Intraurethral Lidocaine Usage in Office-Based Rigid Cystoscopy on Pain Experience

Abstract

Purpose: Cystoscopy is one of the most reliable urological examinations. However, it also a painful one. Intraurethral lidocaine gel injection is widely used to relieve pain during cystoscopy. The purpose of this study is to compare between the use of lidocaine gel and lidocaine solution as a pretreatment for cystoscopy. Materials and Methods: Between March 2016 and May 2017, we studied 147 patients who had undergone cystoscopy at our institution. Patients were divided into four groups. Lidocaine gel and solution were administered just 10 minutes before each test. For randomization, the patient groups were divided into either odd or even number for the test day and as the patient number, irrespective of medical condition. The amount of lidocaine gel and solution of 10 ml each was uniformly injected. After the procedure, patients were asked to rate their pain on a 10-point visual analogue scale. Results: The average degree of pain relief was in the order of solution/10 minutes, gel/immediately, gel/10 minutes, and solution/immediately. The gel was associated with significantly less pain in the immediate group than in 10-minute before group, whereas the solution was associated with significantly better pain relief in the 10-minute before group than in the immediate group. There were no complications to report in all groups. Conclusions: Lidocaine gel and solution showed different changes of pain relief over time. Further prospective studies with a larger population is necessary to better develop a less painful method of cystoscopy in the future.

Effects of Heating Therapy on Pain, Anxiety, Physiologic Measures, and Satisfaction in Patients Undergoing Cystoscopy

“…A variety of medical interventions, such as intra-urethral injection of lidocaine lubricant [8] or flexible cystoscopy [9], have been used to alleviate pain and anxiety during cystoscopy. Flexible cystoscopy is generally less painful than rigid cystoscopy; however, it is expensive, visualizes a smaller area, and requires more skill from urologists, and is therefore not favored [10,11].…”