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

Abstract

Introduction: We sought to prospectively assess anxiety, pain, and embarrassment associated with diagnostic cystoscopy and multichannel urodynamic study (UDS). Methods: All consecutive patients undergoing diagnostic cystoscopy or UDS in our department over a period of nine months were asked to participate. Two anonymous auto-administered questionnaires were specifically designed to collect basic epidemiological data, document medical history, and assess the quality of information provided, along with prevalence and level (0-10 numerical visual analog rating scale) of anxiety, pain, and embarrassment experienced before and/or during the procedures. Statistical analysis was carried out to identify underlying factors that could have influenced patients' experience and ascertain potential correlations between anxiety, pain, and embarrassment. Results: 101 and 185 patients were respectively evaluated immediately after cystoscopy and UDS. Multivariate analysis repeatedly showed statistical correlations between anxiety, pain, and embarrassment, with regard to prevalence and level of intensity in both cystoscopy and UDS populations. Males and young patients were more likely to present anxiety, pain, or embarrassment during cystoscopy and UDS. Interestingly, patients who reported having received complete information before cystoscopy were significantly more likely to experience anxiety (62.6% vs. 20.0%; p=0.009). Conclusions:The present study demonstrated the major impact of gender and age on patients' experience. Interestingly, information provided before cystoscopy was reported to have a negative impact on patients' perception of anxiety; this could be partly prevented by optimizing the way information is provided to patients. IntroductionCystoscopy and multichannel urodynamic study (UDS) are essential and valuable diagnostic tools in our daily urological practice. Cystoscopy is part of the evaluation process in patients complaining of lower urinary tract symptoms (LUTS) and is undertaken repeatedly in patients being monitored for non-invasive bladder tumours. This procedure allows direct visual examination of the bladder cavity and wall to detect abnormalities, such as diverticula, stones, inflammation, and tumours. UDS is usually performed in patients complaining of LUTS or presenting neurological diseases suspected to impact the bladder-sphincter system. The procedure aims to diagnose lower urinary tract disorders through continuous measurement of abdominal, bladder, and urethral pressures during the filling and voiding phases. Despite their invasive nature, as recognized by the urological community, comprehensive evaluations of patients' experience during cystoscopy 1-5 and UDS 6-9 are scarcely reported in the literature. We prospectively assessed anxiety, pain, and embarrassment associated with such procedures and investigated factors that could potentially influence them to find potential ways of improving general tolerance during these examinations. Methods PatientsThe present study was approved by our h...

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