Investigation of a New Catheter on Relieving Pain During Male Cystoscopy–a Randomized Clinical Trial
Vol. 17 No. 3 (2020),
Purpose: To investigate the pain intensity and tolerability of a new catheter applied to urethral surface anesthesia during rigid cystoscopy in male patients, and explore the prospects of its application and the anesthetic method in hospitals at primary levels.
Materials and Methods: 252 adult male patients were randomly divided into the experimental group and the control group.1% lidocaine solution was irrigated into the posterior urethra of the experimental group using the new catheter before cystoscopy, while the control group was administered with lidocaine gel. Both groups were assessed by visual analogue scale(VAS) with their pain perceived during administration of lidocaine (control group) /during insertion of catheter and administration of lidocaine (experimental group) (T1),during the insertion of cystoscope (T2),at the beginning of cystoscopy (T3),The third minute of cystoscopy (T4), during the first urination after the procedure (T5), as well with the maximum pain(Pmax) perceived during the whole procedure. The fluctuations of blood pressure and heart rate in each group before, after and during the procedure were recorded, and the anesthesia costs in both groups were calculated.
Results: Except a slightly higher score in T1, the scores of VAS in experimental group were lower than those of control group in T2,T3 and T4. The Pmax of the control group was 4.92(SD=1.20), which was higher than in the experimental group of 3.89(SD=0.95,P<0.01).There was no significant difference on blood pressure variation in both groups. While heart rate variation in experimental group was lower than that in control group (16.3%,SD=3.4 vs. 22.6%,SD=5.0, P<0.01).No obvious complications were found in both groups. The anesthesia cost of the experimental group is about 1.53 dollars, with 1.75 dollars lower than that of the control group.
Conclusion: It is tolerable and beneficial to apply the new catheter for male urethral anesthesia. It can significantly relieve the pain during rigid cystoscopy in male patients, and is low in cost and easy in operation. Thus this method is worth being recommended to hospitals, especially at community hospitals or primary hospitals.
How to Cite
Stein M,Lubetkin D,Taub HC,et al.The effects of intraurethral lidocaine anesthetic and patient anxiety on pain perception during cystoscopy[J].J Urol,1994,151 (6):1518-1521.
Brekkan E,Ehrnebo M,Malmstrom PU,et al.A controlled study of low and high volume anesthetic jelly as a lubricant and pain reliever during cystoscopy[J].J Urol, 1991,146 (1):24-27
Taghizadeh AK,EI Madani A,Gard PR,et al.When does it hurt?Pain during flexible cystoscopy in men [J].Urol Int,2006,76(4):301-303.
Hanno PM,Wein AJ.Anesthetic techniques for cystoscopy in men[J].J Urol,1983, 130(6):1070-1072
Palit V,Ashurst HN,Biyani CS,et al.Is using lignocaine gel prior to flexible cyst oscopy justified?A randomized prospective study[J].J Urol Int,2003 ,71(4):389-392.
Lv Jianwei,Sha jianjun.Rociverine for spastic pain during cystoscopy[J]. Chinese Journal of General Practitioners,2011,10(4):262-263
Cano-García Mdel C, Casares-Pérez R, Arrabal-Martín M,et al.Use of Lidocaine 2% Gel Does Not Reduce Pain during Flexible Cystoscopy and Is Not Cost-Effective[J]. Urol J. 2015 Nov 14;12(5):2362-2365.
Kobayashi T,Nishizawa K,Mitsumori K,et al.Instillation of anesthetic gel is no longer necessary in the era of flexible cystoscopy:A crossover study[J].J Endorol , 2004,18(5):483-486.
Matsuda D,Irie A,Shimura S,et al.Uncertain analgetic efficacy of intraurethral instillation of anesthetic jelly in rigid cystoscopy for men[J].Nippon Hinyokika Gakkai Zasshi,2005,96(6):617-622.
Choe JH, Kwak KW, Hong JH, et al. Efficacy of lidocaine spray as topical anesthesia for outpatient rigid cystoscopy in women: a prospective, randomized, double-blind trial[J]. Urology. 2008 Apr;71(4):561-566
Cano-García Mdel C, Casares-Pérez R, Arrabal-Martín M,et al.Perception of pain in flexible cystoscopy using intraurethral lidocaine[J].Arch Esp Urol,2016,69 (5):207-211.
Gee JR,Waterman BJ,Jarrard DF,et al.Flexible and rigid cystoscopy in women [J].JSLS,2009,13(2):13
Losco G, Antoniou S, Mark S.Male flexible cystoscopy:does waiting after insertion of topical anaesthetic lubricant improve patient comfort?[J].BJU Int,2011,108 Suppl 2:42-44
Chen YT, Hsiao PJ, Wong WY,et al.Randomized double-blind comparison of lidocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy[J]. J Endourol,2005,19(2):163-166
Goldfischer ER,Cromie WJ,Karrison TG,et al. Randomized,prospective,double- blind study of the effects on pain perception of lidocaine jelly versus plain lubricant during outpatient rigid cystoscopy[J].J Urol,1997,157(1):90-94.
- Abstract Viewed: 122 times
- pdf/5130 Downloaded: 52 times