Randomized Trial of 10 mL and 20 mL of 2% Intraurethral Lidocaine Gel and Placebo in Men Undergoing Flexible Cystoscopy

McFarlane, Nick; Denstedt, John D.; Ganapathy, S.; Razvi, Hassan

doi:10.1089/089277901750299366

Cited by 65 publications

(62 citation statements)

References 5 publications

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“…The use of lidocaine gel has, however, been challenged by several groups. McFarlane et al (6) stated that the instillation of 2% lidocaine gel has no advantage over plain lubricant in providing anesthesia for flexible cystoscopy in men. Chen et al (7) agreed, noting that pain score, pain grade, post-cystoscopic analgesic requirement, and the strength of anesthetics requested for a repeat cystoscopy were similar in men undergoing flexible cystoscopy with intraurethral 2% lidocaine gel or with plain lubricant.…”

Section: Discussionmentioning

confidence: 99%

Is Diagnostic Cystoscopy Painful? Analysis of 1,320 Consecutive Procedures

Greenstein

Senderovich

et al. 2014

Int. braz j urol.

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ARTICLE INFO ______________________________________________________________ ______________________Objective: To prospectively evaluate self-reported pain levels associated with diagnostic cystoscopy. Materials and Methods:Patients who underwent diagnostic cystoscopy and subsequently graded their pain level during the procedure were enrolled. Pain was graded on a Likert visual analog scale (VAS) of 1-10 where 0 = no pain and 10 = excruciating unbearable pain. Local lidocaine gel 2% was used as intraurethral lubricant.Results: Data from 1320 consecutive cystoscopies (929 males, 391 females, age range 15-93 years) between 6/2009-1/2010 were analyzed. This was the first cystoscopy for 814 patients. The overall mean VAS was 2.74 ± 1.51 (range 0-9) for rigid cystoscopy and 2.48 ± 1.53 (range 0-10) for flexible cystoscopy (P = 0.004). The reported mean pain level for first-time cystoscopy was significantly higher than that for repeat cystoscopy (2.8 ± 1.6 vs. 2.2 ± 1.4, P < 0.001), regardless of gender or type of cystoscope. Men reported significantly higher pain levels than women 2.6 ± 1.5 vs. 2.4 ± 1.4 (P < 0.04). The highest mean pain level was reported by men (3.4 ± 1.6) and women (2.5 ± 1.6) for rigid cystoscopy compared to flexible cystoscopy (2.5 ± 1.4 and 1.1 ± 1.9, respectively, P < 0.001). Pain levels > 5 were reported in 75 (5.7%) cystoscopies. Conclusions: Cystoscopy was not associated with distressing levels of pain. Pain levels during first cystoscopies were higher than those for repeated ones. Using a flexible cystoscope is associated with a lower pain level in both men and women and it should be used for both genders.

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Section: Discussionmentioning

confidence: 99%

Is Diagnostic Cystoscopy Painful? Analysis of 1,320 Consecutive Procedures

Greenstein

Senderovich

et al. 2014

Int. braz j urol.

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“…Conversely, McFarlane et al [14] found no difference in pain reduction between instillation of 10 mL and 20 mL of anesthetic gel for flexible cystoscopy in men. The other study reported a mean urethral volume of 16 mL in awake male by assessing the volume of gel required to pass through the bladder neck on ultrasonography.…”

Section: Discussionmentioning

confidence: 96%

“…While some authors report significantly less pain in the 2% lidocaine gel arm relative to the plain lubricating gel, others report no significant differences in pain perception in the two groups (Table 2). [7,13,14,16,17,[24][25][26][27] A meta-analysis reported that there was not a statistically significant difference in mean pain scores between the lidocaine and the plain lubricating gel group. [28] Conversely, in another meta-analysis, lidocaine was associated with higher probability of experiencing less than moderate pain compared with the plain lubricating gel.…”

Section: Discussionmentioning

confidence: 99%

2% Lidocaine gel or plain lubricating gel: Which one should be used in male flexible cystoscopy?

Akkoç

Kartalmiş²,

Aydın

et al. 2016

Turkish Journal of Urology

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Objective: To investigate and compare the effects on pain of intraurethral 2% lidocaine gel and plain lubricating gel in male patients underwent flexible cystoscopy. Material and methods:The data of 220 male patients who underwent flexible cystoscopy between March 2012 and August 2014 were retrospectively analized. The patients were divided into 2 groups according to using intraurethral gel types. Group I included 120 patients who were underwent flexible cystoscopy with 2% lidocaine gel and Group II was consisted from 100 patients who underwent flexible cystoscopy with plain lubricating gel. The groups were compared according to postprocedure data including pain score, procedure time and age of patients. Results:The mean age of the patients in Group I was 50.02±11.87 years while that in Group II was 52.03±13.37 years (p= 0.492). The mean procedure times were 6.02±0.787 and 6.28±0.689 minutes in Group I and Group II respectively (p= 0.061). Pain perception scores were not statistically different between the groups (Group I: 3.10±0.980, Group II: 3.34±0.789, p= 0.132). Conclusion:Use of intraurethral 2% lidocaine gel has no advantage over plain lubricating gel in regard to pain control during flexible cystoscopy in men.

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“…Lignocaine gel has little analgesia only. [2], [3], [4] So far there has been no objective evaluation of the preemptive analgesic effect of NSAID In rigid cystoscopy,pain score during cystoscopy was maximum, followed by the first and second urination after cystoscopy, injection of gel, and urination the day after cystoscopy. [2] We found that oral diclofenac was effective in reducing pain during stent removal and up to 24 h after the procedure in our patients.We included only male patients to avoid the confounding effect of urethral length in assessing the efficacy of diclofenac.…”

Section: Discussionmentioning

confidence: 99%

“…Lignocaine gel during this procedure is not very effective. [1], [2], [3], [4], [5] Numerous reports exist on the effect of local anesthesia against cystoscopy-associated pain, but so far there has been no study on the preemptive analgesic effect of nonsteroidal anti-inflammatory drugs (NSAIDs).…”

Section: Introductionmentioning

confidence: 99%

Preemptive Diclofenac in Men Undergoing Double J Stent Removal- A Randomized Double-Blinded Study

A.R¹,

Chandramurali²

2017

IOSR JDMS

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Randomized Trial of 10 mL and 20 mL of 2% Intraurethral Lidocaine Gel and Placebo in Men Undergoing Flexible Cystoscopy

Abstract: Instillation of 20 mL or 10 mL of 2% lidocaine gel has no advantage over plain lubricant in providing anesthesia for flexible cystoscopy in men.

Cited by 65 publications

References 5 publications

Is Diagnostic Cystoscopy Painful? Analysis of 1,320 Consecutive Procedures

Is Diagnostic Cystoscopy Painful? Analysis of 1,320 Consecutive Procedures

2% Lidocaine gel or plain lubricating gel: Which one should be used in male flexible cystoscopy?

Preemptive Diclofenac in Men Undergoing Double J Stent Removal- A Randomized Double-Blinded Study

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