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Öztürk E, Yikilmaz TN, Hamidi N, Selvi İ, Başar H. Scheduled or immediate cystoscopy: Which option reduces pain and anxiety? Int Urol Nephrol 2023; 55:37-41. [PMID: 36125620 DOI: 10.1007/s11255-022-03364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/10/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Office-based flexible cystoscopy is a common outpatient procedure in daily urology practice. Sometimes, cystoscopy procedures are performed on the initial day or scheduled on the following days. We designed this study to compare immediate versus scheduled cystoscopy in terms of anxiety and pain. METHODS In this study, 160 patients were prospectively randomized to undergo office-based flexible cystoscopy by the same urologist between November 2017 and January 2018. Participants were grouped as scheduled for a cystoscopy on the third day of their application (group 1) and immediate cystoscopy on the same day of the application (group 2). A visual analog scale (VAS), State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI) were completed by the patients. RESULTS Among men, immediate cystoscopy group experienced an increased state anxiety score compared to scheduled group (51.21 ± 8.108 vs 35.29 ± 10.553; p < 0.001). BAI scores were 16.51 ± 8.078 for group1 vs 31.92 ± 8.403 for group2 (p < 0.001). The mean VAS score was 3 ± 1.183 and 4.55 ± 1.155 in group1 and group2, respectively (p < 0.001). Among women, both the trait anxiety score and state anxiety score were found significantly low in scheduled group (mean trait anxiety scores 44.71 ± 6.051 and 49.3 ± 6.670, mean state anxiety scores were 33.71 ± 8.776 and 44.15 ± 7 in group1 and 2, respectively; p < 0.0001). BAI scores were also low in scheduled group (19.02 ± 7.786 vs 34.13 ± 8.367). Additionally, the mean VAS score was significantly high in immediate cystoscopy group compared to scheduled cystoscopy group (3.50 ± 0.784 vs 2.61 ± 0.919; p < 0.001). CONCLUSION To reduce anxiety and pain, informing patients properly about the cystoscopy and scheduling the procedure would be helpful for a better cooperation of the patient.
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Affiliation(s)
- Erdem Öztürk
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey.
| | - Taha Numan Yikilmaz
- Urology Department, Department of Urology, Denizli Egekent Hospital, Denizli, Turkey
| | - Nurullah Hamidi
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey
| | - İsmail Selvi
- Urology Department, Department of Urology, Başakşehir Çam and Sakura Hospital, Istanbul, Turkey
| | - Halil Başar
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey
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Goergen DI, Freitas DMDEO. Virtual Reality as a distraction therapy during cystoscopy: a clinical trial. Rev Col Bras Cir 2022; 49:e20223138. [PMID: 35584530 PMCID: PMC10578813 DOI: 10.1590/0100-6991e-20223138-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/22/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to investigate whether virtual reality (VR) experience is associated with decreased pain sensation among patients who undergo rigid cystoscopy under local anesthesia. METHODS we performed a prospective, randomized, controlled study of 159 patients who were aleatorily enrolled into two groups: VR and control. VR experience intervention consisted of using a headset with a smartphone adapted to a virtual reality glasses where an app-video was played during the procedure. Main outcomes analyzed were pain, discomfort, heart rate variability, difficulty and duration of the cystoscopy. Statistical analyses were performed using a Student's t test, Mann-Whitney test and Chi-square test. A P<0.05 was considered to be statistically significant. RESULTS among 159 patients studied (VR group=80 patients; control group=79 patients), the mean age was 63,6 years and 107 (67,3%) were male. There was no statistically significant difference in baseline characteristics between the 2 groups. VR was significantly associated to decreased heart rate variability (6,29 vs 11,09 bpm, P<0,001) and lower duration of the procedure (5,33 vs 8,65 min, P<0,001). Also, when cystoscopies due to double-J extraction were excluded, VR experience was associated with reduced pain on the visual analog score of pain (3,26 vs 4,33 cm, P=0,023). CONCLUSIONS the use of VR as a distraction therapy while performing outpatient cystoscopies is safe, has no side effects, is associated with less pain and discomfort, and reduces length of procedure.
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Affiliation(s)
| | - Daniel Melecchi DE Oliveira Freitas
- - Hospital Nossa Senhora da Conceição, Urologia - Porto Alegre - RS - Brasil
- - Hospital Moinhos de Vento, Urologia - Porto Alegre - RS - Brasil
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Yang B, Liu S, Mi Y, Wang J, Zhang Y, Wang J. The impact of watching real-time videos of flexible ureteroscopic lithotripsy on anxiety and depression in patients. Int Urol Nephrol 2022; 54:1009-1015. [PMID: 35266064 DOI: 10.1007/s11255-022-03164-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study examines the effect of intraoperative doctor-patient communication with real-time videos in flexible ureteroscopic lithotripsy on patients' anxiety and depression. METHODS Patients with upper urinary tract calculi were randomised into four groups. Group A (n = 29) watched the real-time operation video, but did not accept the relevant explanation during the operation; Group B (n = 31) received an explanation about the operation process during the operation alone. Patients in Group C (n = 33) watched the real-time operation video and received an explanation about the operation process during the operation. Group D (n = 31) neither watched the operation video nor received an explanation about the operation process. The self-rated anxiety and depression scores of the patients were evaluated using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) before and after the operation. RESULTS The clinical and demographic profiles (average age, gender distribution, educational level, body mass index, stone size, the position of stones in each groups, the length of stayand the numbers of severe postoperative complications) of the for groups showed no preoperation difference (P > 0.05). The preoperative anxiety scores and the preoperative depression scores showed no significant difference in the four groups (P > 0.05). The scores of postoperative anxiety and depression in groups A (n = 29), B (n = 31), and C (n = 33) were significantly lower than those in Group D (n = 31), (P < 0. 05). Compared to groups A and B, the scores of anxiety and depression in Group C were significantly decreased (P < 0.05). CONCLUSION During flexible ureteroscopic lithotripsy, doctor-patient communication combined with real-time video can significantly reduce patients' postoperative anxiety and depression, and contribute to their physical and mental health recovery.
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Affiliation(s)
- Bin Yang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shuqin Liu
- Department of Radiology, Second Hospital of Shanxi Medical University, No. 382 Wuyi Road, Taiyuan, Shanxi, People's Republic of China
| | - Yang Mi
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jinyao Wang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China. .,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Yangang Zhang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jingyu Wang
- Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Kwon OS, Kwon BK, Kim JH, Kim BH. Effects of heating therapy on pain, anxiety, physiologic measures, and satisfaction in patients undergoing cystoscopy. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:73-79. [DOI: 10.1016/j.anr.2022.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/27/2022] [Accepted: 02/07/2022] [Indexed: 11/02/2022] Open
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Toralla O, Lopez Jornet P, Pons-Fuster E. The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020783. [PMID: 35055603 PMCID: PMC8775441 DOI: 10.3390/ijerph19020783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. MATERIAL AND METHODS A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah's Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. CONCLUSIONS The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.
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Affiliation(s)
- Oscar Toralla
- Departamento Odontologia, Universidad San Carlos de Guatemala, Guatemala 01018, Guatemala;
| | - Pia Lopez Jornet
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
- Correspondence:
| | - Eduardo Pons-Fuster
- Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain;
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GOERGEN DIEGOINÁCIO, FREITAS DANIELMELECCHIDEOLIVEIRA. A Realidade Virtual como terapia de distração durante cistoscopias: um ensaio clínico. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: investigar se a experiência de realidade virtual (RV) está associada à diminuição da dor em pacientes submetidos à cistoscopia rígida sob anestesia local. Métodos: foi realizado um estudo prospectivo, randomizado e controlado de 159 pacientes que foram alocados aleatoriamente em dois grupos: RV e controle. A intervenção da experiência de RV consistiu no uso de óculos de realidade virtual com smartphone adaptado e fones de ouvido, onde um vídeo foi reproduzido durante o procedimento. Os principais desfechos analisados foram dor, desconforto, variabilidade da frequência cardíaca, dificuldade e duração da cistoscopia. As análises estatísticas foram realizadas com o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado. Um P<0,05 foi considerado como estatisticamente significativo. Resultados: entre os 159 pacientes estudados (grupo RV=80; grupo controle=79), a média de idade foi 63,6 anos e 107 (67,3%) eram do sexo masculino. Não houve diferença estatisticamente significativa nas características basais entre os grupos. A RV foi significativamente associada à menor variabilidade da frequência cardíaca (6,29 vs 11,09 bpm, P<0,001) e menor duração do procedimento (5,33 vs 8,65 min, P<0,001). Além disso, quando cistoscopias devido à extração de duplo J foram excluídas, a RV foi associada à redução da dor na escala visual analógica (3,26 vs 4,33cm, P=0,023). Conclusões: o uso da RV como terapia de distração durante a realização de cistoscopias ambulatoriais é seguro, não tem efeitos colaterais, está associado a menos dor e desconforto e reduz a duração do procedimento.
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Pain reduction methods during transurethral cystoscopy. Contemp Oncol (Pozn) 2021; 25:80-87. [PMID: 34667433 PMCID: PMC8506429 DOI: 10.5114/wo.2021.106652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/24/2021] [Indexed: 11/17/2022] Open
Abstract
Transurethral cystoscopy (CS) is a common urological procedure, performed mostly for diagnostic but also for therapeutic purposes. Although CS is generally well tolerated, some patients describe the pain related to the procedure as high or even “unbearable”. As a result, many patients fear and avoid both primary and/or follow-up cystoscopies. This may lead to uncontrolled progression of neoplastic disease. Therefore, it is crucial to maximally increase the comfort of the patient and to implement safe and effective analgesia before the procedure. Providing the patients with appropriate care during CS can encourage them to comply with diagnostic schedules and improve their prognosis. The aim of this review is to analyze the available literature on various methods of pain reduction during transurethral CS. The PubMed electronic database limited to English articles published until January 2021 was used in the process. Meta-analyses, systematic reviews, randomized controlled trials, clinical trials, prospective randomized studies, multicenter comparisons, reviews and retrospective comparisons were used. As a result, 65 articles were included in this review.
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Gezginci E, Bedir S, Ozcan C, Iyigun E. Does Watching a Relaxing Video During Cystoscopy Affect Pain and Anxiety Levels of Female Patients? A Randomized Controlled Trial. Pain Manag Nurs 2020; 22:214-219. [PMID: 33008780 DOI: 10.1016/j.pmn.2020.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/13/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cystoscopy is noted to be more painful in men. Research has been done to support the use of video in men to reduce pain; it would follow that video would be useful in reducing pain in women as well. AIMS The aim of this study was to evaluate the effect of watching a relaxing video during cystoscopy on the pain and anxiety levels of female patients. DESIGN The study was a single-center, parallel, randomized, controlled, nonblinded trial. SETTING This study was carried out in the cystoscopy unit of a training and research hospital in Turkey. PARTICIPANTS Sixty female patients aged 18 years and older undergoing rigid cystoscopy for the first time and under local anesthesia. METHODS The participants were randomized into two equal groups: video and control. Data were collected with Visual Analog Scale, State-Trait Anxiety Scale, and hemodynamic parameters. RESULTS A statistically significant difference was found between the two groups in terms of pain levels during and after cystoscopy (p < .001). Pain levels were significantly lower in the video group during and after the procedure. A statistically significant difference was also found between the groups in terms of anxiety levels before and after cystoscopy (p < .05). Anxiety levels were significantly lower in the video group after the procedure. Satisfaction levels were higher in the video group (p < .001). CONCLUSION According to this study, watching a relaxing video during cystoscopy had a positive effect on pain, anxiety, satisfaction levels, and hemodynamic parameters of the patients.
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Affiliation(s)
- Elif Gezginci
- Department of Surgical Nursing, Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey.
| | - Selahattin Bedir
- Department of Urology, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Cihat Ozcan
- Department of Urology, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Emine Iyigun
- Department of Surgical Nursing, Gulhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
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Bonakdar A, Sahebazzamani F, Rasaee MJ, Hosseinkhani S, Rahbarizadeh F, Mahboudi F, Ganjali MR. In silico design and in vitro characterization of a recombinant antigen for specific recognition of NMP22. Int J Biol Macromol 2019; 140:69-77. [PMID: 31404598 DOI: 10.1016/j.ijbiomac.2019.08.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 01/22/2023]
Abstract
Although urine cytology and cystoscopy are current gold standard methods in diagnosis and surveillance of Bladder cancer (BC), they have some limitations which necessitates novel diagnostic approaches to compensate their drawbacks. In this regard, Nuclear Matrix Protein 22 (NMP22) is introduced as a potential tumor biomarker for BC detection (FDA approved). NMP22 determination mainly occurs through immunoassay platforms, raising a proper antibody against its antigen. Hence, development of such immunoassays seems crucial. Various bioinformatic tools were harnessed to select a region with lowest variability, highest density for linear and conformational epitopes, lowest post translational modifications, highest antigenicity, best physicochemical properties and reliable transcriptional properties. Subsequently, E. coli BL21 (DE3) and P. pastoris GS115 were applied for exogenous expression. Ultimately, protein purification and quantification was followed by ELISA test for antibody analyses. Both host successfully expressed the antigen, while the E. coli expression was with higher yield. The commercial anti-NMP22 antibodies showed relatively equal detection results. However, the slight better detection for the antigen with P. pastoris origin could be deduced as better structural properties for P. pastoris. These results indicate higher expression yields and lower costs for over-expression of this eukaryotic antigen.
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Affiliation(s)
- Alireza Bonakdar
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Sahebazzamani
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Javad Rasaee
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saman Hosseinkhani
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Fatemeh Rahbarizadeh
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Mohammad Reza Ganjali
- Center of Excellence in Electrochemistry, University of Tehran, Tehran, Iran; Biosensor Research Center, Endocrinology & Metabolism Molecular - Cellular Sciences Institute, Iran
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The superiority of the analgesic effect of intraurethral Bupivacaine during outpatient flexible cystoscopy in male patients. AFRICAN JOURNAL OF UROLOGY 2018. [DOI: 10.1016/j.afju.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gezginci E, Iyigun E, Kibar Y, Bedir S. Three Distraction Methods for Pain Reduction During Cystoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain, Anxiety, and Satisfaction. J Endourol 2018; 32:1078-1084. [DOI: 10.1089/end.2018.0491] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Elif Gezginci
- Faculty of Nursing, University of Health Sciences, Istanbul, Turkey
| | - Emine Iyigun
- Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Turkey
| | - Yusuf Kibar
- Department of Urology, Private Koru Hospital, Ankara, Turkey
| | - Selahattin Bedir
- Department of Urology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Kim HJ, Kim JW, Park HS, Moon DG, Lee JG, Oh MM. The use of a heating pad to reduce anxiety, pain, and distress during cystoscopy in female patients. Int Urogynecol J 2018; 30:1705-1710. [DOI: 10.1007/s00192-018-3786-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/28/2018] [Indexed: 11/30/2022]
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Biardeau X, Lam O, Ba V, Campeau L, Corcos J. Prospective evaluation of anxiety, pain, and embarrassment associated with cystoscopy and urodynamic testing in clinical practice. Can Urol Assoc J 2017; 11:104-110. [PMID: 28515809 DOI: 10.5489/cuaj.4127] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to prospectively assess anxiety, pain, and embarrassment associated with diagnostic cystoscopy and multi-channel 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.
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Affiliation(s)
- Xavier Biardeau
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Ornella Lam
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Van Ba
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Lysanne Campeau
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Jacques Corcos
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
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Kazancioglu HO, Dahhan AS, Acar AH. How could multimedia information about dental implant surgery effects patients' anxiety level? Med Oral Patol Oral Cir Bucal 2017; 22:e102-e107. [PMID: 27918733 PMCID: PMC5217487 DOI: 10.4317/medoral.21254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 07/27/2016] [Indexed: 01/09/2023] Open
Abstract
Background To evaluate the effects of different patient education techniques on patients’ anxiety levels before and after dental implant surgery. Material and Methods Sixty patients were randomized into three groups; each contained 20 patients; [group 1, basic information given verbally, with details of operation and recovery; group 2 (study group), basic information given verbally with details of operative procedures and recovery, and by watching a movie on single implant surgery]; and a control group [basic information given verbally “but it was devoid of the details of the operative procedures and recovery”]. Anxiety levels were assessed using the Spielberger’s State-Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS). Pain was assessed with a visual analog scale (VAS). Results The most significant changes were observed in the movie group (P < 0.05). Patients who were more anxious also used more analgesic medication. Linear regression analysis showed that female patients had higher levels of anxiety (P < 0.05). Conclusions Preoperative multimedia information increases anxiety level. Key words:Implant, anxiety, pain, dental, video and patient knowledge.
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Affiliation(s)
- H-O Kazancioglu
- Bezmialem Vakif University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, 34093, Fatih, Istanbul, Turkey,
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Anxiety and depression analyses of patients undergoing diagnostic cystoscopy. Qual Life Res 2016; 25:2307-14. [DOI: 10.1007/s11136-016-1264-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
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Koenig J, Sevinc S, Frohme C, Heers H, Hofmann R, Hegele A. Does visualisation during urethrocystoscopy provide pain relief? Results of an observational study. BMC Urol 2015; 15:56. [PMID: 26126393 PMCID: PMC4487843 DOI: 10.1186/s12894-015-0053-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 06/11/2015] [Indexed: 11/12/2022] Open
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.
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Affiliation(s)
- J Koenig
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
| | - S Sevinc
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
| | - C Frohme
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
| | - H Heers
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
| | - R Hofmann
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
| | - A Hegele
- Department of Urology and Pediatric Urology, University hospital Marburg, Philipps University, Marburg, Germany.
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Kazancioglu HO, Tek M, Ezirganli S, Demirtas N. Does watching a video on third molar surgery increase patients' anxiety level? Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:272-7. [PMID: 25561389 DOI: 10.1016/j.oooo.2014.10.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/26/2014] [Accepted: 10/17/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To identify the effects of watching live taping of third molar removal on patients' anxiety levels before and after extraction. STUDY DESIGN This study was based on a prospective, cross-sectional, observational investigation of the different patient education techniques about the effect of third molar removal on patients' anxiety level. A total of 333 patients were randomized into three groups: two study groups (for group 1, basic information was given verbally; for group 2, which was the study group, basic information was given verbally and through a movie on third molar extraction); and a control group (basic information was given verbally; it did not include information on operative procedures and recovery). Anxiety levels were assessed by using the Dental Anxiety Scale (DAS) and the Spielberger State-Trait Anxiety Inventory (STAI). Pain was assessed with a visual analog scale. Statistical analysis was performed with SPSS 16.0. RESULTS Group 2 patients were significantly more anxious before the surgical procedure, and the most significant decreases in DAS and STAI scores were observed in that group. The age, surgery time, and education level were not correlated with anxiety or pain levels; however, female patients had high levels of anxiety (P < .05). CONCLUSION Preoperative multimedia information increases the anxiety of patients undergoing third molar surgery.
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Affiliation(s)
- Hakki Oguz Kazancioglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mustafa Tek
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Abant Izzet Baysal University, Bolul, Turkey
| | - Seref Ezirganli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Nihat Demirtas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
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Qi F, Liu Y, Zhao R, Zou X, Zhang L, Li J, Wang Y, Li F, Zou X, Xia Y, Wang X, Xing L, Li C, Lu J, Tang J, Zhou F, Liu C, Gui Y, Cai Z, Sun X. Quantitation of rare circulating tumor cells by folate receptor α ligand-targeted PCR in bladder transitional cell carcinoma and its potential diagnostic significance. Tumour Biol 2014; 35:7217-23. [PMID: 24771263 DOI: 10.1007/s13277-014-1894-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 03/25/2014] [Indexed: 01/22/2023] Open
Abstract
Numerous attempts for detection of circulating tumor cells (CTC) have been made to develop reliable assays for early diagnosis of cancers. In this study, we validated the application of folate receptor α (FRα) as the tumor marker to detect CTC through tumor-specific ligand PCR (LT-PCR) and assessed its utility for diagnosis of bladder transitional cell carcinoma (TCC). Immunohistochemistry for FRα was performed on ten bladder TCC tissues. Enzyme-linked immunosorbent assay (ELISA) for FRα was performed on both urine and serum specimens from bladder TCC patients (n = 64 and n = 20, respectively) and healthy volunteers (n = 20 and n = 23, respectively). Western blot analysis and qRT-PCR were performed to confirm the expression of FRα in bladder TCC cells. CTC values in 3-mL peripheral blood were measured in 57 bladder TCC patients, 48 healthy volunteers, and 15 subjects with benign urologic pathologies by the folate receptor α ligand-targeted PCR. We found that FRα protein was overexpressed in both bladder TCC cells and tissues. The levels of FRα mRNA were also much higher in bladder cancer cell lines 5637 and SW780 than those of leukocyte. Values of FRα were higher in both serum and urine specimens of bladder TCC patients than those of control. CTC values were also higher in 3-mL peripheral blood of bladder TCC patients than those of control (median 26.5 Cu/3 mL vs 14.0 Cu/3 mL). Area under the receiver operating characteristic (ROC) curve for bladder TCC detection was 0.819, 95 % CI (0.738-0.883). At the cutoff value of 15.43 Cu/3 mL, the sensitivity and the specificity for detecting bladder cancer are 82.14 and 61.9 %, respectively. We concluded that quantitation of CTCs through FRα ligand-PCR could be a promising method for noninvasive diagnosis of bladder TCC.
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Affiliation(s)
- Fuming Qi
- Department of Urological Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Impact of self-watching double j stent insertion on pain experience of male patients: a randomized control study using visual analog scale. ISRN UROLOGY 2013; 2013:523625. [PMID: 23691368 PMCID: PMC3649350 DOI: 10.1155/2013/523625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/17/2013] [Indexed: 11/17/2022]
Abstract
Objective. To confirm safety and feasibility of double J stent insertion under local anesthesia and to assess the effect of detailed explanation and observing double J stent insertion on pain experience of male patients. Material and Methods. Eighty consenting males, randomized and divided prospectively into group A, who were allowed to observe DJ stent insertion, and group B, were not observed. All DJ stent insertions were done by senior urologist in operating urology room with or without fluoroscopy guidance. At the end of the procedure the vital signs and duration of the procedure were documented and patients were asked to fill unmarked 100 mm visual analogue pain scale (VAS) as soon as the surgeon leaves operating room. Results. Mean age of entire study group was 38.8 years; the majority of the patients had DJ stent insertion for obstructed ureteric stone, with uneventful outcomes. Postprocedural systolic blood pressure and mean pain using VAS showed statistically significant difference between groups A and B. Conclusion. DJ stent insertion under local anesthesia is a safe and feasible procedure. We recommended self-watching and detailed explanation to patients who underwent DJ stent insertion to reduce the pain and anxiety associated with the procedure.
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Wong LM, Huang JG, Yong TL, Robertson I, Brough SJS. Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double-blind, controlled trial. BJU Int 2011; 108:718-21. [PMID: 21438987 DOI: 10.1111/j.1464-410x.2010.09883.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE • To determine if sodium bicarbonate (Ural) reduces painful voiding after flexible cystoscopy. PATIENTS AND METHODS • 300 patients over 18 years old undergoing elective flexible cystoscopy were enrolled in a randomized, double-blinded, placebo-controlled trial. Patients with active urinary tract infections, indwelling urinary catheters and/or requiring additional procedures such as biopsy and dilatation were excluded. • Painful voiding was quantified using a pain analogue scale from 0 to 10. Pre-existing painful voiding, previous experience with Ural and flexible cystoscopy were recorded. • Flexible cystoscopy was performed to a standard protocol. Patients were randomised after recruitment to receive Ural or placebo (glucose) powder four times a day for two days after the procedure. Trial outcome was assessed by estimating the change in pain incidence and severity from before to two days after by post-procedural questionnaire. RESULTS • Painful voiding was present in 84 of the 300 patients post flexible cystoscopy (45 of 160 patients receiving Ural; 39 of 140 receiving placebo), but overall mean pain scores were low (1.25; standard deviation 2.4; on a 0-10 scale). • Treatment with Ural compared to placebo was associated with a non-significant reduction in frequency of pain (28.9% vs 31.3%; incidence rate ratio 0.66; 95% CI 0.29-1.46; P = 0.30) and severity of pain (odds ratio 0.72; 95% CI 0.30-1.74; P = 0.47). CONCLUSION •In the replicable context of low post-cystoscopy pain levels, we believe Ural does not reduce painful voiding after flexible cystoscopy.
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Affiliation(s)
- Lih-Ming Wong
- Department of Urology, Launceston General Hospital, Launceston, Australia.
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21
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Impact of patient's self-viewing of flexible cystoscopy on pain using a visual analog scale in a randomized controlled trial. Urology 2010; 77:21-3. [PMID: 20974485 DOI: 10.1016/j.urology.2010.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 08/11/2010] [Accepted: 08/13/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the difference in pain score of patients allowed to view their flexible cystoscopy procedure compared with those who have not viewed the procedure on the video monitor. METHODS It is a prospective, randomized, controlled study. A total of 76 patients with different clinical indications for flexible cystoscopy were enrolled in the study. Patients were divided into 2 groups; group A and group B with 38 patients each. Group A patients viewed the procedure on a video monitor, whereas group B, the control group, did not. Statistical analyses were performed using a χ(2) test, Student's t test, and paired t test. A P value of <0.05 was considered to be statistically significant. RESULTS There were no statistically significant differences in demographic characteristics between the 2 groups. Mean age, duration of the procedure, and indications for the procedure were also comparable in the 2 groups. There was, however, a statistically significant difference in pain scores between the 2 groups (P < .001). The numbers of patients reporting pain in the study group (group A) were lower than in the control group (group B). There was a statistically significant difference in the postprocedural pulse rate; however, the systolic blood pressure pre- and postprocedure remained the same. CONCLUSIONS Patients' who viewed the cystoscopic procedure on a video monitor reported less pain on a visual analog scale compared with the control group.
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Bayar A, Tuncay I, Atasoy N, Ayoğlu H, Keser S, Ege A. The effect of watching live arthroscopic views on postoperative anxiety of patients. Knee Surg Sports Traumatol Arthrosc 2008; 16:982-7. [PMID: 18566798 DOI: 10.1007/s00167-008-0576-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 05/16/2008] [Indexed: 10/21/2022]
Abstract
Surgery is a stressful experience. Many minor interventions have been shown to cause considerable anxiety in patients, but whether arthroscopy leads to such anxiety is not well-known. Methods for lowering perioperative anxiety have been sought and listening to music or watching a movie have been recommended. The method of permitting patients to watch their own endoscopy has been studied infrequently. Our aim in this study was to find out the effect of watching simultaneous arthroscopic views on postoperative anxiety. A total of 63 patients were randomly divided into two groups: those watching their own arthroscopy formed group W, while patients that were only verbally informed formed group NW. The mean age of patients in both groups were 33 and 34, respectively. Meniscal surgery was the most commonly performed procedure (49/63 patients). The patients filled in state scale of State-trait anxiety inventory (STAI) forms and the study questionnaire (SQ) prepared for this study, just before and after the arthroscopy. Group W had significantly lower postoperative scores of STAI-S, whole questionnaire (Q-score) and all but one of individual statements in SQ. Having a previous operation history did not affect STAI scores. Age and level of education was not correlated with any of the studied parameters either. The ratio of patients that were pleased with the arthroscopy experience in group W and NW were 94 and 63%, respectively. Watching live arthroscopic views has led to a significant decrease in postoperative anxiety and worries about the surgery and the postoperative period, while increasing overall understanding and satisfaction of the patient.
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Affiliation(s)
- Ahmet Bayar
- Ortopedi ve Travmatoloji, Zonguldak Karaelmas Universitesi Tip Fakültesi, Hastanesi, 67600 Kozlu, Zonguldak, Turkey.
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Gunendran T, Briggs RH, Wemyss-Holden GD, Neilson D. Reply. Urology 2008. [DOI: 10.1016/j.urology.2008.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lidocaine 2% Gel Versus Plain Lubricating Gel for Pain Reduction During Flexible Cystoscopy: A Meta-Analysis of Prospective, Randomized, Controlled Trials. J Urol 2008; 179:986-90. [DOI: 10.1016/j.juro.2007.10.065] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Indexed: 11/19/2022]
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25
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Tahseen S, Reid PC. Psychological distress associated with colposcopy: patients' perception. Eur J Obstet Gynecol Reprod Biol 2007; 139:90-4. [PMID: 17980478 DOI: 10.1016/j.ejogrb.2007.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Revised: 09/12/2007] [Accepted: 09/13/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Cervical screening and colposcopy are associated with varying degrees of anxiety in women. Interventions are in place to reduce anxiety but the effectiveness of these needs examination. Our objective was to develop an understanding of factors associated with anxiety in relation to colposcopy and to seek women's opinion on interventions designed to reduce anxiety. STUDY DESIGN Prospective, anonymised survey. Determination of anxiety level and effectiveness of interventions within the colposcopy experience, i.e. information leaflet, video-screen display, nursing and medical intervention and exploration of medical terms, i.e. 'CIN'. RESULTS Prior to attendance 36% of patients felt they were very worried, 54% slightly worried and 10% not worried. All patients found the standardised NHS information leaflet helpful to a variable degree. During colposcopy 30% of patients found watching on a video-screen display very helpful, whilst a significant number (18%) found it increased their worry. Stratification of results showed that women with pre-existing high level of anxiety were least satisfied with indices examined. CONCLUSION Our results indicate that the higher the index level of anxiety regarding colposcopy, the less likely women were to find either the leaflet or the video-screen display helpful. Research should focus on the 'very anxious' women, as they are least satisfied with existing measures in place to reduce anxiety. However, evidence is presented to imply this may not be possible.
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Kobayashi T, Kamoto T, Ogawa O. Re: Office based flexible cystoscopy may be less painful for men allowed to view the procedure. A. R. Patel, J. S. Jones, S. Angie and D. Babineau J Urol 2007; 177: 1843-1845. J Urol 2007; 178:2703-4; author reply 2704. [PMID: 17945277 DOI: 10.1016/j.juro.2007.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Indexed: 10/22/2022]
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Abstract
AIM To determine patients' problems with day case cystoscopy and their problem solving ways and patients' self-care at home. BACKGROUND Day surgery has become increasingly common in the last 20 years. Cystoscopic procedures are increasingly being carried out as a diagnostic and therapeutic procedures. DESIGN AND METHOD This descriptive/prospective study comprised 50 patients undergoing day case cystoscopic procedures in the university hospital of Turkey. The data were collected using telephone interview three days after the procedure. The two questionnaire used were Symptom Measurement Questionnaire and Symptom Management Questionnaire. Discharge information and written instruction was given to all patients. RESULTS It was found in the investigation that the most common problems experienced by the patients were tiredness, haematuria, dysuria, pain over bladder and difficulty in voiding after flexible cystoscopy in first day. Generally, urinary elimination problems were experienced by majority of the patients. At second day, these problems were also common. The mean score for all problems decreased after three days. The patients stated that they were able to deal with their symptoms either independently or to a lesser extent with assistance of a carer. But they were unable to deal with problems such as especially haematuria. CONCLUSION Problems experiences by the patients at home after cystoscopy influenced some daily living activities. The problems related to voiding are more frequently observed after cystoscopy. Although some these problems are related to the procedures, some were present previously. RELEVANCE TO CLINICAL PRACTICE This findings indicate that patient-centred care should be strengthened at home in urological day surgery.
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Affiliation(s)
- S Erkal
- Ankara University, Cebeci School of Health, Ankara, Turkey.
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Patel AR, Jones JS, Angie S, Babineau D. Office based flexible cystoscopy may be less painful for men allowed to view the procedure. J Urol 2007; 177:1843-5. [PMID: 17437832 DOI: 10.1016/j.juro.2007.01.070] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- Amit R Patel
- Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
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29
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Erkal S. Patients’ experiences at home after day case cystoscopy. J Clin Nurs 2007. [DOI: 10.1111/j.1365-2702.2005.01500.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Shariat SF, Zippe C, Lüdecke G, Boman H, Sanchez-Carbayo M, Casella R, Mian C, Friedrich MG, Eissa S, Akaza H, Sawczuk I, Serretta V, Huland H, Hedelin H, Rupesh R, Miyanaga N, Sagalowsky AI, Wians F, Roehrborn CG, Lotan Y, Perrotte P, Benayoun S, Marberger MJ, Karakiewicz PI. NOMOGRAMS INCLUDING NUCLEAR MATRIX PROTEIN 22 FOR PREDICTION OF DISEASE RECURRENCE AND PROGRESSION IN PATIENTS WITH Ta, T1 OR CIS TRANSITIONAL CELL CARCINOMA OF THE BLADDER. J Urol 2005; 173:1518-25. [PMID: 15821471 DOI: 10.1097/01.ju.0000154696.48217.75] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We developed and validated nomograms that accurately predict disease recurrence and progression in patients with Ta, T1, or CIS transitional cell carcinoma (TCC) of the bladder using a large international cohort. METHODS Univariate and multivariate logistic regression models targeted histologically confirmed disease recurrence, and focused on 2,542 patients with bladder TCC from 10 participating centers. Variables consisted of pre-cystoscopy voided urine Nuclear Matrix Protein 22 (NMP22) assay, urine cytology, age and gender. Resulting nomograms were internally validated with bootstrapping. Nomogram performance was explored graphically with Loess smoothing plots. RESULTS Overall 957 patients had recurrent TCC. Tumor grade and stage was available for 898 patients, including 24% grade I, 43% grade II, and 33% grade III; 45% stage Ta, 32% T1 and/or CIS, and 23% T2 or greater. Bootstrap corrected predictive accuracy for any TCC recurrence was 0.842; grade III Ta/T1 or CIS was 0.869; and T2 or higher stage TCC of any grade was 0.858. Virtually perfect performance characteristics were observed for the nomograms predicting any TCC recurrence or grade III Ta/T1 or CIS. The nomogram predicting T2 or higher stage TCC overestimated the observed probability for predicted values greater than 45%. CONCLUSIONS We developed and internally validated nomograms that incorporate urinary NMP22, cytology, age and gender to predict with high accuracy the probability of disease recurrence and progression in patients with Ta, T1, and/or CIS bladder TCC. These nomograms could provide a means for individualizing followup in patients with Ta, T1, CIS bladder TCC.
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Affiliation(s)
- Shahrokh F Shariat
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
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Müezzinoglu T, Ceylan Y, Temeltaş G, Lekili M, Büyüksu C. Evaluation of pain caused by urethrocystoscopy in patients with superficial bladder cancer: a perspective of quality of life. Oncol Res Treat 2005; 28:260-4. [PMID: 15867482 DOI: 10.1159/000085110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM The aim of this study is to evaluate patients' tolerance to pain caused by urethrocystoscopy (UCS) in both diagnosis and the period of follow-up in patients with superficial bladder cancer, and to evaluate these results with respect to quality of life. PATIENTS AND METHODS Between March 2003 and October 2004, 66 patients with bladder cancer or hematuria underwent UCS and recorded their overall pain level. RESULTS The mean age was 60.4 (range 26-83) years. UCS was done only one time in 22 patients for the diagnosis of etiology of hematuria and was done 4 times in 44 patients every 3 months for bladder cancer follow-up. The mean pain scores on first, second, third, and fourth UCS were 4.3+/-2.2, 4.7+/-2.5, 4.68+/-2.45, and 5.1+/-2.5, respectively. Statistically significant differences were found among mean pain scores of patients on first, third, and forth cystoscopic examinations (p < 0.05). No correlation was found between age and pain scores in this study group (p > 0.05). CONCLUSION UCS is a painful surgical procedure and pain tolerance was not observed on repeated UCS. Therefore urologists need to use more effective anesthetic methods to provide better patients' tolerance to pain and quality of life during the endoscopic procedure.
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Affiliation(s)
- Talha Müezzinoglu
- Department of Urology, School of Medicine, Celal Bayar University, Manisa, Turkey
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