Patient Tolerance During Outpatient Flexible CystoscopyA Prospective, Randomized, Double‐blind Study Comparing Plain Lubrication and Lidocaine Gel

Rodríguez-Rubio, F; Sanz, Gonzalo Mateo; Garrido, Sofía; Sánchez, Carlos; Estudillo, F.

doi:10.1080/00365590410018666

Cited by 33 publications

(23 citation statements)

References 9 publications

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“…Several studies have evaluated the efficacy of lidocaine gel in regard to the discomfort felt during the instillation of the lidocaine gel before instrumentation, volume of lidocaine used, lidocaine temperature and the time that it was instilled before cystoscopy [13,17,18]. Furthermore, some studies demonstrated no significant difference between lidocaine gel lubrication and plain gel lubrication in decreasing pain and discomfort during cystoscopy [13,19]. 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].…”

Section: Discussionmentioning

confidence: 99%

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: 99%

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Özdemır¹

2014

Ann Clin Anal Med

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“…With the emergence of more sophisticated and small caliber flexible cystoscopes, the need for topical lidocaine has been questioned. While several studies have shown that intraurethral anesthetic lubricant reduces pain compared with plain lubrication [2], others have failed in demonstrating any benefit in patient comfort [3]. Furthermore, there is no benefit from waiting a short time between the instillation of lidocaine gel and the insertion of the cystoscope [4].…”

Section: Introductionmentioning

confidence: 99%

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Carrión¹,

Garcı́a-Cruz²,

Fernández³

et al. 2016

Urol Int

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Objective: The study aimed to test the hypothesis that the instillation of lidocaine gel does not reduce the pain related to flexible cystoscopy. Material and Methods: A prospective randomized study was designed to compare the pain perception between intraurethral instillation of lidocaine gel and saline solution in flexible cystoscopy. One hundred consecutive male patients attending for flexible cystoscopy were randomized to receive 10 ml of lidocaine gel or 10 ml of saline solution. Saline solution was also used for the irrigation pressure. Patients recorded their pain on a 10 cm Visual Analog Scale before and after the procedure. Patients also assessed whether the cystoscopy was more painful than the previous one. Statistical comparison was made using the t test for parametrical data and the Mann-Whitney U test for non-parametrical data. Results: Mean pain score in the lidocaine group was 0.67 ± 1.11 cm (range 0-5) compared to 0.55 ± 1.10 cm (range 0-5) in the saline solution group. Pain perception did not differ significantly between the 2 groups (mean difference 0.12 cm, 95% CI -0.32 to 0.55, p = 0.40). Conclusions: Prior lubrication of the urethra does not reduce the pain produced during flexible cystoscopy. The introduction of flexible cystoscopes under direct vision and with an irrigation pressure might guarantee sufficient comfort and the lubricant gel instillation could be avoided.

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“…Cystoscopy has been proven quite successful in surveillance and follow-up of patients with treated bladder cancer. The drawback of cystoscopy is that it is quite expensive, invasive and uncomfortable (6). Urine cytology has been the gold standard for bladder cancer screening and surveillance in the past (7) but it is subjective and requires adequate number of exfoliated cells in the urine, and cellular alterations are likely due to change in collection conditions and therapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Urinary and Serum CA 19-9 as Markers of Early Stage Urothelial Carcinoma

2013

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Objectives: Although the glycoprotein group tumor marker CA 19-9 has been detected in both serum and urine of bladder cancer patients, information about their comparative role in screening of low grade transitional cell carcinoma (LGTCC) and high grade transitional cell carcinoma (HGTCC) is rare. Materials and Methods: In this study we measured both the urinary and serum levels of CA 19-9 in 35 LGTCC and 20 HGTCC patients by ELISA and determined the cut off value of both urinary and serum CA 19-9 levels by receiver operator characteristic curve (ROC) for both patient groups. Odds ratio (OR) for CA 19-9 was analyzed with its range at 95% confidence interval to analyze the role of this tumor marker as a screening parameter for both of these cancer types. Results: For urinary CA 19-9 the OR was 20.16 with an interval of 4.91-82.71 whereas for the serum CA 19-9 it was 7.5 with an interval of 2.28-24.62. Conclusions: From these data we suggest that urinary CA 19-9 is a better screening parameter with optimum sensitivity and specificity than its serum counterpart for diagnosis of low grade and early stages of transitional cell carcinoma of urinary bladder. Furthermore, it can be suggested that urinary CA 19-9 can be used as better prognostic marker for LGTCC than its serum counterpart.

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Patient Tolerance During Outpatient Flexible CystoscopyA Prospective, Randomized, Double‐blind Study Comparing Plain Lubrication and Lidocaine Gel

Abstract: There are no differences in the perception of discomfort and pain by patients when anesthetic lubricant or simple lubrication are used if the waiting time before the exploration is 5 min.

Cited by 33 publications

References 9 publications

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Factors Predictive of Pain During Cystoscopy: A Prospective Study

Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy

Comparison of Urinary and Serum CA 19-9 as Markers of Early Stage Urothelial Carcinoma

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