PURPOSE: An experienced urology nurse observed that patients seemed to tolerate the procedure better when allowed to see the monitor in real time during office based cystoscopy. We assessed the impact of this on visual analog scale pain scores. MATERIALS AND METHODS: A total of 100 consecutive male patients underwentflexible cystoscopy, as performed by a single surgeon during the study period. Patients were randomized into 2 groups. Patients in group 1 were allowed to visualize the video screen with the surgeon, while patients in group 2 had the screen positioned so that only the surgeon could visualize the procedure. Water soluble lubricant was used on all endoscopes and all men received 10 cc 2% viscous lidocaine intraurethral before cystoscopy. No sedatives or analgesics were administered. All patients provided consent before the procedure and they were asked to record their pain experience on a 100 mm visual analog pain scale as soon as the surgeon left the room. RESULTS: Men who were allowed to visualize the cystoscopy had lower visual analog scale pain scores than those who were unable to visualize the screen (14 vs 23, Wilcoxon rank sum test p=0.02). CONCLUSIONS: To our knowledge no study has shown the impact of distraction of cystoscopic findings on procedure pain levels. Men viewing cystoscopy on the video monitor experienced an approximately 40% decrease in the pain level compared to those who did not view the procedure on the monitor. We encourage office urologists to incorporate this useful point of technique during flexible cystoscopy.
RCT Entities:
PURPOSE: An experienced urology nurse observed that patients seemed to tolerate the procedure better when allowed to see the monitor in real time during office based cystoscopy. We assessed the impact of this on visual analog scale pain scores. MATERIALS AND METHODS: A total of 100 consecutive male patients underwent flexible cystoscopy, as performed by a single surgeon during the study period. Patients were randomized into 2 groups. Patients in group 1 were allowed to visualize the video screen with the surgeon, while patients in group 2 had the screen positioned so that only the surgeon could visualize the procedure. Water soluble lubricant was used on all endoscopes and all men received 10 cc 2% viscous lidocaine intraurethral before cystoscopy. No sedatives or analgesics were administered. All patients provided consent before the procedure and they were asked to record their pain experience on a 100 mm visual analog pain scale as soon as the surgeon left the room. RESULTS:Men who were allowed to visualize the cystoscopy had lower visual analog scale pain scores than those who were unable to visualize the screen (14 vs 23, Wilcoxon rank sum test p=0.02). CONCLUSIONS: To our knowledge no study has shown the impact of distraction of cystoscopic findings on procedure pain levels. Men viewing cystoscopy on the video monitor experienced an approximately 40% decrease in the pain level compared to those who did not view the procedure on the monitor. We encourage office urologists to incorporate this useful point of technique during flexible cystoscopy.
Authors: Hyun Ju Kim; Jong Wook Kim; Hong Seok Park; Du Geon Moon; Jeong Gu Lee; Mi Mi Oh Journal: Int Urogynecol J Date: 2018-10-22 Impact factor: 2.894
Authors: Lieschen H Quiroz; S Abbas Shobeiri; Mikio A Nihira; Jordan Brady; Robert A Wild Journal: Int Urogynecol J Date: 2012-05-09 Impact factor: 2.894
Authors: Jason R Gee; Bradley J Waterman; David F Jarrard; Sean P Hedican; Reginald C Bruskewitz; Stephen Y Nakada Journal: JSLS Date: 2009 Apr-Jun Impact factor: 2.172