Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way

Zhang, Zhensheng; Xiao-lin, Wang; Zeng, Shuxiong; Tang, Liang; Cao, Zhi; Zhang, Chao; Xu, Chuanliang; Sun, Yinghao

doi:10.1089/end.2014.0714

Cited by 11 publications

(15 citation statements)

References 20 publications

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“…This finding was not universal, as statistically significant differences were not observed at all assessed time points, or in all examined groups. However, there is a trend to worse pain scoring during the first cystoscopy and in younger men, which is also described by other authors [3–5, 20–22]. While the aim of our study was to optimise local anaesthesia for cystoscopy, these findings are clinically useless despite their relevance.…”

Section: Discussionsupporting

confidence: 64%

“…Zhang et al recently improved this technique. They confirmed that higher irrigation pressure is associated with less discomfort during cystoscopy and proposed to raise the irrigation solution bag and adjust the height in order to easily improve patients’ satisfaction [22]. Apart from technical tips and tricks, Yeo et al found that listening to classical music during rigid cystoscopy is a simple, economical and effective means of enhancing patient comfort and reducing feelings of pain, anxiety, and dissatisfaction [23].…”

Section: Discussionmentioning

confidence: 99%

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Anaesthesia of the posterior urethra and pain reduction during cystoscopy - a randomized controlled trial.

Poletajew

Bender

Pudełko

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionStandard intra-urethral instillation of anaesthetic gel may not sufficiently exclude pain perception during cystoscopy.AimTo evaluate the impact of the anaesthesia within the posterior urethra on pain intensity related to cystoscopy in men.Material and methodsOne hundred and twenty-seven men undergoing cystoscopy were prospectively enrolled in the study. Patients were randomly assigned to the experimental or control group (66 vs. 61 patients). Intra-urethral instillation of 2% lidocaine gel was done in both groups. In the experimental group, the posterior urethra was additionally anaesthetized with distribution of the lidocaine gel by catheterisation. The study endpoints were pain intensity at successive time points of the procedure assessed on a numeric rating scale, overall pain intensity assessed on a Likert scale, the need for analgesics during 6 h after the procedure, and the frequency of urinary tract infections (UTIs) during 14 days after the procedure.ResultsPain perception during cystoscopy did not differ significantly between the two groups (p > 0.05). However, after 6 h patients in the experimental group were more likely to declare that the cystoscopy was painless (81.8% vs. 70.2%, relative risk = 1.17). The need for analgesics and the incidence of UTI were similar in both groups (p > 0.05). Statistically significant differences regarding pain perception were observed depending on patients’ age and the number of transurethral procedures performed in the past, with no relation to type of anaesthesia (p < 0.05).ConclusionsAnaesthesia of the posterior urethra is not more efficacious in reducing pain related to cystoscopy than standard instillation of anaesthetic gel. However, it improves the general perception of the procedure, and hence may positively influence patients’ compliance.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Anaesthesia of the posterior urethra and pain reduction during cystoscopy - a randomized controlled trial.

Poletajew

Bender

Pudełko

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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“…Apart from the technological advances in modern flexible cystoscopes, we think that the irrigation pressure would also play an important role in patient tolerance. Zhang et al [17] demonstrated that achieving a higher irrigation pressure for flexible cystoscopy improved male patient comfort.…”

Section: Discussionmentioning

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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“…Currently, researchers have conducted many trials to seek potentially adjuvant therapy to alleviate patient pain during cystoscopy, especially for male patients. The proposed nonpharmacological methods included increasing irrigation pressure (3)(4)(5), delaying the instillation time of topical anesthetics in the urethra (6)(7)(8), allowing patients to watch the procedure process (9)(10)(11), listening to music (12,13), hand-holding (14), urinating during FC (15), and virtual reality distraction (16). All these interventions are practical, inexpensive, and harmless.…”

Section: Introductionmentioning

confidence: 99%

Does office-based flexible cystoscopy provide better pain perception than rigid cystoscopy: a systematic review and meta- analysis

et al. 2021

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Background: The aim of our study is to determine whether flexible cystoscopy (FC) leads to less pain perception than rigid cystoscopy (RC).Methods: Eligible studies were identified through three common databases, including PubMed, the Cochrane Library and Embase. We systematically reviewed studies comparing FC to RC, and extracted data from randomized trials from December 1, 1984 to January 12, 2021, with no language restrictions. Methodological rigor, and risk of bias were evaluated by two independent reviewers using Cochrane Collaboration's tools. The analysis was completed via STATA version 14.2.Results: We initially identified 463 studies, and four articles met the criteria for inclusion. Overall, we did not observe a significant difference between FC and RC regarding pain perception [standard mean difference (SMD): −1.19; 95% CI: −2.69 to 0.32], and there was significant heterogeneity among studies (I 2 =97.6%, P<0.001). This was consistent with the results stratified by gender (male patients, SMD: −0.96, 95% CI: −2.50 to 0.59; female patients, SMD: −1.42; 95% CI: −4.49 to 1.64).Conclusions: Our study revealed that RC is a tolerable procedure, and FC may not be more comfortable than RC. However, further larger well-designed trials are warranted to demonstrate our findings, and explore whether FC is more beneficial to patient sexual function, anxiety, quality of life, and lower urinary tract symptoms than RC.

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Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way

Abstract: Achieving higher irrigation pressure for flexible cystoscopy by adjusting the height of irrigation solution bag improves male patients' comfort. It is recommended for male patients.

Cited by 11 publications

References 20 publications

Anaesthesia of the posterior urethra and pain reduction during cystoscopy - a randomized controlled trial.

Anaesthesia of the posterior urethra and pain reduction during cystoscopy - a randomized controlled trial.

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

Does office-based flexible cystoscopy provide better pain perception than rigid cystoscopy: a systematic review and meta- analysis

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