title: Flexible cystoscopy: is the volume and content of the urethral gel critical?
abstract: OBJECTIVE
  To determine whether volume (10 or 20mL) or the presence of 2% lidocaine (lignocaine) in the gel used for urethral lubrication alters the discomfort felt during flexible cystoscopy.
  
  
  METHODS
  A randomized double-blind trial was performed in men attending for flexible cystoscopy. Patients were assigned to one of four groups: 10 mL of gel with or without lidocaine and 20 mL with or without lidocaine. Gel was retained for 10 minutes prior to cystoscopy. Pain felt during both the instillation of the gel and the cystoscopy itself was evaluated using a visual analog scale (0-10).
  
  
  RESULTS
  Interim analysis after 147 patients had been recruited revealed a significant difference between the groups in terms of the pain felt on instillation of the gel, leading to an early termination of the trial. There was a significant reduction in pain on cystoscopy in patients receiving 20 mL of gel if this contained lidocaine.
  
  
  CONCLUSIONS
  The least pain on cystoscopy occurred in patients receiving 20 mL of gel containing lidocaine.
authors.affiliation: Urology Consultant, Waikato Hospital, Hamilton, New Zealand. urology@hwl.co.nz
authors.forename: M
authors.initials: M
authors.lastname: Holmes
authors.forename: J
authors.initials: J
authors.lastname: Stewart
authors.forename: M
authors.initials: M
authors.lastname: Rice
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D020684:Cystoscopes; D003558:Cystoscopy / Q000009:adverse effects*; D005782:Gels / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D018583:Pliability
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine