Greenstein A, Greenstein I, Senderovich S, Mabjeesh NJ. Is diagnostic cystoscopy painful? Analysis of 1,320 consecutive procedures. Int Braz J Urol. 2014 Jul-Aug;40(4):533-8. PMID: 25251958.

Int Braz J Urol. 2014 Jul-Aug;40(4):533-8. doi: 10.1590/S1677-5538.IBJU.2014.04.13.

Is diagnostic cystoscopy painful? Analysis of 1,320 consecutive procedures.

Greenstein A(1), Greenstein I(2), Senderovich S(3), Mabjeesh NJ(1).

Author information:
(1)Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv.
(2)Hebrew University Hadassah Medical School, Jerusalem, Israel.
(3)Assuta Hashalom Medical Center, Assuta Medical Centers, Tel Aviv, Israel.

OBJECTIVE: To prospectively evaluate self-reported pain levels associated with diagnostic cystoscopy.

MATERIALS AND METHODS: Patients who underwent diagnostic cystoscopy and subsequently graded their pain level during the procedure were enrolled. Pain was graded on a Likert visual analog scale (VAS) of 1-10 where 0 = no pain and 10 = excruciating unbearable pain. Local lidocaine gel 2% was used as intraurethral lubricant.

RESULTS: Data from 1320 consecutive cystoscopies (929 males, 391 females, age range 15-93 years) between 6/2009-1/2010 were analyzed. This was the first cystoscopy for 814 patients. The overall mean VAS was 2.74 ± 1.51 (range 0-9) for rigid cystoscopy and 2.48 ± 1.53 (range 0-10) for flexible cystoscopy (P = 0.004). The reported mean pain level for first-time cystoscopy was significantly higher than that for repeat cystoscopy (2.8 ± 1.6 vs. 2.2 ± 1.4, P < 0.001), regardless of gender or type of cystoscope. Men reported significantly higher pain levels than women 2.6 ± 1.5 vs. 2.4 ± 1.4 (P < 0.04). The highest mean pain level was reported by men (3.4 ± 1.6) and women (2.5 ± 1.6) for rigid cystoscopy compared to flexible cystoscopy (2.5 ± 1.4 and 1.1 ± 1.9, respectively, P < 0.001). Pain levels > 5 were reported in 75 (5.7%) cystoscopies.

CONCLUSIONS: Cystoscopy was not associated with distressing levels of pain. Pain levels during first cystoscopies were higher than those for repeated ones. Using a flexible cystoscope is associated with a lower pain level in both men and women and it should be used for both genders.

PMID: 25251958 [PubMed - indexed for MEDLINE]

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