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Published in: BMC Urology 1/2015

Open Access 01-12-2015 | Research article

Does visualisation during urethrocystoscopy provide pain relief? Results of an observational study

Authors: J. Koenig, S. Sevinc, C. Frohme, H. Heers, R. Hofmann, A. Hegele

Published in: BMC Urology | Issue 1/2015

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Abstract

Background

To measure the effects of real-time visualisation during urethrocystoscopy on pain in patients who underwent ambulatory urethrocystoscopy.

Methods

An observational study was designed. From June 2012 to June 2013 patients who had ambulatory urethrocystoscopy participated in the study. In order to measure pain perception we used a numeric rating scale (NRS) 0 to 10. Additional data was collected including gender, reason for intervention, use of a rigid or a flexible instrument and whether the patient had had urethrocystoscopy before.

Results

185 patients were evaluated. 125 patients preferred to watch their urethrocystoscopy on a real-time video screen, 60 patients did not. There was no statistically relevant difference in pain perception between those patients who watched their urethrocystoscopy on a real-time video screen and those who did not (p = 0.063). However, men who were allowed to watch their flexible urethrocystoscopy experienced significantly less pain, than those who did not (p = 0.007). No such effects could be measured for rigid urethrocystoscopy (p = 0.317). Furthermore, women experienced significantly higher levels of pain during the urethrocystoscopy than men (p = 0.032).

Conclusions

Visualisation during urethrocystoscopy procedures in general does not significantly decrease pain in patients. Nevertheless, men who undergo flexible urethrocystoscopy should be offered to watch their procedure in real-time on a video screen. To make urethrocystoscopy less painful for both genders, especially for women, should be subject to further research.
Literature
1.
go back to reference Hofmann R. Endoskopische Urologie, Atlas und Lehrbuch. 2. Aufl. Heidelberg: Springer; 2009. p. p. 29.CrossRef Hofmann R. Endoskopische Urologie, Atlas und Lehrbuch. 2. Aufl. Heidelberg: Springer; 2009. p. p. 29.CrossRef
2.
go back to reference Flannigan GM, Gelister JS, Noble JG, et al. Rigid versus flexible cystoscopy. A controlled trial of patient tolerance. Br J Urol. 1988;62(6):537–40.CrossRefPubMed Flannigan GM, Gelister JS, Noble JG, et al. Rigid versus flexible cystoscopy. A controlled trial of patient tolerance. Br J Urol. 1988;62(6):537–40.CrossRefPubMed
3.
go back to reference Patel AR, Jones JS, Babineau D. Lidocaine 2 % gel versus plain lubricating gel for pain reduction during flexible cystoscopy: a meta-analysis of prospective, randomized, controlled trials. J Urol. 2008;179(3):986–90.CrossRefPubMed Patel AR, Jones JS, Babineau D. Lidocaine 2 % gel versus plain lubricating gel for pain reduction during flexible cystoscopy: a meta-analysis of prospective, randomized, controlled trials. J Urol. 2008;179(3):986–90.CrossRefPubMed
4.
go back to reference Gunendran T, Briggs RH, Wemyss-Holden GD, et al. Does increasing hydrostatic pressure (“bag squeeze”) during flexible cystoscopy improve patient comfort: a randomized, controlled study. Urology. 2008;72(2):255–8. discussion 258–9.CrossRefPubMed Gunendran T, Briggs RH, Wemyss-Holden GD, et al. Does increasing hydrostatic pressure (“bag squeeze”) during flexible cystoscopy improve patient comfort: a randomized, controlled study. Urology. 2008;72(2):255–8. discussion 258–9.CrossRefPubMed
5.
go back to reference Calleary JG, Masood J, Van-Mallaerts R, et al. Nitrous oxide inhalation to improve patient acceptance and reduce procedure related pain of flexible cystoscopy for men younger than 55 years. J Urol. 2007;178(1):184–8. discussion 188.CrossRefPubMed Calleary JG, Masood J, Van-Mallaerts R, et al. Nitrous oxide inhalation to improve patient acceptance and reduce procedure related pain of flexible cystoscopy for men younger than 55 years. J Urol. 2007;178(1):184–8. discussion 188.CrossRefPubMed
6.
go back to reference Song YS, Song ES, Kim KJ, et al. Midazolam anesthesia during rigid and flexible cystoscopy. Urol Res. 2007;35(3):139–42.CrossRefPubMed Song YS, Song ES, Kim KJ, et al. Midazolam anesthesia during rigid and flexible cystoscopy. Urol Res. 2007;35(3):139–42.CrossRefPubMed
7.
go back to reference Hruby G, Ames C, Chen C, et al. Assessment of efficacy of transcutaneous electrical nerve stimulation for pain management during office-based flexible cystoscopy. Urology. 2006;67(5):914–7.CrossRefPubMed Hruby G, Ames C, Chen C, et al. Assessment of efficacy of transcutaneous electrical nerve stimulation for pain management during office-based flexible cystoscopy. Urology. 2006;67(5):914–7.CrossRefPubMed
8.
go back to reference Clements S, Sells H, Wright M. Use of video in flexible cystoscopy: a prospective randomised study of effect on patient experience. Ambul Surg. 2004;11(1–2):45–6.CrossRef Clements S, Sells H, Wright M. Use of video in flexible cystoscopy: a prospective randomised study of effect on patient experience. Ambul Surg. 2004;11(1–2):45–6.CrossRef
9.
go back to reference Patel AR, Jones JS, Angie S, et al. Office based flexible cystoscopy may be less painful for men allowed to view the procedure. J Urol. 2007;177(5):1843–5.CrossRefPubMed Patel AR, Jones JS, Angie S, et al. Office based flexible cystoscopy may be less painful for men allowed to view the procedure. J Urol. 2007;177(5):1843–5.CrossRefPubMed
10.
go back to reference Soomro KQ, Nasir AR, Ather MH. Impact of patient’s self-viewing of flexible cystoscopy on pain using a visual analog scale in a randomized controlled trial. Urology. 2011;77(1):21–3.CrossRefPubMed Soomro KQ, Nasir AR, Ather MH. Impact of patient’s self-viewing of flexible cystoscopy on pain using a visual analog scale in a randomized controlled trial. Urology. 2011;77(1):21–3.CrossRefPubMed
11.
go back to reference Zhang Z, Tang L, Wang X, et al. Seeing is believing: a randomized controlled study from China of real-time visualization of flexible cystoscopy to improve male patient comfort. J Endourol. 2011;25(8):1343–6.CrossRefPubMed Zhang Z, Tang L, Wang X, et al. Seeing is believing: a randomized controlled study from China of real-time visualization of flexible cystoscopy to improve male patient comfort. J Endourol. 2011;25(8):1343–6.CrossRefPubMed
12.
go back to reference Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. 2010;30(8):1011–8.CrossRefPubMed Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. 2010;30(8):1011–8.CrossRefPubMed
13.
go back to reference Serlin RC, Mendoza TR, Nakamura Y, et al. When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function. Pain. 1995;61(2):277–84.CrossRefPubMed Serlin RC, Mendoza TR, Nakamura Y, et al. When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function. Pain. 1995;61(2):277–84.CrossRefPubMed
14.
go back to reference Cornel EB, Oosterwijk E, Kiemeney LA. The effect on pain experienced by male patients of watching their office-based flexible cystoscopy. BJU Int. 2008;102(10):1445–6.PubMed Cornel EB, Oosterwijk E, Kiemeney LA. The effect on pain experienced by male patients of watching their office-based flexible cystoscopy. BJU Int. 2008;102(10):1445–6.PubMed
15.
go back to reference Patel AR, Jones JS, Babineau D. Impact of real-time visualization of cystoscopy findings on procedural pain in female patients. J Endourol. 2008;22(12):2695–8.CrossRefPubMed Patel AR, Jones JS, Babineau D. Impact of real-time visualization of cystoscopy findings on procedural pain in female patients. J Endourol. 2008;22(12):2695–8.CrossRefPubMed
16.
go back to reference Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798–804.CrossRefPubMed Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798–804.CrossRefPubMed
17.
go back to reference Miller C, Newton SE. Pain perception and expression: the influence of gender, personal self-efficacy, and lifespan socialization. Pain Manag Nurs. 2006;7(4):148–52.CrossRefPubMed Miller C, Newton SE. Pain perception and expression: the influence of gender, personal self-efficacy, and lifespan socialization. Pain Manag Nurs. 2006;7(4):148–52.CrossRefPubMed
18.
go back to reference Kesari D, Kovisman V, Cytron S, et al. Effects on pain and anxiety of patients viewing their cystoscopy in addition to a detailed explanation: a controlled study. BJU Int. 2003;92(7):751–2.CrossRefPubMed Kesari D, Kovisman V, Cytron S, et al. Effects on pain and anxiety of patients viewing their cystoscopy in addition to a detailed explanation: a controlled study. BJU Int. 2003;92(7):751–2.CrossRefPubMed
19.
go back to reference Quiroz LH, Shobeiri SA, Nihira MA, et al. Randomized trial comparing office flexible to rigid cystoscopy in women. Int Urogynecol J. 2012;23(11):1625–30.CrossRefPubMed Quiroz LH, Shobeiri SA, Nihira MA, et al. Randomized trial comparing office flexible to rigid cystoscopy in women. Int Urogynecol J. 2012;23(11):1625–30.CrossRefPubMed
21.
go back to reference Greenstein A, Greenstein I, Senderovich S, Mabjeesh NJ. Is diagnostic cystoscopy painful ? Analysis of 1,320 consecutive procedures. Int Braz J Urol. 2014;40(4):S.533–8.CrossRef Greenstein A, Greenstein I, Senderovich S, Mabjeesh NJ. Is diagnostic cystoscopy painful ? Analysis of 1,320 consecutive procedures. Int Braz J Urol. 2014;40(4):S.533–8.CrossRef
22.
go back to reference Taghizadeh AK, El Madani A, Gard PR, et al. When does it hurt? Pain during flexible cystoscopy in men. Urol Int. 2006;76(4):301–3.CrossRefPubMed Taghizadeh AK, El Madani A, Gard PR, et al. When does it hurt? Pain during flexible cystoscopy in men. Urol Int. 2006;76(4):301–3.CrossRefPubMed
23.
go back to reference Yeo JK, Cho DY, Oh MM, et al. Listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction in patients: a pilot randomized controlled trial. J Endourol. 2013;27(4):459–62.CrossRefPubMedPubMedCentral Yeo JK, Cho DY, Oh MM, et al. Listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction in patients: a pilot randomized controlled trial. J Endourol. 2013;27(4):459–62.CrossRefPubMedPubMedCentral
24.
go back to reference Zhang Z, Wang X, Xu C et al.: Music Reduces Panic: An Initial Study of Listening to Preferred Music Improves Male Patient Discomfort and Anxiety During Flexible Cystoscopy. J. Endourol. 2014; ahead of print Zhang Z, Wang X, Xu C et al.: Music Reduces Panic: An Initial Study of Listening to Preferred Music Improves Male Patient Discomfort and Anxiety During Flexible Cystoscopy. J. Endourol. 2014; ahead of print
Metadata
Title
Does visualisation during urethrocystoscopy provide pain relief? Results of an observational study
Authors
J. Koenig
S. Sevinc
C. Frohme
H. Heers
R. Hofmann
A. Hegele
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-015-0053-2

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