Does information provided to men before a urodynamic study affect their expectation of pain?

Abstract

UDS, were included (mean age 56.4 years, range 25-89). Of these patients, 15 had had previous instrumentation of the urethra (urethral catheterization, cystoscopy), and 14 had had a prostatectomy. One urologist provided a detailed explanation of the different stages of the UDS. Use of an anaesthetic gel, and instrumentation of the urethra and anus by an experienced urologist, were emphasized. Pain was assessed using a visual analogue pain scale three times, to provide an expected pain score (EPS) on entering the examination room, after the explanation, and the actual pain felt during the UDS. RESULTSThe mean EPS before the explanation was 4.2, significantly higher (5.17) after the explanation ( P = 0.02) and the actual pain scored during the UDS was 3.76, lower than both the previous EPS. In patients who had had previous instrumentation of the urethra, the EPS after the explanation was significantly higher, at 6.06 ( P < 0.05). Pain scores were not significantly different in patients after prostatectomy. CONCLUSIONSThe routine guidance provided to male patients undergoing UDS enhances their expectations of pain, especially in those who have had previous instrumentation of the urethra. As the fear of pain may alter the information provided by the patient, different strategies of providing patients with information about UDS should be devised.

Prospective evaluation of anxiety, pain, and embarrassment associated with cystoscopy and urodynamic testing in clinical practice

“…Such a tangle between apprehension, painful sensation, and discomfort has already been described in the literature, 10,11 and several authors have demonstrated that patients systematically anticipated more pain than they actually experienced. 3,5,12 In the present study, multivariate analysis divulged an increased proportion of patients with anxiety before cystoscopy in the younger population (18-50 years old). Such cystoscopy-and UDs-related anxiety, pain, and embarrassment a correlation has already been demonstrated by Yiou et al in patients undergoing UDS.…”

“…25 However, more simply, we believe that the quality of medical information provided could play a major role in patient perceptions of anxiety, pain, or embarrassment and should be considered as a fundamental issue. Indeed, although comprehensive explanation of the procedure is crucial, it has been demonstrated to significantly increase anxiety, 12 and probably augments pain and embarrassment if not delivered optimally.…”

The impact of detailed explanatory leaflets on patient satisfaction with urodynamic consultation: A double‐blind randomized controlled trial

“…6 It would also be interesting to measure the impact of explanatory leaflets on postprocedure pain perception in female patients. Greenstein et al 26 concluded that pain from urodynamics was more resented in men than in women, especially when they had experienced similar procedures before, and female patients who underwent urodynamic testing anticipated higher degrees of discomfort than they experienced during the procedure. 27 Therefore, further research should evaluate the impact of different leaflet contents about urodynamics.…”

Impacto do estudo urodinâmico em mulheres com incontinência urinária

“…Constitui-se de vários parâmetros, que são avaliados durante a fase de enchimento ou esvaziamento miccional 1,13 . Para que os resultados sejam confiáveis, o exame deve reproduzir os sintomas do paciente, e isto significa que a cooperação voluntária é primordial 14 . A paciente deve sentir-se confortável do ponto de vista físico e emocional e, para que isto ocorra, um conjunto de medidas devem ser realizadas pela equipe multiprofissional.…”

“…Uma medida importante, aplicada na maioria dos exames invasivos, é a informação prévia sobre o método 14 . Em nossos resultados, embora todas as pacientes tenham recebido explicação verbal sobre as etapas do exame, menos da metade sabiam de sua utilidade e 51% sabiam o nome do estudo.…”