexible and Rigid Cystoscopy on Quality of Life, Pain Perception and Lower Urinary Tract Symptoms: A Prospective Randomized Study

İslamoğlu¹,

Akdoğan²,

Yüksel³

et al. 2018

Akd Med J

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Objective: To compare the effects of flexible and rigid cystoscopy on quality of life, pain perception and lower urinary tract symptoms. Material and Methods: A total of 168 patients with bladder tumor history were prospectively randomized to flexible and rigid cystoscopy arms. For the quality of life assessment, a cancer specific module was administered just before and one week after cystoscopy. The expected and experienced pain was recorded by a visual analogue scale before and immediately after the procedure. Lower urinary tract symptoms were assessed using the International Prostate Symptom Score before and 2, 7 and 30 days after the procedure. Results: Of the 168 patients, 140 were eligible for the study and responded to the questionnaires. Of these, 69 and 71 patients were from the flexible and rigid arms, respectively. The mean visual analogue scale scores after the procedure were significantly lower for the flexible arm compared to the rigid arm (2.57±1.83 and 4.48±2.18, respectively, p<0.01). Patients undergoing flexible cystoscopy experienced less pain then they expected in contrast to the patients in the rigid arm (p<0.01). Quality of life parameters did not change after cystoscopy in the two groups (p<0.01). Lower urinary tract symptoms scores increased insignificantly on the second day in both arms and returned to baseline on the seventh day. Conclusion: Flexible cystoscopy, caused less pain than rigid cystoscopy. However quality of life scores were not different in the two groups indicating that stress and anxiety may affect these parameters more than the pain experienced during the procedure.

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“…No significant change in sexual function was found at the fourth week compared with that at the preoperative baseline. Patients were reported to have had a more comfortable experience after flexible ureteroscopy with decreased pain and anxiety [25]. Nevertheless, in general, sexual dysfunction rarely occurs, even after rigid endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Impact of Endourological procedures with or without double-J stent on sexual function: a systematic review and meta-analysis

Yang

et al. 2020

BMC Urol

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Background: Endourological procedures are widely used to treat benign urinary disorders and the double-J stent is routinely used. However, its potential impact on sexual function remains unclear. Therefore, we performed a quantitative systematic review to determine the relationship between endourological procedures with or without double-J stent and post-operative sexual function. Methods: We conducted a search of PubMed, EMBASE, Web of Science, and Cochrane Library databases up to December 2018 for studies that compared sexual function before and after endourological procedures. The quality of the included studies was evaluated using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). We performed subgroup analyses to explore heterogeneity. A random effects model was used to combine the results. Results: Five prospective studies involving 485 sexually active participants were identified. Pooled results showed that, in patients without a double-J stent, the change in sexual function after endourological procedures was not significant in men (mean difference [MD]: − 0.61, 95% confidence interval [CI]: − 1.43 to 0.22, p = 0.148) or women (MD: 0.53, 95% CI: − 0.52 to 1.57, p = 0.322). However, in patients with indwelling double-J stent, sexual function scores significantly declined after the procedure in both men (MD:-4.25, 95% CI: − 6.20 to − 2.30, p < 0.001) and women (MD:-7.17, 95% CI: − 7.88 to − 6.47, p < 0.001). Conclusions: Our meta-analysis suggests that indwelling double-J stent after endourological procedures could be a crucial factor causing temporary sexual dysfunction post-operatively. Our results may be used to provide evidencebased advice to patients.

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How different cystoscopy methods influence patient sexual satisfaction, anxiety, and depression levels: a randomized prospective trial

Cited by 32 publications

References 44 publications

Quality of life in bladder cancer patients receiving medical oncological treatment; a systematic review of the literature

Quality of life in bladder cancer patients receiving medical oncological treatment; a systematic review of the literature

The Effect of Flexible and Rigid Cystoscopy on Quality of Life, Pain Perception and Lower Urinary Tract Symptoms: A Prospective Randomized Study

Impact of Endourological procedures with or without double-J stent on sexual function: a systematic review and meta-analysis

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