Intraurethral Lubricants: A Critical Literature Review and Recommendations

Abstract

In current clinical practice, lidocaine gel is widely used as a local anesthetic lubricant before various forms of transurethral instrumentation. Over the past few years, the value of local anesthesia during urethral catheterization and flexible or rigid cystoscopy has been questioned. Strong data are lacking, and the results from the different studies are contradictory. As a result, the correct use of the intraurethral gels is, for the most part, left to individual preference. The purpose of this review is to provide an overview of the characteristics of the intraurethral gels, to assess the effectiveness, and to define evidence-based indications for their use.

Effect of Intraurethral Dwell Time of Local Anesthetic Jelly on Pain Perception in Men Undergoing Outpatient Rigid Cystoscopy: A Randomized Prospective Study

“…1 Tzortzis et al in review of literature observed that intraurethral anesthetic jelly dwell time of 10-20 minutes is optimum for pain relief in men undergoing rigid cystoscopy. 10 Literature review on the effectiveness of local anesthetic jelly for pain relief during male flexible cystoscopy shows conflicting results. Patel et al, in their meta-analysis, reported on 817 patients from nine eligible trials.…”

The Effects of Hyaluronic Acid and Carboxymethylcellulose in Preventing Recurrence of Urethral Stricture After Endoscopic Internal Urethrotomy: A Multicenter, Randomized Controlled, Single-Blinded Study

“…The chlorhexidine gel is widely used for this procedure. 21 However, there are no studies of the effects of lubricants on the recurrence of urethral stricture. Future studies should look at the impact of different lubricants on the recurrence of urethral stricture after EIU.…”

Comparison of the Use of Prilocaine and Lidocaine Gel During the Cystoscopy

“…Araştırmacıların çoğunun bireysel tercihler yapmış olması, çalışma sonuçlarında bildirilen etki konusunda ciddi bir veri eksikliğinin olması bu konunun çık-mazlarıdır. Bu nedenle ağrısız transüretral uygulamalar için genel anestezi tercih nedeni olmuştur [14]. Genel anestezinin maliyeti, riskleri ve oldukça zaman alan hazırlık döneminden dolayı, klinik uygulamada daha pratik olan üretral yoldan lokal anestezik verilerek işlem yapılması gündeme gelmiştir.…”