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Office Based Flexible Cystoscopy May Be Less Painful For Men Allowed To View The Procedure

May 07, 2017

UroToday- Office based cystoscopy has undergone many changes including, introduction of the flexible cystoscope and use of intraurethral lidocaine. However, some patients are still hesitant to undergo surveillance at the recommended interval due to perceived discomfort.

The group from Cleveland studies 100 consecutive male patients who underwent flexible cystoscopy and randomized them into 2 groups. One group was allowed to visualize the procedure on a video screen while the other group had the screen positioned away from their line of sight. All men received 10 cc 2% viscous lidocaine intraurethral before 16.2 Fr digital chip cystoscopy and no sedatives or analgesics were allowed. Not surprisingly, men who were visually 'distracted' had a lower visual analog scale pain score (14) than those who were unable to visualize the screen (23, Wilcoxon rank sum test p=0.02).

This 40% decrease in the pain level for men viewing the procedure on the video screen is a useful tool to use during flexible cystoscopy. I personally have been using such a technique for many years and it not only allows me to distract the patients from the pain but also allows me to educate patients regarding the appearance of their bladders. This is especially useful in situation where individuals who live far away alternate their surveillance between the 'home urologist' and 'the specialist' and can act as controls themselves.

Patel AR, Jones JS, Angie S, Babineau D

J Urol. 177(5):1843-5, May 2007

Reported by UroToday Contributing Editor Ashish Kamat, M.D

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