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Dong Z, Qu X, Zhang L, Chen X, Dong Y, Chen H, Cui Y. Efficacy and Safety of Oxybuprocaine Hydrochloride Gel in Alleviating Pain during Male Urethral Catheterization: A Single-Center Randomized Controlled Study. Int J Clin Pract 2022; 2022:5734387. [PMID: 36177365 PMCID: PMC9492377 DOI: 10.1155/2022/5734387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine whether oxybuprocaine hydrochloride gel could alleviate pain during male catheterization. METHODS Between September 2021 and March 2022, a randomized controlled trial was conducted at the Urology Department of Harbin Medical University Cancer Hospital (China). A total of 192 adult male patients requiring catheterization were enrolled and randomly assigned to one of two groups: 96 in the test group and 96 in the control group. The test group included patients who received oxybuprocaine hydrochloride gel as urethral lubricant, while patients in the control group received liquid paraffin. The preoperative and postoperative pain scores were compared using nonparametric tests. RESULTS At the baseline, there was no significant difference between the two groups. There was no significant difference in preoperative pain scores between the test group (mean ± SD = 20.04 ± 2.68 mm) and the control group (mean ± SD = 20.21 ± 3.23 mm) (p=0.694). Postoperative pain scores increased significantly in the test (mean ± SD = 31.98 ± 2.57 mm, p < 0.001) and control groups (mean ± SD = 38.96 ± 2.02 mm, p < 0.001) groups. Postoperative pain scores were significantly lower in the test group (mean ± SD = 31.98 ± 2.57 mm) than those in the control group (mean ± SD = 38.96 ± 2.02 mm (p < 0.001). CONCLUSIONS The use of oxybuprocaine hydrochloride gel significantly reduced pain during male urethral catheterization. The study provides evidence for clinicians to use oxybuprocaine hydrochloride gel during male catheterization.
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Affiliation(s)
- Zhenkun Dong
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xutong Qu
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lu Zhang
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xueting Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuhang Dong
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hui Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yan Cui
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China
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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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Qiu Y, Liu X, Wei W, Du G. Dorsal penile nerve block alleviates pain in men undergoing rigid cystoscopy: A single‐center, randomized, double‐blind, and placebo‐controlled trial. BJUI COMPASS 2021; 2:260-266. [PMID: 35475300 PMCID: PMC8988839 DOI: 10.1002/bco2.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/20/2020] [Accepted: 01/17/2021] [Indexed: 02/05/2023] Open
Abstract
Objective To assess the effectiveness and safety of dorsal penile nerve block (DPNB) compared with tetracaine gel in analgesia for men undergoing rigid cystoscopy. Patients and methods This study was conducted as a prospective, randomized, double‐blind, placebo‐controlled, and single‐center trial. Men undergoing diagnostic rigid cystoscopy were randomly allocated into one of three groups (n = 86 each): (1) tetracaine gel group (DPNB with saline), (2) DPNB group (DPNB with ropivacaine + plain lubricant), and (3) combination group (DPNB with ropivacaine + tetracaine gel). The primary outcome was visual analog scale (VAS) for pain at cystoscopic inspection of the external sphincter. Results VAS (median [interquartile]) at inspection of the external sphincter was significantly lower in both DPNB and combination groups than that in tetracaine gel group (4 [3–6] and 4 [3–5] vs 6 [5–7], P < .0001), with a 33% reduction of median VAS. Overall pain level during procedure was significantly alleviated in the DPNB and combination groups with more stabilized HR and MAP when compared with tetracaine gel group. No adverse events were observed during DPNB including penile hematoma, erection, local anesthetic toxicosis or incompletion of cystoscopy. Conclusion Our study suggests analgesia provided by DPNB with or without tetracaine gel instilled is superior to that provided by tetracaine gel alone in men undergoing diagnostic rigid cystoscopy. Clinical Trials Registration ClinicalTrials.gov registration number: NCT02502487.
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Affiliation(s)
- Yan Qiu
- Department of Anesthesiology West China Hospital of Sichuan University Chengdu China
| | - Xinhao Liu
- Department of Anesthesiology West China Hospital of Sichuan University Chengdu China
| | - Wuran Wei
- Department of Urinary Surgery West China Hospital of Sichuan University Chengdu China
| | - Guizhi Du
- Department of Anesthesiology West China Hospital of Sichuan University Chengdu China
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Keane KG, Redmond EJ, McIntyre C, O'Connor E, Madden A, O'Connell C, Inder SM, Smyth LG, Thomas AZ, Flynn RJ, Manecksha RP. Does instillation of lidocaine gel following flexible cystoscopy decrease the severity of post procedure symptoms? A randomised controlled trial assessing the efficacy of lidocaine gel post flexible cystoscopy. Ir J Med Sci 2021; 190:1553-1559. [PMID: 33449326 PMCID: PMC7809241 DOI: 10.1007/s11845-020-02458-2] [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: 11/05/2020] [Accepted: 12/03/2020] [Indexed: 12/02/2022]
Abstract
Objective To assess whether instillation of lidocaine gel both before and after flexible cystoscopy is more effective at reducing post procedural symptoms than instillation of lidocaine gel pre flexible cystoscopy alone. We hypothesise that inadequate urethral dwell time and dilution of lidocaine gel by the irrigation fluid during flexible cystoscopy limits its anaesthetic efficacy. Only one other study has attempted to reduce bothersome urinary symptoms through an intervention after flexible cystoscopy. Methods This was a randomised controlled trial in which patients were randomised 1:1 to receive lidocaine gel pre and post flexible cystoscopy (treatment) or lidocaine gel pre flexible cystoscopy only (control). Patient-reported outcome measures were used to assess symptoms and quality of life prior to cystoscopy, on day 2 and day 7 post cystoscopy. Result Fifty patients were divided equally between the treatment and control groups. There were no significant differences in baseline characteristics between the groups (p = 1.000). An overall symptoms variable was measured, though no significant difference was found in the distribution of responses between the groups at baseline, 2 or 7 days after the flexible cystoscopy (p = 0.423, 0.651,0.735). In the treatment group, 1 patient (4.0%) presented to a doctor for review following flexible cystoscopy, and 4 patients (16.0%) presented in the control group (p = 0.349). Conclusion Initial study results suggest that post-operative lidocaine does not significantly limit the exacerbation of urinary symptoms following flexible cystoscopy; however, our results are not powered to detect a small difference. We do not recommend a change in practice based on our results.
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Affiliation(s)
- K G Keane
- Department of Urology, Tallaght University Hospital, Dublin, Ireland.
| | - E J Redmond
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - C McIntyre
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - E O'Connor
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - A Madden
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - C O'Connell
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - S M Inder
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - L G Smyth
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - A Z Thomas
- Department of Urology, Tallaght University Hospital, Dublin, Ireland.,Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R J Flynn
- Department of Urology, Tallaght University Hospital, Dublin, Ireland.,Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R P Manecksha
- Department of Urology, Tallaght University Hospital, Dublin, Ireland.,Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Ölçücü MT, Yılmaz K, Karamık K, Okuducu Y, Özsoy Ç, Aktaş Y, Çakır S, Ateş M. Effects of Listening to Binaural Beats on Anxiety Levels and Pain Scores in Male Patients Undergoing Cystoscopy and Ureteral Stent Removal: A Randomized Placebo-Controlled Trial. J Endourol 2020; 35:54-61. [PMID: 33107329 DOI: 10.1089/end.2020.0353] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose: To investigate the effects of pure binaural beats on anxiety and pain scores in male patients undergoing diagnostic cystoscopy (DC) and ureteral stent removal (USR) under local anesthesia. Materials and Methods: This was a prospective, randomized placebo-controlled study. Patients in the DC group (DCG) and USR group (USRG) were divided into three subgroups according to interventions applied; DCG-1 and USRG-1, patients listened to binaural beats; DCG-2 and USRG-2, patients listened to classical music; and DCG-3 and USRG-3, patients wore headphones, but were not exposed to audio (control group). The State-Trait Anxiety Inventory (STAI) and Visual Analog Scale (VAS) were used for measuring anxiety and pain scores, respectively. Demographic data, initial STAI, tolerance rate of interventions, terminal STAI (STAI-T), differences of STAI (delta STAI, STAI-D), and VAS scores were compared. Results: Between July 2019 and March 2020, a total of 252 and 159 eligible male patients for DCG and USRG were included, respectively. After exclusions, remaining patients were DCG-1, n = 61; DCG-2, n = 73; DCG-3, n = 75; USRG-1, n = 41; USRG-2, n = 50; and USRG-3, n = 52. The tolerance rate in binaural beat groups was significantly lower than in other groups (p < 0.05 for all). There were significant decreases in terms of STAI-T when DCG-1 and DCG-2 were compared with DCG-3 and USRG-1 and USRG-2 were compared with USRG-3 (p < 0.05 for all). There were significant decreases in STAI-D scores when DCG-1 and DCG-2 were compared with DCG-3 and when USRG-1 and USRG-2 were compared with USRG-3 (p < 0.001 for all). Binaural beat groups had significantly lower VAS scores than other groups and classical music groups had significantly lower VAS scores than control groups (p < 0.05 for all). Conclusions: Listening to pure binaural beats may be a simple and effective method to reduce anxiety levels and pain scores associated with the DC and USR procedures in males.
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Affiliation(s)
- Mahmut Taha Ölçücü
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Kayhan Yılmaz
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Kaan Karamık
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Yahya Okuducu
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Çağatay Özsoy
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Yasin Aktaş
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Serdar Çakır
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Mutlu Ateş
- Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
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Xie Y, Wang W, Yan W, Liu D, Liu Y. Efficacy of urination in alleviating man's urethral pain associated with flexible cystoscopy: a single-center randomized trial. BMC Urol 2020; 20:2. [PMID: 31959171 PMCID: PMC6971873 DOI: 10.1186/s12894-019-0541-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/21/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This study aimed to assess whether urethral pain can be alleviated by urination in male patients undergoing flexible cystoscopy. METHODS Ninety-six male outpatients undergoing flexible cystoscopy were randomly divided into two groups. Patients in the test group urinated during flexible cystoscopy, whilst patients in the control group received no instructions to do so. All patients received 10 mL of 2% lidocaine gel prior to assessment. Using 0 (no-pain) to 10 (unbearable severe pain) pain scores (VAS), we assessed patient discomfort prior to anesthesia gel perfusion (baseline), during gel perfusion, during cystoscope insertion through the urethra, and 15 min post-examination analysis. The entire protocol was completed by a single doctor in our Department of Urology. RESULTS The groups showed no statistical differences regarding age or examination time. During cystoscope insertion, the test group recorded significantly lower pain scores 2 (IQR 1-3) - compared to the control group 3 (IQR 2-3), (P = 0.001). No significant differences between other evaluation points were observed between groups. CONCLUSION Urethral pain can be significantly alleviated by urination in male patients undergoing flexible cystoscopy through the urethra. TRIAL REGISTRATION Registry name: Clinical study of urination action to relieve urethral pain associated with flexible cystoscopy. Registration number: ChiCTR-INR-17013294 Date of Registration: 2017-11-08.
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Affiliation(s)
- Yingwei Xie
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Wei Wang
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Wei Yan
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Dan Liu
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Yuexin Liu
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
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