Psychological distress in out-patients undergoing flexible cystoscopy for the investigation of bladder cancer

Abstract

Objectives: Flexible cystoscopy can cause patients significant psychological distress, especially when utilised in the diagnostic pathway for suspected bladder cancer. We aimed to assess the prevalence of general anxiety and depression, as well as procedure-related worry and pain in patients undergoing local anaesthetic flexible cystoscopy and to determine whether these conditions occur more frequently in subsets of the population. Patients and methods: Patients referred for flexible cystoscopy were invited to participate. Patients were asked to complete a questionnaire containing the Hospital Anxiety and Depression Scale (HADS), a worry score and a question regarding the most stressful event in the diagnostic pathway. Following the procedure patients were also asked to complete a pain score. Results: A total of 175 patients participated in the study. The prevalence of significant anxiety was 15% and depression 3.5%. This was higher in younger, female and unmarried patients. Procedure-related worry and pain were generally low. Conclusions: We found the prevalence of anxiety and depression in patients undergoing flexible cystoscopy to be raised compared to a similar cohort of patients undergoing TRUS-guided prostate biopsy. We have identified subgroups more likely to experience these symptoms and have also identified the sections of the diagnostic pathway that are most likely to cause anxiety and depression. By doing this we can target those patients who are more likely to suffer during the diagnostic process and aim to improve their experience. We can also implement targeted changes to the pathway to reduce the impact it may have on patients' mental health.

The Relationship between Siege Stressors, Anxiety, and Depression among Patients with Cancer in Gaza Strip

“…This give privilege to female cancer patients to experience wide range of siege stressors more than males that affected them because of limited medication, difficulty in transfer and more problems related and lead to depressive symptoms among females. In addition, the current study results were consistent with the study of Ellis et al [14] found that the prevalence of was female and unmarried patients. Also, the results seem to be inconsistent with the results of Lubbad et al [23] that indicated significant differences between the means of depression according to sex in favor of males.…”

“…Such findings may be due to continue siege the imposed by the Israel government on Gaza strip for long time period and reflected on the mental health of the cancer patients. However, Ellis et al [14] found that the prevalence of significant depression 3.5%. This was higher in younger, female and unmarried patients.…”

“…However, Lubbad et al [23] in their study "the impact of the siege on the mental health of university students" reported that, 2% have no anxiety; 39.8% have mild anxiety; 42.3% have moderate anxiety; 15.8% have severe anxiety. Where, Ellis et al [14] found the prevalence of significant anxiety was 15%. This was higher in younger, female and unmarried patients that appear to be consistent with our results.…”

“…The results seem to be consistent with the results of Lubbad et al [23] revealed significant differences between the means of depression and family income toward low income families. But, Gogne et al [26] found that depression was found to be higher in literate (25,54.3%) and employed (14,53.8%) patients.…”

Comparison of Holmium Laser Enucleation and Plasmakinetic Resection of Prostate: A Randomized Trial with 72-Month Follow-Up

“…Flexible cystoscopy is an important diagnostic tool for the urologist and is used in an outpatient setting for patients who present with hematuria and LUTS, as well as in the diagnosis of bladder cancer, and important for surveillance of patients with known bladder cancer. 15 Investigations that directly assess prostatic anatomy allow the accurate diagnosis of restructuring before it significantly progresses, provide additional qualitative information on the state of healing, and help determine both the need for and the type of intervention. 16 However, the evidence for patients undergoing flexible cystoscopy in relation to LUTS in the long-term follow-up is absent and remains controversial.…”